Association between LDL-C/HDL-C ratio and long-term carotid plaque risk in middle-aged and elderly rural populations:
Yingzhe Shao1, Juan Hao1, Hailu Zhang2
1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
Insights
The LDL-C/HDL-C ratio (LHR) is linked to a higher risk of developing carotid plaques in older Chinese adults. This ratio may serve as a valuable screening tool for carotid plaque in this population.
Area of Science:
- Cardiovascular Epidemiology
- Biomarker Research
- Public Health
Background:
- Atherosclerotic diseases remain a leading cause of global mortality.
- The LDL-C/HDL-C ratio (LHR) is a potential cardiovascular risk biomarker.
- The LHR's long-term association with carotid plaque risk in low-income Chinese populations is unclear.
Purpose of the Study:
- To investigate the relationship between the LHR and the long-term risk of developing carotid plaques.
- To assess the LHR as a potential screening indicator for carotid plaques in a specific demographic.
- To explore potential non-linear associations between LHR and carotid plaque development.
Main Methods:
- Prospective cohort study of adults aged ≥45 years in rural Tianjin, China.
- Baseline data collected in 2014, follow-up data in 2019.
- Carotid ultrasound used to assess new carotid plaques; logistic regression and restricted cubic spline (RCS) analysis employed.
Main Results:
- Over six years, 38.3% of participants developed new carotid plaques.
- Higher LHR significantly correlated with increased carotid plaque risk (OR=1.359 per unit increase).
- RCS analysis revealed a non-linear positive association, with an optimal cut-off LHR of 1.257.
Conclusions:
- A non-linear positive correlation exists between LHR and long-term carotid plaque risk in middle-aged and elderly Chinese.
- LHR demonstrates potential as an effective screening indicator for carotid plaques in grassroots populations.
- Elevated LHR levels are associated with increased odds of developing carotid plaques.
Background:
Atherosclerotic cardiovascular and cerebrovascular diseases are still the main cause of global incidence rate and mortality. The LDL-C/HDL-C ratio (LHR) has been identified as a potential biomarker for cardiovascular risk. However, the relationship between it and the long-term risk of carotid plaques is not yet clear, especially in low-income populations in China.
Methods:
This prospective cohort study included adults aged ≥45 years without carotid plaque at baseline from low-income rural areas of Tianjin, China. Baseline characteristics were collected in 2014, and follow-up data were obtained in 2019. The primary outcome was the development of new carotid plaques, assessed using carotid ultrasound. The relationship between the LDL-C/HDL-C ratio (LHR) and new carotid plaques was analyzed using multifactorial logistic regression, with the presence or absence of new-onset plaques as the dependent variable. Additionally, we utilized restricted cubic spline (RCS) regression to visually present the potential nonlinear relationship between LHR and the risk of carotid plaque.
Results:
Over the six-year follow-up period, 606 participants (38.3%) developed new carotid plaques. Higher LHR was significantly associated with an increased risk of new carotid plaques, with each unit increase in LHR corresponding to a 35.9% higher risk (OR = 1.359, 95% CI: 1.180-1.566, p < 0.001). The RCS curve indicated a non-linear positive association between LHR and the likelihood of carotid plaques (p for non-linearity = 0.019), with an optimal cut-off at 1.257. Logistic regression analysis confirmed that LHR > 1.257 was linked to increased odds of carotid plaques in both unadjusted (OR: 1.80, p < 0.001) and adjusted models (OR: 1.835, p < 0.001), with LHR ≤ 1.257 serving as the reference. In subgroup analysis, all subgroups consistently demonstrated a significant association between increased LHR (all OR > 1).
Conclusion:
The research results indicate that there is a non-linear positive correlation between LHR and the long-term risk of carotid plaques in middle-aged and elderly populations, suggesting that LHR may be an effective indicator for screening carotid plaques in grassroots middle-aged and elderly populations.
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