Key result
Cumulative LDL-C burden linked to ~67% higher risk of abnormal CIMT.
Why the study?
Research focus has shifted from individual lipoproteins to their cumulative exposure in relation to carotid intima-media thickness as an early atherosclerosis marker.
Does cumulative exposure to diverse lipid profiles increase carotid intima-media thickness in an asymptomatic population?
Cohort (n=2,348)
Does cumulative exposure to diverse lipid profiles increase carotid intima-media thickness in an asymptomatic population?
Effect estimate: β coefficient 0.0013 (95% CI 0.0004-0.0022)
p-value: p=<0.05
Cumulative exposure to total cholesterol and LDL cholesterol is independently associated with increased carotid intima-media thickness, highlighting the importance of long-term optimal lipid levels for preventing subclinical atherosclerosis.
Cumulative TC/LDLC burden may aid subclinical atherosclerosis risk stratification; extends single-measurement data but leaves causal impact open.
BACKGROUND AND AIMS: We aimed to investigate the relationship between the cumulative exposure to different lipid parameters and carotid intima-media thickness(CIMT), which is considered a marker for the early stage of atherosclerosis. This is due to the shift in research focus from assessing individual lipoproteins to considering their cumulative exposure. METHODS AND RESULTS: The study included 2,348 participants who had their lipid parameters measured biennially since 2006.To calculate the cumulative lipid burden, the weighted sum of the difference between the measured value and the cutoff value of each parameter, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), and non-HDLC, was added. Carotid ultrasound was used to detect CIMT. The association between cumulative lipid burden and CIMT was evaluated using linear and logistic analyses. TC and LDLC burden were significantly associated with thickening CIMT (p<0.05). A 2.65-fold, 1.67-fold increased risk of abnormal CIMT was documented in the highest quartile of these two lipid burdens. Notably, a dose-dependent relationship was observed in the overall population when taking non-HDLC burden as a continuous variable (fully-adjusted β coefficient=0.0013, 95%CI 0.0004-0.0022). CONCLUSIONS: Out of the five lipid parameters, TC and LDLC burden showed independent associations with abnormal CIMT. it is crucial to attain optimal lipid levels for the prevention and treatment of subclinical atherosclerosis.
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Wang et al. (2023) conducted a cohort in Asymptomatic population (subclinical atherosclerosis) (n=2,348). Cumulative exposure to lipid parameters (TC, TG, LDLC, HDLC, non-HDLC) vs. Lower quartiles of lipid burden was evaluated on Carotid intima-media thickness (CIMT) (β coefficient 0.0013, 95% CI 0.0004-0.0022, p=<0.05). Cumulative exposure to total cholesterol and LDL cholesterol burden was independently associated with a 2.65-fold and 1.67-fold increased risk of abnormal carotid intima-media thickness (p<0.05).
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