Association between non-high-density lipoprotein cholesterol levels and the prevalence of asymptomatic extracranial internal carotid artery stenosis in a Chinese community-based study

Eur J Neurol. 2019 May;26(5):740-746. doi: 10.1111/ene.13882. Epub 2019 Jan 23.

Abstract

Background and purpose: Extracranial internal carotid artery thromboembolism is one major cause of ischaemic stroke and the predictive value of non-high-density lipoprotein cholesterol (non-HDLC) is superior to low-density lipoprotein cholesterol (LDLC). This study aimed to assess the association between non-HDLC levels and the prevalence of asymptomatic extracranial internal carotid artery stenosis (EICAS) as well as the predictive value of non-HDLC over LDLC on EICAS presence.

Methods: The Asymptomatic Polyvascular Abnormalities Community study is a subset of the Kailuan study emphasizing asymptomatic polyvascular abnormalities in Chinese adults. A total of 5351 participants, aged ≥40, without history of cardiovascular disease were enrolled in this study. Carotid duplex ultrasonography was carried out for the detection of EICAS.

Results: Of the 5351 patients, 2.5% (131/5351) were diagnosed with EICAS (stenosis ≥50%). Univariate analysis showed that non-HDLC is an independent indicator for asymptomatic EICAS [odds ratio (OR) 1.49, 95% confidence interval (CI) 1.17-1.91]; the same result was reached in multivariate analysis after adjustment for confounding factors (OR 1.32, 95% CI 1.00-1.75), especially for people with hypertension (OR 1.52, 95% CI 1.11-2.08), whilst non-HDLC failed to show better predictive value of EICAS than LDLC (OR 1.45, 95% CI 1.02-2.05).

Conclusions: Non-HDLC is an independent risk factor for EICAS prevalence, especially for hypertension patients. Although the predictive value of non-HDLC was no better than LDLC on EICAS presence, non-HDLC is still a powerful atherogenic factor and potential therapeutic target for EICAS.

Keywords: carotid ultrasound; epidemiology; extracranial carotid artery stenosis; non-HDLC; risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carotid Artery, Internal* / diagnostic imaging
  • Carotid Stenosis / blood*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / epidemiology*
  • China / epidemiology
  • Cholesterol / blood*
  • Female
  • Humans
  • Hypertension / complications
  • Lipoproteins / blood*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Ultrasonography, Doppler, Duplex

Substances

  • Lipoproteins
  • lipoprotein cholesterol
  • Cholesterol