Key result
Higher remnant cholesterol levels were significantly associated with an increased risk of joint arteriosclerosis and atherosclerosis progression (OR 1.20 per 10 mg/dL increase), independent of LDL cholesterol.
Why the study?
Remnant cholesterol predicts cardiovascular disease, but its effect on joint arteriosclerosis and atherosclerosis progression remains unclear.
Does elevated remnant cholesterol predict joint arteriosclerosis and atherosclerosis progression in a general population without baseline cardiovascular disease?
Cohort (n=3,186)
Yes
Does elevated remnant cholesterol predict joint arteriosclerosis and atherosclerosis progression in a general population without baseline cardiovascular disease?
Odds Ratio: 1.2 (95% CI 1.13–1.28)
p-value: p=<0.001
Remnant cholesterol is independently associated with the progression of arteriosclerosis and atherosclerosis, suggesting it may serve as an earlier risk factor than LDL-C in the general population.
May refine vascular risk prediction in general populations; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: Arteriosclerosis and atherosclerosis are closely related with cardiovascular disease (CVD) risk. Remnant cholesterol (RC) could predict CVD. However, its effect on joint arteriosclerosis and atherosclerosis progression remains unclear. This study aims to evaluate the association of RC with joint arteriosclerosis and atherosclerosis progression trajectories in the general population. METHODS: This study collected data across five biennial surveys of the Beijing Health Management Cohort from 2010 to 2019. Multi-trajectory model was used to determine the joint arteriosclerosis and atherosclerosis progression patterns by brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI). We also performed discordance analyses for RC vs. low density lipoprotein cholesterol (LDL-C) using ordinal logistics model. RESULTS: A total of 3186 participants were included, with three clusters following distinct arteriosclerosis and atherosclerosis progression patterns identified using a multi-trajectory model. In the multivariable-adjusted ordinal logistics analyses, RC was significantly associated with baPWV and ABI progression (OR: 1.20; 95% CI: 1.13-1.28, per 10 mg/dL). For the discordance analyses, the discordant low RC group was associated with decreased risk compared to the concordant group (OR: 0.73; 95% CI: 0.60-0.89). People with a high RC level were at an increased risk of joint arteriosclerosis and atherosclerosis progression, even with optimal LDL-C. CONCLUSIONS: RC is independently associated with joint arteriosclerosis and atherosclerosis progression beyond LDL-C. RC could be an earlier risk factor than LDL-C of arteriosclerosis and atherosclerosis in the general population.
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Wu et al. (2023) conducted a cohort in Arteriosclerosis and atherosclerosis (n=3,186). Remnant cholesterol vs. Lower remnant cholesterol levels was evaluated on Joint arteriosclerosis and atherosclerosis progression (OR 1.20, 95% CI 1.13-1.28, p=<0.001). Higher remnant cholesterol levels were significantly associated with an increased risk of joint arteriosclerosis and atherosclerosis progression (OR 1.20 per 10 mg/dL increase), independent of LDL cholesterol.
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