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Published on: February 7, 2015
Non-HDL-C/HDL-C ratio is associated with carotid plaque stability in general population: A cross-sectional study
Anran Wang1, Yapeng Li1, Lue Zhou1
1Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Insights
The non-high-density lipoprotein cholesterol (non-HDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio is linked to carotid plaque stability. This lipid ratio may help identify individuals at higher risk for carotid plaque, a key factor in stroke development.
Area of Science:
- Cardiovascular Medicine
- Atherosclerosis Research
- Lipid Metabolism
Background:
- Carotid atherosclerosis and unstable plaque rupture are significant contributors to stroke.
- The non-high-density lipoprotein cholesterol (non-HDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio integrates information on both atherogenic and anti-atherogenic particles.
- Previous studies indicate an association between this lipid ratio and carotid atherosclerosis, but its link to plaque stability remains unexplored.
Purpose of the Study:
- To investigate the association between the non-HDL-C/HDL-C ratio and carotid plaque stability.
- To determine if this lipid ratio can serve as an indicator for high-risk carotid plaques.
Main Methods:
- A cross-sectional study involving 27,436 urban workers (aged ≥20 years) undergoing health screening.
- Carotid plaque stability assessed via ultrasonography.
- Multinomial logistic regression models used to analyze the relationship between the non-HDL-C/HDL-C ratio and plaque stability, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs).
Main Results:
- Prevalence of both stable and unstable carotid plaque increased significantly with higher quartiles of the non-HDL-C/HDL-C ratio (p for trend < 0.001).
- Mean non-HDL-C/HDL-C ratios were progressively higher in participants with unstable plaque, stable plaque, and no plaque (p < 0.001).
- After adjusting for cardiovascular risk factors, the highest non-HDL-C/HDL-C ratio quartile was associated with increased odds of stable plaque (OR=1.70) and unstable plaque (OR=2.34) compared to no plaque. A significant association was also found between unstable plaque and stable plaque (OR=1.38).
Conclusions:
- The non-HDL-C/HDL-C ratio demonstrates a significant association with carotid plaque stability.
- This lipid ratio may serve as a valuable biomarker for the early detection of high-risk carotid plaques.
- Findings support the potential clinical utility of the non-HDL-C/HDL-C ratio in cardiovascular risk assessment.
Background:
Carotid atherosclerosis, especially the rupture of unstable plaques, plays an important role in the development of stroke. A novel lipid ratio, the non-high-density lipoprotein cholesterol (non-HDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio, contains both atherogenic and anti-atherogenic particle information, and has been shown to be associated with carotid atherosclerosis. However, there is no data on evaluating the association between non-HDL-C/HDL-C ratio and carotid plaque stability.
Methods:
This study was carried out on 27,436 urban workers aged 20 years or older who participated in a comprehensive health screening between January 2016 and December 2017. Carotid plaque stability was assessed using ultrasonography. Multinomial logistic regression models were used to explore the relationship between the non-HDL-C/HDL-C ratio and carotid plaque stability by odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed to verify the robustness of the results.
Results:
Carotid plaque was detected in 7,161 (26.1%) participants, with stable and unstable plaque accounting for 3,277 (11.9%) and 3,884 (14.2%), respectively. The prevalence of stable carotid plaque substantially increased with increasing non-HDL-C/HDL-C ratio quartile levels (p for trend < 0.001) and with a similar association for unstable carotid plaque (p for trend < 0.001). The mean non-HDL-C/HDL-C ratios (mean ± SD) of non-carotid plaque (2.9 ± 1.1), stable carotid plaque (3.2 ± 1.2), and unstable carotid plaque (3.4 ± 1.4) gradually increased (p < 0.001). In multinomial logistic regression, ORs (95% CIs) for the highest vs. lowest quartile of the non-HDL-C/HDL-C ratio were 1.70 (1.48-1.95) between stable carotid plaques and no carotid plaque, 2.34 (2.06-2.67) between unstable carotid plaques and no carotid plaque, and 1.38 (1.18-1.61) between unstable carotid plaques and stable carotid plaque, after adjusting for common cardiovascular risk factors. The results of subgroup analysis and sensitivity analysis were similar.
Conclusion:
Our findings suggested that the non-HDL-C/HDL-C ratio was significantly associated with carotid plaque stability and might be a useful indicator for the early identification of high-risk carotid plaque.
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