Key result
A total cholesterol/HDL ratio <=5.0 was associated with a lower adjusted carotid intima-media thickness compared to a ratio >5.0.
Why the study?
Do traditional risk factors, specifically HDL cholesterol, influence carotid intima-media thickness in asymptomatic patients with familial hypercholesterolemia?
Observational (n=196)
Do traditional risk factors, specifically HDL cholesterol, influence carotid intima-media thickness in asymptomatic patients with familial hypercholesterolemia?
Higher HDL cholesterol and lower total cholesterol/HDL ratio are strong independent predictors of reduced preclinical carotid atherosclerosis in patients with familial hypercholesterolemia.
Answers are grounded in this paper and cite their sources.
Should not yet change FH management; leaves open whether ratio modification slows atherosclerosis progression.
OBJECTIVE: The effect of risk factors on carotid atherosclerosis in heterozygous familial hypercholesterolemia (FH) is unclear. We evaluated carotid intima-media thickness (IMT) by sonography in relation to classical and emergent risk factors in a large FH cohort. METHODS AND RESULTS: Risk factors and carotid IMT were assessed in 196 asymptomatic subjects aged > or =25 years fulfilling strict diagnostic criteria for clinical FH who were either undertreated or treatment-naive. Conventional risk factors, but not lipoprotein(a), homocysteine, or apolipoprotein E (apoE) genotypes were univariately related to IMT. Age-adjusted and gender-adjusted IMT increased with increasing low-density lipoprotein (LDL) cholesterol and decreased with increasing high-density lipoprotein (HDL) cholesterol. Compared with a total cholesterol/HDL ratio >5.0, a ratio < or =5.0 was associated with a lower adjusted IMT, with a mean difference of -0. 09 mm (95% confidence interval, -0.13 to -0.04). By multivariate analysis, age, HDL cholesterol (negatively), physical exercise, family history of early-onset coronary heart disease, LDL cholesterol, and leukocyte count, in this order, were independent associations of IMT (r2=0.429, P<0.001). CONCLUSIONS: Traditional risk factors account for a sizeable proportion of variation in carotid IMT in FH. Because the HDL cholesterol level and the total cholesterol/HDL ratio are strong predictors of preclinical carotid atherosclerosis, HDL cholesterol-raising strategies should have an important therapeutic role in FH.
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Junyent et al. (2006) conducted an observational in Familial Hypercholesterolemia (n=196). Total cholesterol/HDL ratio <=5.0 vs. Total cholesterol/HDL ratio >5.0 was evaluated on Carotid intima-media thickness (IMT) (MD -0.09 mm, 95% CI -0.13 to -0.04). A total cholesterol/HDL ratio <=5.0 was associated with a lower adjusted carotid intima-media thickness compared to a ratio >5.0.
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