Key result
A high LDL-C/HDL-C ratio (Q4 vs Q1) was significantly associated with an increased risk of thickened carotid intima-media thickness (OR 1.81; 95% CI 1.41-2.34; p trend < 0.001).
Why the study?
There have been few reports evaluating the association between the LDL-C/HDL-C ratio and thickened carotid intima-media thickness in the general Chinese population.
Does a high LDL-C/HDL-C ratio increase the risk of thickened CIMT in a general Chinese population?
Case-Control (n=3,660)
Does a high LDL-C/HDL-C ratio increase the risk of thickened CIMT in a general Chinese population?
Odds Ratio: 1.81 (95% CI 1.41–2.34)
p-value: p=<0.001
A high LDL-C/HDL-C ratio is significantly associated with an increased risk of thickened carotid intima-media thickness in the general Chinese population, independent of traditional risk factors.
Supports LDL-C/HDL-C ratio as a marker of subclinical carotid disease in Chinese adults; hypothesis-generating and requires prospective validation before clinical adoption.
Background It is indicated that Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C ratio) has greater predictive value for thickened carotid intima-media thickness (CIMT) comparing with classic lipid parameters. However, there have been few reports about their association in general Chinese population. Method We included a total of 1220 CIMT participants and 2440 matched controls, who had ultrasonography of carotid artery during 2009 and 2016. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for thickened CIMT risk associated with LDL-C/HDL-C ratio. Result In the univariate logistic regression model, there was significant association between LDL-C/HDL-C ratio and thickened CIMT (Q4 vs. Q1, OR = 1.94, 95% CI: 1.60–2.36; p trend < 0.05). After adjusting for potential covariates, LDL-C/HDL-C ratio remained significantly associated with thickened CIMT (Q4 vs. Q1, OR = 1.81, 95% CI: 1.41–2.34, p trend < 0.001; ≥3.05 v.s. <3.05, OR = 1.66, 95% CI: 1.37–2.02). In subgroup analyses, the association between LDL-C/HDL-C ratio and thickened CIMT remained significant in the subgroups stratified by sex, impaired fasting glucose (IFG), hypertension, and fatty liver disease but only remained significant in the subgroups of ≥45 years (OR = 2.01, 95% CI: 1.46–2.76; P trend <0.05), BMI ≥24 (kg/m 2 ) (OR = 2.22; 95% CI = 1.63-3.03; Ptrend < 0.05) and BMI ≥25 (kg/m 2 ) (OR = 2.50, 95% CI: 1.76–3.54; P trend < 0.05), dyslipidemia (OR = 3.28, 95% CI: 1.83–5,85; P trend < 0.001), and without periodontitis (OR = 2.08, 95% CI: 1.54–2.81 ; Ptrend < 0.05) comparing Q4 to Q1. Similar results were observed in the subgroup analyses for LDL-C/HDL-C ratio ≥3.05 v.s. <3.05 except for the age stratification. Conclusion High LDL-C/HDL-C ratio could significantly increase the risk of thickened CIMT independent of gender, IFG, hypertension, and fatty liver disease in general Chinese population.
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Zhang et al. (2021) conducted a case-control in Thickened carotid intima-media thickness (CIMT) (n=3,660). High LDL-C/HDL-C ratio vs. Low LDL-C/HDL-C ratio (Q1 or <3.05) was evaluated on Thickened carotid intima-media thickness (OR 1.81, 95% CI 1.41-2.34, p=<0.001). A high LDL-C/HDL-C ratio (Q4 vs Q1) was significantly associated with an increased risk of thickened carotid intima-media thickness (OR 1.81; 95% CI 1.41-2.34; p trend < 0.001).
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