The Associations of Lipid Profiles With Cardiovascular Diseases and Death in a 10-Year Prospective Cohort Study

Jiayi Dong; Song Yang; Qian Zhuang; Junxiang Sun; Pengfei Wei; Xianghai Zhao; Yanchun Chen; Xiaotian Chen; Mengxia Li; Lai Wei; Changying Chen; Yao Fan; Chong Shen

doi:10.3389/fcvm.2021.745539

The Associations of Lipid Profiles With Cardiovascular Diseases and Death in a 10-Year Prospective Cohort Study

Front Cardiovasc Med. 2021 Nov 25:8:745539. doi: 10.3389/fcvm.2021.745539. eCollection 2021.

Authors

Jiayi Dong¹, Song Yang², Qian Zhuang², Junxiang Sun², Pengfei Wei², Xianghai Zhao², Yanchun Chen², Xiaotian Chen¹, Mengxia Li¹, Lai Wei¹, Changying Chen¹, Yao Fan³, Chong Shen^{1

3}

Affiliations

¹ Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
² Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China.
³ Department of Clinical Epidemiology, Geriatric Hospital of Nanjing Medical University, Nanjing, China.

Abstract

Background: Dyslipidemia is one of the modifiable risk factors for cardiovascular diseases (CVD). Identifying subjects with lipid abnormality facilitates preventative interventions. Objectives: To evaluate the effects of lipid indices on the risks of ischemic stroke (IS), coronary heart disease (CHD), CVD, all-cause death, and CVD death. Methods: The cohort study of 4,128 subjects started in May 2009 and followed up to July 2020. Restricted cubic spline (RCS) regression analysis was used to explore the dose-response relationship between lipid indices with outcomes. Cox proportional hazard regression analysis was used to estimate the association with a hazard ratio (HR) and 95% CI. Results: RCS analysis showed that there were significant linear associations of TG with IS, non-high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (ApoB), and total cholesterol (TC)/HDL-C ratio with all-cause death, non-HDL-C and RC with CVD death, and significant non-linear associations of ApoB with IS and CVD, TC, LDL-C, ApoAI, and TC/HDL-C ratio with CHD, and TC with all-cause death (all P <0.1). Cox regression analysis revealed that subjects with TC <155 mg/dl (vs. 155-184 mg/dl), > 185 mg/dl (vs. 155-184 mg/dl), and ApoB <0.7 g/l (vs. ≥0.7 g/l) had higher risks of CHD (P < 0.05), the adjusted HRs (95% CIs) were 1.933 (1.248-2.993), 1.561 (1.077-2.261), and 1.502 (1.01-2.234), respectively. Subjects with ApoAI > 2.1 g/l (vs. 1.6-2.1 g/l) and TG <80 mg/dl (vs. 80-177 mg/dl) had higher risks of CVD and all-cause death (P < 0.05), the adjusted HRs (95% CIs) were 1.476 (1.031-2.115) and 1.234 (1.002-1.519), respectively. Conclusions: Lower or higher levels of TC, higher level of ApoAI, and lower level of ApoB were associated with increased risks of CVD, and lower level of TG was associated with increased all-cause death. Maintaining optimal lipid levels would help to prevent CVD and reduce mortality.

Keywords: apolipoprotein; cardiovascular diseases; cohort study; death; derived lipid indices; lipids.