Key result
Elevated non-HDL cholesterol predicts ~189% higher CHD risk in non-diabetics.
Why the study?
Does non-HDL cholesterol better predict coronary heart disease compared to other lipid parameters in diabetic and non-diabetic adult Saudis?
Cross-Sectional (n=733)
No
Does non-HDL cholesterol better predict coronary heart disease compared to other lipid parameters in diabetic and non-diabetic adult Saudis?
Non-HDL cholesterol is a stronger predictor of coronary heart disease than other lipid parameters among non-diabetic Saudi adults, supporting its use as a target for lipid-lowering therapy.
Supports non-HDL assessment for CHD risk in non-diabetic Saudis; leaves open differential utility by diabetes status and requires prospective validation.
BACKGROUND: Several trials from different populations have reported that non-high density lipoprotein cholesterol (non-HDL-C) has more predictive power than low-density lipoprotein cholesterol (LDL-C) in detecting coronary heart disease (CHD) and none in any Arab community whose propensity to develop CHD is higher compared to other ethnicities. This study aims to determine and compare the impact of non-HDL-C versus other lipid parameters, in predicting coronary heart disease among diabetic versus non-diabetic adult Saudis and identify the lipid parameters which make a significant contribution in the development of coronary heart disease, diabetes mellitus, and metabolic syndrome. 733 adult Saudis were recruited and divided into groups of diabetics and non-diabetics. Each participant completed a questionnaire, underwent physical exam including 12-L ECG, and submitted a fasting blood sample where glucose and lipid parameters were analyzed using routine procedures. RESULTS: 462 subjects (age 45.03 +/- 11.52; BMI 28.91 +/- 6.07) were classified non-diabetics while the remaining 271 (age 52.73 +/- 11.45, BMI 30.15 +/- 6.62) were diabetics. 99 out of 465 (21.3%) of non-diabetics had CHD and 114 out of 271 (52.5%) in the diabetics. Non-HDL cholesterol was the best predictor among the non-diabetics (odds-ratio 2.89, CI 1.10-7.58, p-0.03). Total cholesterol was the highest single predictor for the development of CHD among the lipids (odds-ratio 1.36, CI 0.68-2.71, p-0.39) but HDL-cholesterol although small was significant (odds-ratio 0.52, CI 0.27-0.99, p-0.05). CONCLUSION: This study supports the use of non-HDL cholesterol as the more practical and reliable target for lipid lowering therapy among the Saudi population.
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Al‐Daghri et al. (2007) conducted a cross-sectional in Coronary heart disease (n=733). Non-HDL cholesterol vs. Other lipid parameters (LDL-C, HDL-C, Total Cholesterol, Triglycerides) was evaluated on Coronary heart disease (CHD) prediction in non-diabetics (OR 2.89, 95% CI 1.10-7.58, p=0.03). Elevated non-HDL cholesterol was the strongest predictor of coronary heart disease among non-diabetic Saudis (OR 2.89), whereas total cholesterol was the highest single predictor among diabetics.
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