Carotid Atherosclerosis and Metabolic Characteristics Among High-Risk Cardiovascular Populations of Four Ethnic Groups — Yunnan Province, China, 2024

Introduction: This study explored the distribution of carotid atherosclerosis (CAS) in high-risk individuals with cardiovascular disease (CVD) across four ethnic groups: the Han, Yi, Dai, and Lisu.Methods: The China-PAR model was used to estimate 10-year CVD risk.Participants with a 10-year risk score of 10% or higher underwent carotid ultrasonography, biochemical tests for blood glucose, lipids, homocysteine, and a standardized physical examination.Results: The Han had the lowest remnant cholesterol (Remnant-C) levels but the highest atherogenic index of plasma (AIP), triglyceride-glucose (TyG), and lipid accumulation product (LAP) levels.The Dai had the highest prevalence of hypertension, diabetes, hyperhomocysteinemia (HHcy), and Remnant-C.The Lisu had the lowest prevalence of diabetes and HHcy but the highest rates of obesity, central obesity, and dyslipidemia.Yi had the lowest burden of overweight, obesity, dyslipidemia, and the continuous metabolic syndrome score (cMetS), AIP, TyG, and LAP.Carotid intima-media thickness (cIMT) differed minimally among ethnic groups (range: 0.81-0.85mm).The Dai had the lowest prevalence of carotid plaque (CP) 15.27% (341/2,233), yet the highest prevalence of carotid stenosis (CS) 46.22% (1,032/2,233).In contrast, Lisu had the highest prevalence of CP 57.29% (495/864) and the lowest prevalence of CS 3.13% (27/864).The Han population had the highest prevalence of multiple CP 31.82%(6,081/19,109) and CAS 74.79% (14,291/19,019), while the Yi population had the lowest prevalence 70.53% (3,453/4,896).Conclusion: The marked ethnic differences in CAS and metabolic status should be taken into account in future CVD prevention and control strategies.Cardiovascular disease (CVD) is the leading cause of death worldwide (1), and atherosclerosis (AS) is a major contributor to its growing burden.Therefore, identifying populations at a high risk of AS is central to effective CVD prevention (2).However, differences in genetic background, lifestyle, dietary patterns, and environmental exposure result in distinct distributions of atherosclerotic lesions and CVD risk across ethnic groups (3).Consequently, it has been proposed that ethnic-specific reference values for markers such as carotid intima-media thickness (cIMT) should be established to enable more precise CVD prevention (4).Carotid atherosclerosis (CAS) is a widely used indicator of systemic AS risk.Although international studies have reported extensive data on ethnic differences (3), research on the prevalence and metabolic characteristics of CAS across ethnic groups in China remains limited.Yunnan Province has the most diverse ethnic minority population in China, with 25 ethnic groups native to the region.This study aimed to characterize the CAS and metabolic profiles among populations at high risk for CVD from the Han, Yi, Dai, and Lisu ethnic groups using a unified sample collection and analysis protocol.The findings provide evidence for research on AS mechanisms, inform the development of reference standards and intervention strategies, and support efforts to reduce the regional burden of CVD. METHODS Study PopulationThe 2024 Yunnan Province Screening and Intervention Project for High-Risk Populations of Cardiovascular Disease was conducted in five counties: Jinggu, Fumin, Yuanmou, Wuding, and Yongping.