Discordance between remnant cholesterol and low-density lipoprotein cholesterol predicts cardiovascular disease: the Kailuan prospective cohort study.

IF 2.7 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology Pub Date : 2024-06-03 DOI:10.1016/j.hjc.2024.05.002

Yijun Zhang, Shouling Wu, Xue Tian, Qin Xu, Xue Xia, Xiaoli Zhang, Jing Li, Shuohua Chen, Fen Liu, Anxin Wang

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Abstract

Objective: Previous studies have shown that remnant cholesterol (RC) is associated with cardiovascular disease (CVD). The study aimed to identify the association of RC and the discordance between RC and lipoprotein cholesterol (LDL-C) with CVD.

Methods: Data were obtained from the Kailuan study. RC was calculated as the non-high-density lipoprotein cholesterol minus LDL-C. Discordant RC and LDL-C were defined by percentile difference and clinical cut-off points. Cox proportional hazard models were used to explore the association of RC and the discordance between RC and LDL-C with CVD.

Results: A total of 96,769 participants were included, with a median age of 51.61 years and 79.56% were male. There was a significant association between RC levels and the risk of CVD, with an HR of 1.10 (95% CI, 1.08-1.13) in the continuous analysis. The group with a discordantly high RC had a significant increase in CVD, MI, and stroke risk, with HRs of 1.18 (95% CI, 1.10-1.26), 1.23 (1.06-1.43), and 1.15 (1.07-1.24), respectively. Compared with the group with low LDL-C and low RC, the group with low LDL-C and high RC had significantly higher incidences of CVD (HR, 1.33 [95% CI, 1.26-1.40]), MI (HR, 1.59 [95% CI, 1.41-1.80]), and stroke (HR, 1.28 [95% CI, 1.20-1.35]).

Conclusions: Elevated levels of RC and discordantly high RC with LDL-C were associated with the risk of CVD, MI, and stroke. These findings demonstrate the clinical significance of identifying residual risk related to RC.

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残余胆固醇与低密度脂蛋白胆固醇之间的不一致性可预测心血管疾病：开滦前瞻性队列研究。

背景：以往的研究表明，残余胆固醇（RC）与心血管疾病（CVD）有关。本研究旨在确定残余胆固醇以及残余胆固醇与脂蛋白胆固醇（LDL-C）之间的不一致性与心血管疾病的关系：方法：数据来自开滦研究。RC的计算方法是非高密度脂蛋白胆固醇减去低密度脂蛋白胆固醇。不一致的 RC 和 LDL-C 由百分位数差异和临床临界点定义。采用 Cox 比例危险模型探讨 RC 和 RC 与 LDL-C 不一致与心血管疾病的关系：共纳入 96 769 名参与者，中位年龄为 51.61 岁，男性占 79.56%。RC水平与心血管疾病风险之间存在明显关联，连续分析的HR值为1.10（95% CI，1.08-1.13）。不一致的高 RC 组心血管疾病、心肌梗死和中风风险显著增加，HR 分别为 1.18（95%CI，1.10-1.26）、1.23（1.06-1.43）和 1.15（1.07-1.24）。与低 LDL-C 和低 RC 组相比，低 LDL-C 和高 RC 组的心血管疾病（HR，1.33 [95% CI，1.26-1.40]）、心肌梗死（HR，1.59 [95% CI，1.41-1.80]）和中风（HR，1.28 [95% CI，1.20-1.35]）发病率明显更高：RC水平升高以及RC与低密度脂蛋白胆固醇（LDL-C）不一致的高水平均与心血管疾病、心肌梗死和脑卒中的风险有关。这些发现表明，识别与 RC 相关的残余风险具有重要的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

7.30%

发文量

审稿时长

56 days

期刊介绍： The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.