Low‐Density Lipoprotein Cholesterol/High‐Density Lipoprotein Cholesterol Ratio and Carotid Intima‐Media Thickness: A Cohort Study in China
Pei Qin, Jing Shi, Liming Cao, Xue Li, Yanmei Lou, Changyi Wang, Jianping Ma, Li Wang, Xiaolin Peng, Hongen Chen, Shan Xu, Ping Zhao, Dongsheng Hu, Fulan Hu
Abstract
Abstract Low‐density lipoprotein cholesterol to high‐density lipoprotein cholesterol (LDL‐C/HDL‐C) ratio may carry additional information and has been suggested as a better predictor for atherosclerosis progression and cardiovascular disease (CVD) than LDL‐C and HDL‐C alone. Therefore, we aim to explore the association between LDL‐C/HDL‐C ratio and high carotid intima‐media thickness (CIMT) risk in a large Cohort in Beijing, China. This cohort study included 13,612 adults without high CIMT at first entry and who attended the baseline examination and at least one follow‐up annual examination between 2009 and 2016. We used multivariable Cox regression to estimate hazard ratios (HR) with their 95% confidence intervals (CI) for the association between LDL‐C/HDL‐C ratio and risk of high CIMT. During 37,912 person‐years of follow‐up, 1996 (1268 men and 728 women) developed high CIMT. Compared with the first quartile of LDL‐C/HDL‐C ratio, the risk of high CIMT was significantly increased for the fourth quartile of LDL‐C/HDL‐C ratio (HR = 1.51, 95% CI: 1.29–1.78). We observed a significant association between LDL‐C/HDL‐C ratio and high CIMT risk comparing LDL‐C/HDL‐C ratio >2.78 with LDL‐C/HDL‐C ratio ≤2.78 and significant dose–response relationship between LDL‐C/HDL‐C ratio and risk of high CIMT. The restricted cubic spline showed a significant nonlinear association between LDL‐C/HDL‐C ratio and the risk of high CIMT ( p non‐linearity = 0.009). We identify a significant association between LDL‐C/HDL‐C ratio and the risk of high CIMT in the Chinese Cohort study. Future studies are needed to evaluate the effectiveness of reducing LDL‐C/HDL‐C ratio treatment on the development of high CIMT.