What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Arterial stiffness (n=16733). Intervention: Non-HDL-c ≥100 mg/dl vs. Non-HDL-c <100 mg/dl. Primary outcome: Arterial stiffness (defined as the upper quartile of baPWV) (OR 1.66, 95% CI 1.11-2.50).

What question did this study set out to answer?

To determine whether triglycerides, non-HDL-c, and the total cholesterol/HDL-c ratio remain associated with arterial stiffness across a broad range of LDL-c concentrations.

March 27, 2019Hypertension ResearchOpen Access

Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population

Q: What are the key findings of this study?

Elevated non-HDL-c, triglycerides, and TC/HDL-c ratio were consistently associated with arterial stiffness across a range of LDL-c levels, including an OR of 1.66 for non-HDL-c ≥100 mg/dl when LDL-c was <70 mg/dl.

Q: What question did this study set out to answer?

To determine whether triglycerides, non-HDL-c, and the total cholesterol/HDL-c ratio remain associated with arterial stiffness across a broad range of LDL-c concentrations.

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Key result

Elevated non-HDL-c, triglycerides, and TC/HDL-c ratio were consistently associated with arterial stiffness across a range of LDL-c levels, including an OR of 1.66 for non-HDL-c ≥100 mg/dl when LDL-c was <70 mg/dl.

Why the study?

It was unclear whether lipid parameters like triglycerides, non-HDL-c, and the TC/HDL-c ratio remain related to arterial stiffness across a range of LDL-c levels.

Are elevated non-HDL-c, triglycerides, and TC/HDL-c ratio associated with increased arterial stiffness in Chinese adults, independent of LDL-c levels?

Population

16,733 Chinese adult volunteers undergoing health check-ups

Comparison

Elevated vs lower non-HDL-c, triglycerides, and TC/HDL-c ratio across LDL-c levels

Design

Cross-sectional study

Authors

JWJia WenFudan University YHYun HuangShanghai Jiao Tong University YLYao LuTulane University

Discussion

Member takes

Implication

May extend arterial stiffness risk assessment beyond LDL-c; hypothesis-generating for targeted non-HDL-c intervention trials.

Key Points

To determine whether triglycerides, non-HDL-c, and the total cholesterol/HDL-c ratio remain associated with arterial stiffness across a broad range of LDL-c concentrations.
Conducted a cross-sectional study of 16,733 Chinese adult volunteers who completed health check-ups between January 2014 and January 2015.
Measured brachial-ankle pulse wave velocity (baPWV) alongside clinical and biochemical markers, defining arterial stiffness as the upper quartile of baPWV.
Used multivariable logistic regression models to assess associations between individual lipid measures and arterial stiffness across categories of LDL-c.
In participants with LDL-c <70 mg/dl, arterial stiffness risk was significantly higher for those with non-HDL-c ≥100 mg/dl (multivariable-adjusted OR 1.66, 95% CI 1.11–2.50) compared to <100 mg/dl.
Within the LDL-c <70 mg/dl group, elevated triglycerides (≥150 mg/dl; OR 2.44, 95% CI 1.61–3.71) and a TC/HDL-c ratio ≥4 (OR 1.74, 95% CI 1.15–2.65) were also independently associated with arterial stiffness.
Consistent associations between elevated non-HDL-c, triglycerides, TC/HDL-c ratio, and arterial stiffness were observed across all higher LDL-c strata up to ≥160 mg/dl.

Study Design

Type

Cross-Sectional (n=16,733)

Multicenter

Structured PICO

Are elevated non-HDL-c, triglycerides, and TC/HDL-c ratio associated with increased arterial stiffness in Chinese adults, independent of LDL-c levels?

Population

16,733 Chinese adult volunteers aged 18 years or older who underwent health check-ups, evaluated for the association between lipid parameters and arterial stiffness.

Exposure

Elevated non-HDL-c (≥100 mg/dl), triglycerides (≥150 mg/dl), and TC/HDL-c ratio (≥4)

Comparator

Lower levels of non-HDL-c (<100 mg/dl), triglycerides (<150 mg/dl), and TC/HDL-c ratio (<4)

Outcome

Arterial stiffness, defined as the upper quartile of brachial-ankle pulse wave velocity (baPWV)surrogate

Main Result

Odds Ratio: 1.66 (95% CI 1.11–2.5)

Non-HDL-c, triglycerides, and the TC/HDL-c ratio are associated with arterial stiffness even at optimal LDL-c levels (<70 mg/dl), highlighting their role as markers of residual cardiovascular risk.

Limitations

The voluntary cohort may be biased by the healthy worker effect.
Participants were mostly urban, relatively younger, and healthier than the general population, limiting generalizability.
The cross-sectional study design makes it difficult to infer causality between dyslipidemia and arterial stiffness.
Voluntary cohort, potential healthy worker effect
Mostly urban participants who were relatively younger and healthier than the general Chinese population
Cross-sectional design cannot infer causality

Cite This Study

Wen et al. (2019) conducted a cross-sectional in Arterial stiffness (n=16,733). Non-HDL-c ≥100 mg/dl vs. Non-HDL-c <100 mg/dl was evaluated on Arterial stiffness (defined as the upper quartile of baPWV) (OR 1.66, 95% CI 1.11-2.50). Elevated non-HDL-c, triglycerides, and TC/HDL-c ratio were consistently associated with arterial stiffness across a range of LDL-c levels, including an OR of 1.66 for non-HDL-c ≥100 mg/dl when LDL-c was <70 mg/dl.

synapsesocial.com/papers/6a75dfacb1c5cc4eb2b1d28f https://doi.org/10.1038/s41440-019-0251-5

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Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider