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An increased high-density lipoprotein cholesterol/apolipoprotein A-I ratio is associated with increased

Ki-Chul Sung1, Seungho Ryu2, Sarah H Wild3

  • 1Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Heart (British Cardiac Society)
|February 1, 2015
PubMed

Insights

The ratio of high-density lipoprotein cholesterol (HDL-C) to apolipoprotein A-I (Apo A-I) may predict cardiovascular disease (CVD), cancer, and overall mortality risk. An elevated HDL-C/Apo A-I ratio is linked to increased mortality from these conditions.

Area of Science:

  • Biochemistry
  • Epidemiology
  • Cardiovascular Medicine

Background:

  • High-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (Apo A-I) are established cardiovascular risk factors.
  • The independent contribution of the HDL-C/Apo A-I ratio to disease risk remains unclear.

Purpose of the Study:

  • To investigate the association between HDL-C and Apo A-I concentrations, and their ratio, with the risk of mortality.
  • Specifically examining risks for cardiovascular disease (CVD), cancer, and all-cause mortality.

Main Methods:

  • Analysis of data from an occupational cohort of 263,340 individuals (2002-2009).
  • Utilized Cox proportional hazards models to estimate mortality risk.
  • Employed sex-specific lowest quartiles of HDL-C, Apo A-I, and the HDL-C/Apo A-I ratio as reference groups.

Main Results:

  • No significant association was found between HDL-C quartiles and mortality outcomes.
  • A significant positive trend was observed between increasing HDL-C/Apo A-I ratio quartiles and mortality from CVD, cancer, and all causes (p<0.016, p<0.001, p<0.001).
  • The highest HDL-C/Apo A-I ratio quartile showed adjusted hazard ratios of 2.37 for CVD, 2.32 for cancer, and 1.87 for all-cause mortality compared to the lowest quartile.

Conclusions:

  • An elevated HDL-C/Apo A-I ratio is identified as a potential shared risk factor for cardiovascular disease, cancer, and all-cause mortality.
  • This finding highlights the clinical significance of the HDL-C/Apo A-I ratio beyond individual component levels.
Abstract

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