Related Experiment Videos
Plasma lipids, HDL and apolipoproteins, and coronary heart disease in men less than 50 years old. A case-control
G I Cubero1, J J Reguero, A Batalla
1Servicio de Cardiologia, Hospital Universitario Central de Asturias, Oviedo, Spain.
Insights
The ratio of total cholesterol to HDL cholesterol greater than or equal to 5 is a significant predictor of early coronary heart disease in men under 50. This lipid ratio offers greater predictive power than total cholesterol alone for cardiovascular disease risk.
Area of Science:
- Cardiology
- Lipidology
- Preventive Medicine
Background:
- Early-onset coronary heart disease (CHD) poses a significant health burden in younger male populations.
- Lipoprotein profiles are crucial indicators of cardiovascular risk, but their predictive value in younger men requires further elucidation.
Purpose of the Study:
- To investigate the predictive capability of various lipoprotein parameters for identifying early coronary heart disease (CHD) in men under 50 years old.
- To assess the relative risk associated with specific lipid and lipoprotein concentrations in a Southern European male cohort.
Main Methods:
- A case-control study involving 157 men with CHD symptoms and 415 age-matched male controls without CHD.
- Measurement of plasma concentrations of total cholesterol (TChol), HDL-cholesterol (HDLChol), triglycerides (TG), apoproteins A1 and B, and Lp(a).
- Calculation of odds ratios using the Mantel-Haenszel procedure to estimate relative risk for various lipid parameters.
Main Results:
- A total cholesterol to HDL cholesterol ratio (TChol/HDLChol) ≥ 5 demonstrated the highest odds ratio (10.7) for early CHD.
- Low HDL-cholesterol (< 0.9 mmol/L) and elevated triglycerides (> 2.25 mmol/L) were also significant risk factors.
- Elevated Lp(a) and Apo B also showed increased odds ratios, while TChol levels alone had limited predictive value.
Conclusions:
- The TChol/HDLChol ratio ≥ 5 is a powerful predictor of early coronary heart disease in men under 50.
- Lipoprotein analysis, particularly the TChol/HDLChol ratio, is more valuable than total cholesterol alone for assessing cardiovascular risk in this demographic.
Objective:
To determine the predictive value of lipoproteins for early coronary heart disease in men less than 50 years old from southern Europe.
Methods And Results:
One hundred and fifty-seven men less than 50 years old were consecutively evaluated for symptoms of coronary heart disease in a tertiary referral hospital. A group of 415 male miners with mean age of 41 +/- 8 years without clinical or electrocardiographic evidence of coronary disease served as controls. Blood samples were taken by venipuncture as soon as possible after admission to the hospital from cases and after 12 hours of fasting in controls. Plasma concentrations of total cholesterol (TChol), HDL-cholesterol (HDLChol), triglycerides (TG), apoproteins A1 and B and Lp(a) were determined. The odds ratios, as estimators of relative risk, were computed using the Mantel-Haenszel procedure. The odds ratios from highest to lowest were a TChol/HDLChol ratio equal to or greater than 5: 10.7 (95% confidence interval (CI) 6.1 to 18.8), TG > 2.25 mmol.l-1 and HDLChol < 0.9 mmol.l-1: 7.4 (95% CI 3.9 to 14.1), HDLChol < 0.9 mmol.l-1: 6.9 (95% CI 4.5 to 10.6), TG > 2.25 mmol.l-1: 3.3 (95% CI 2.0 to 5.3), Lp(a) > 30 mg.dl-1: 2.7 (95% CI 1.8 to 4.1), Apo B > 120 mg.dl-1: 2.4 (95% CI 1.3 to 4.2), non-HDLChol > 5.2 mmol.l-1: 2.2 (CI 1.4 to 3.3), TChol > 6.5 mmol.l-1: 1 (95% CI 0.6 to 1.6), TChol > 5.2 mmol.l-1: 0.9 (95% CI 0.6 to 1.3).
Conclusions:
This study indicates that in males less than 50 years a ratio TChol/HDLChol > or = 5 presents the greatest risk power for early coronary heart disease. Plasma concentrations of TChol alone did not demonstrate to have value as risk factor for cardiovascular disease.