[Total/HDL cholesterol ratio and non HDL cholesterol as predictors for increased intima media thickness]

LDL, HDL cholesterol and triglycerides, are the most commonly used lipid cardiovascular risk predictor indicators. However population based studies have shown that non-HDL cholesterol and total/HDL cholesterol ratio are better predictors, are easy to measure and do not require fasting.

To determine which lipid indicators are better determinants of subclinical atherosclerosis, measured by intima media thickness (IMT) among subjects without demonstrated atherosclerosis.

Lipid profile, height, weight, blood pressure and bilateral IMT, measured by ultrasound with automatic border recognition software, were assessed in 770 men and 854 women aged 45 ± 11 years, in Santiago de Chile.

Mean total cholesterol was 202, HDL 50, LDL 121, triglycerides 157 and non-HDL cholesterol 152 mg/dl. Total/HDL cholesterol ratio was 4.3. Mean IMT was 0.62 mm. All lipid markers were significantly correlated with IMT. This correlation was higher for non-HDL cholesterol (r = 0.24, p < 0.0001) and total/HDL cholesterol ratio(r = 0.23, p < 0.0001). In both men and women, total/HDL cholesterol ratio was the best predictor of having an IMT over the 75th percentile (odds ratio 1.21, 95% confidence intervals 1.09-1.35, p < 0.01).

Total/HDL cholesterol ratio was the best determinant of subclinical atherosclerosis.