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Comparison of various lipid parameters in association of target organ damage: a cohort study

Chen Chi¹, Jiadela Teliewubai¹, Yu-Yan Lu¹

¹Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.

Lipids in Health and Disease

|August 27, 2018

Insights

Non-HDL cholesterol and total cholesterol to HDL ratio better predict target organ damage in elderly individuals than other lipid markers. These findings may inform future lipid-lowering therapies for this population.

Area of Science:

Cardiovascular Health
Lipid Metabolism
Geriatric Medicine

Background:

Lipid management guidelines vary regarding non-HDL cholesterol recommendations.
Target organ damage (TOD) assessment is crucial in elderly populations.
This study investigates lipid parameters' association with TOD in community-dwelling elders.

Purpose of the Study:

To evaluate the relationship between various lipid parameters and TOD.
To identify which lipid parameters are most predictive of TOD in the elderly.
To inform clinical lipid-lowering strategies.

Main Methods:

1599 elderly participants (mean age 71.4 years) were recruited.
Eight lipid parameters (e.g., non-HDL-C, TC/HDL) and creatinine were measured.
Pulse wave velocity (aortic stiffness) and ankle-brachial index (peripheral arterial disease) assessed TOD.

Main Results:

Individual lipid parameters showed varied correlations with TOD indices.
Combined lipid parameters (non-HDL-C, TC/HDL, TG/HDL, LDL/HDL) significantly correlated with all TOD.
Non-HDL-C and TC/HDL ratio were significantly associated with TOD in regression analyses.

Conclusions:

Non-HDL cholesterol and TC/HDL ratio are superior predictors of TOD in elderly individuals.
These findings support the use of non-HDL-C and TC/HDL in clinical practice.
Consideration of these lipid parameters may optimize lipid-lowering therapy in older adults.

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Abstract

Background:

Recommendations of non-HDL amplification varied from different guidelines. We aim to test the relationships between various lipid parameters and target organ damage (TOD) including aortic stiffness, peripheral arterial disease and chronic kidney disease in a community-based elderly cohort.

Methods:

1599 (aged 71.4 ± 6.1 years) participants were recruited. Eight lipid parameters, including total cholesterol (TC), triglycerides (TG), LDL-C, HDL-C, non-HDL-C, TC/HDL ratio, TG/HDL ratio and LDL/HDL ratio, together with other plasma biomarkers like creatinine were measured. Pulse wave velocity (PWV) was measured by the SphygmoCor device, and ankle-brachial index (ABI) was assessed by Omron VP-1000 device.

Results:

Four individual lipid parameters (TC, TG, LDL-C and HDL-C) significantly correlated with most, but not all, TOD indices. Meanwhile, 4 combined lipid parameters, namely non-HDL-C, TC/HDL, TG/HDL and LCL/HDL, significantly correlated with all TOD (P ≤ 0.033). In multiple linear regression analyses, 4 combined lipid parameters also significantly associated with TOD (P ≤ 0.027), while none of individual lipid parameters significantly associated with all TOD indices. In multiple logistic regression analyses, only non-HDLC and TC/HDL significantly associated with TOD (P ≤ 0.039), and other lipid parameters did not significantly associate with TOD.

Conclusion:

In an elderly community sample, non-HDLC and TC/HDLC were better associated with TOD than other lipid parameters. This finding should be considered in future clinical lipid-lowing therapy.

Trial Registration:

This trial was retrospectively registered in ClinicalTrials.gov (No. NCT02368938 , registered on 15 Feb 2015).

Keywords:

Cholesterol Lipid Lipoprotein Primary prevention Target organ damage

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