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LDL-C/HDL-C Ratio Predicts Carotid Intima-Media Thickness Progression Better Than HDL-C or LDL-C Alone
Mika Enomoto1, Hisashi Adachi, Yuji Hirai
1Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan.
Insights
The ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) better predicts atherosclerosis progression than individual levels. This finding highlights the LDL-C/HDL-C ratio
Area of Science:
- Cardiovascular Medicine
- Lipid Metabolism
- Atherosclerosis Research
Background:
- High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are established atherosclerosis predictors.
- The ratio of LDL-C to HDL-C (LDL-C/HDL-C) has shown potential in predicting disease progression.
- The optimal lipid marker for subclinical atherosclerosis progression remains under investigation.
Purpose of the Study:
- To determine the most effective predictor of subclinical atherosclerosis progression.
- To compare the predictive power of LDL-C, HDL-C, and the LDL-C/HDL-C ratio on carotid intima-media thickness (IMT) changes.
Main Methods:
- Prospective cohort study involving 1,920 subjects with baseline health examinations in 1999 and follow-up in 2007.
- Carotid intima-media thickness (IMT) changes were measured using ultrasonography.
- Statistical analysis, including analysis of covariance, was used to assess relationships between lipid parameters and IMT progression.
Main Results:
- Changes in IMT over eight years were significantly inversely related to HDL-C and positively related to the LDL-C/HDL-C ratio.
- Increases in the LDL-C/HDL-C ratio, particularly when divided into quartiles, were significantly associated with IMT progression.
- The LDL-C/HDL-C ratio demonstrated a stronger association with IMT progression compared to LDL-C or HDL-C alone.
Conclusions:
- The LDL-C/HDL-C ratio is a superior predictor of subclinical atherosclerosis progression compared to individual LDL-C or HDL-C levels.
- This ratio may offer valuable insights for risk stratification and management of atherosclerosis.
- Further research can explore the clinical utility of the LDL-C/HDL-C ratio in cardiovascular disease prevention.
Abstract:
High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are strong predictors of atherosclerosis. Statin-induced changes in the ratio of LDL-C to HDL-C (LDL-C/HDL-C) predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the best predictor of subclinical atherosclerosis remains unknown. Our objective was to investigate this issue by measuring changes in carotid intima-media thickness (IMT). A total of 1,920 subjects received health examinations in 1999, and were followed up in 2007. Changes in IMT (follow-up IMT/baseline IMT × 100) were measured by ultrasonography. Our results showed that changes in IMT after eight years were significantly related to HDL-C (inversely, P < 0.05) and to LDL-C/HDL-C ratio (P < 0.05). When the LDL-C/HDL-C ratios were divided into quartiles, analysis of covariance showed that increases in the ratio were related to IMT progression (P < 0.05). This prospective study demonstrated the LDL-C/HDL-C ratio is a better predictor of IMT progression than HDL-C or LDL-C alone.
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