Association between LDL-C/HDL-C Ratio and Carotid Atherosclerosis in an Asymptomatic Japanese Population: A Cross-Sectional Study

Background and aims LDL-C/HDL-C ratio predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the association between LDL-C/HDL-C ratio and Carotid Atherosclerosis(CA) is still controversial. There is a lack of research on this topic in theAsymptomatic Japanese Population. This study aims to provide further results. Methods The study population was a cross-sectional study of 1904 subjects free of cardio-cerebrovascular disease at baseline(mean age 57±11.9 years, 51.9% male). All participant sultrasonography of the carotid artery. The presence of carotid plaque score(PS) aand plaque number (PN) were evaluated by ultrasonography. Multivariate logistic regression models to estimatethe LDL-C/HDL-C ratio and PS relationship. Participants were stratified into three groups based on LDL-C/HDL-C ratio tertiles. Interaction and stratified analyses were conductedaccording to age, sex, smoking status, drinking status, fatty, and histories of diabetes. Results In regression models and after multiple adjustments, the risk of PS was significantly associated with serum LDL-C/HDL-C ratio levels in which LDL-C/HDL-C ratio was included as a categorical variable. It remained significant for the highest vs the first tertile of the LDL-C/HDL-C ratio (OR=1.50, 95% CI 1.04–2.17). Stratified analysis,we found that the association was more significant aged <65 years old, female and non-diabetes subgroups.Interaction analysis showed no interaction between LDL-C/HDL-C ratio and PS in the fatty,smoking, and drinking subgroups. Conclusions In conclusion, LDL-C/HDL-C ratio is an independent risk factor for CA in the Japanese population. A prospective and randomized clinical trial of LDL-C/HDL-C ratio lowering therapy in the Japanese population is needed to assess the causal nature of the relationship.