LDL-C/HDL-C ratio as a predictor of atherosclerosis in the Japanese population: insights from a cross-sectional study.

BACKGROUND

Atherosclerosis is a major contributor to cardiovascular disease, and dyslipidemia, particularly low-density lipoprotein cholesterol (LDL-C)/ high-density lipoprotein cholesterol (HDL-C) ratio, plays a critical role in its pathogenesis. Although extensive research has been conducted in Western populations, the relationship between LDL-C/HDL-C ratio and atherosclerosis in the Japanese population remains underexplored. The aim of this study was to investigate the association between LDL-C/HDL-C ratio and atherosclerosis, as measured by brachial-ankle pulse wave velocity (baPWV), in a Japanese cohort.

METHODS

This secondary analysis used data from a cross-sectional study involving 912 participants. LDL-C/HDL-C ratio was calculated from fasting blood samples and baPWV was used to assess atherosclerosis. Univariate and multivariate analyses were performed to evaluate the association between LDL-C/HDL-C ratio and baPWV, adjusting for age, sex, body mass index (BMI), and other potential confounders. Subgroup analyses were performed to explore variations by demographic and clinical factors.

RESULTS

The mean age of the study population was 51.1 years, and 64.9% were male. Significant differences were observed across LDL-C/HDL-C ratio tertiles for age, sex, BMI, blood pressure, liver enzymes, lipid profiles and lifestyle factors (p < 0.001 for most). Univariate analyses showed strong associations between atherosclerosis and age, sex, BMI, blood pressure, liver function markers, metabolic factors and lifestyle behaviours (p < 0.001 for most). Multivariate linear regression models were used to examine the association between LDL-C/HDL-C ratio and baPWV, adjusting for factors such as age, sex, BMI, and other metabolic variables. Subgroup analyses showed significant associations between LDL-C/HDL-C ratio and baPWV in women (p = 0.036), participants aged < 55 years (p = 0.009), and those with BMI < 25 kg/m² (p = 0.044). No significant interactions were observed between subgroups (p for interaction > 0.05).

CONCLUSIONS

LDL-C/HDL-C ratio is significantly associated with atherosclerosis in the Japanese population, with varying strength in different demographic and clinical subgroups. These findings highlight the importance of LDL-C/HDL-C ratio as a predictor of atherosclerosis and underscore the need for targeted interventions to manage cardiovascular risk in this population.

CLINICAL TRIAL NUMBER

Not applicable.