High triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C) and high
non–HDL-C levels are risk factors for cardiovascular disease (CVD). It is unclear
whether the combinations of their adverse changes are related with CVD risk in different
gender and diabetes status, particularly in Chinese population. This study aims to
evaluate the CVD risk associated with different adverse lipid combinations. A total
of 38,989 participants from Chinese Multicenter Longitudinal Health Management Cohorts
(mean age 42 years; 62% male) without baseline CVD were followed up for incident CVD
from 2007 to 2015. Participants with various combinations of baseline TG, non-HDL-C,
and HDL-C levels within- or out of range according to Adult Treatment Panel III were
grouped into 8 distinct lipid categories. Cox models estimated the multivariable-adjusted
hazard ratios (HRs) and 95% confidence intervals (CIs) of different lipid categories
for CVD. After multivariable adjustment, a low level of HDL-C combined with either
a high level of non–HDL-C alone or TG alone were associated with increased CVD risk
with adjusted HRs (95% CIs) of 1.77 (1.36 to 2.30) and 2.08 (1.30 to 3.34) in male
participants. Diabetic participants with high non–HDL-C and low HDL-C levels (adjusted
HR 2.93, 95% CI 1.15 to 7.46), and non-diabetic participants with high TG and low
HDL-C levels (adjusted HR 1.73, 95% CI 1.33 to 2.26) had greater risk of incident
CVD. These relations remained significant when limited analysis to participants with
normal LDL-C levels of <3.4 mmol/L, indicating the various combinations of out-of-range
lipid profiles other than LDL-C are associated with different CVD risk and the associations
depend on gender and glycemic status.
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Article Info
Publication History
Published online: June 06, 2019
Received in revised form:
May 14,
2019
Received:
February 14,
2019
Footnotes
This study was supported by the National Natural Science Foundation, China (no. 81573259 ).
Identification
Copyright
© 2019 Published by Elsevier Inc.
