Association between Non-HDL-C/HDL-C Ratio and Carotid Intima–Media Thickness in Post-Menopausal Women

Abstract

Atherogenic lipoproteins (particularly, very low-density lipoproteins, VLDL) are associated with subclinical atherosclerosis. The present study aims at evaluating whether routinely analysed lipid parameters are associated with carotid intima–media thickness, a proxy for subclinical atherosclerosis. Lipid parameters from 220 post-menopausal women undergoing ultrasound investigation of the carotid arteries were analysed. Forty-five percent of women showed subclinical atherosclerosis on carotid ultrasound. The mean carotid intima–media thickness was 1.26 ± 0.38 mm. The mean value of the non-HDL-C/HDL-C ratio was 3.1 ± 1.2. Univariate analysis showed a significant association between non-HDL-C/HDL-C ratio and intima–media thickness (r = 0.21, p = 0.001). After adjusting for cardiovascular risk factors (age, systolic blood pressure, smoking, body mass index Homeostasis model assessment: insulin resistance and high-sensitivity C-Reactive-Protein), multivariate analysis showed a significant association between non-HDL-C/HDL-C ratio and intima–media thickness (β = 0.039, p = 0.04). Logistic regression analysis showed that the highest tertile of the non-HDL-C/HDL-C ratio was associated with the presence of carotid plaques (OR = 3.47, p = 0.003). Finally, a strong correlation between non-HDL-C/HDL-C ratio and cholesterol bound to VLDL (r = 0.77, p < 0.001) has been found. Non-HDL-C/HDL-C ratio is associated with the presence of carotid atherosclerosis in post-menopausal women and is strongly correlated to VLDL-C levels.

A higher non‐HDL‐C/HDL‐C ratio was associated with an increased risk of progression of nonculprit coronary lesion in patients with acute coronary syndrome undergoing percutaneous coronary intervention

“…Furthermore, an analysis of 46 786 patients with type 2 diabetes showed that lower levels of non‐HDL‐C/HDL‐C are more effective risk markers for ASCVD compared to LDL‐C levels below 3 mmol/L 26 . In a primary prevention study conducted on 220 postmenopausal women, the non‐HDL‐C/HDL‐C ratio showed a stronger association with increased carotid intima‐media thickness in comparison to other lipid parameters 27 . Additionally, a study on 5822 Chinese individuals diagnosed with metabolic syndrome found a progressive increase in carotid intima‐media thickness across quartiles of the non‐HDL‐C/HDL‐C ratio, with no significant differences observed between the apoB/apoA1 ratio and non‐HDL‐C/HDL‐C ratio in predicting carotid atherosclerosis 28 …”

“…26 In a primary prevention study conducted on 220 postmenopausal women, the non-HDL-C/HDL-C ratio showed a stronger association with increased carotid intimamedia thickness in comparison to other lipid parameters. 27 Additionally, a study on 5822 Chinese individuals diagnosed with metabolic syndrome found a progressive increase in carotid intima-media thickness across quartiles of the non-HDL-C/HDL-C ratio, with no significant differences observed between the apoB/apoA1 ratio and non-HDL-C/HDL-C ratio in predicting carotid atherosclerosis. 28 Lipoproteins containing apoB have a significant impact on the development and progression of atherosclerotic plaques by accumulating in the arterial intima, leading to atherogenic effects.…”

Carotid Atherosclerosis and its Correlation with ApoB/ApoA-I and Non-HDL-c/HDL-c Ratios among Adults with Type 2 Diabetes: A Cross-Sectional Study in Southwestern Uganda

“…Qin et al demonstrated that an increased non-HDL-c/HDL-c was signi cantly associated with elevated CIMT among Chinese individuals [37]. Among postmenopausal women, the non-HDL-c/HDL-c ratio was found to be signi cantly associated with CIMT [38,39]. Non-HDLc, which is calculated by TC minus HDL-c, provides a robust measure of the cholesterol content of all atherogenic lipoproteins as it also incorporates the potential risk conferred by high levels of atherogenic TG-rich remnants in addition to the risk due to LDL-c [40].…”

Spotlight on very-low-density lipoprotein as a driver of cardiometabolic disorders: Implications for disease progression and mechanistic insights

“…In patients with type 2 diabetes who previously underwent coronary stent implantation, an elevated VLDL-C level >0.52 mmol/L was independently associated with in-stent restenosis (hazard ratio = 3.01) ( 21 ). Iannuzzi et al ( 22 ) used ultrasound to measure carotid intima–media thickness in postmenopausal women and showed that VLDL-C was the lipoprotein most strongly associated with subclinical atherosclerosis. In addition, evidence from clinical studies has consistently indicated a causal role for TG-rich lipoproteins such as VLDL in ASCVD.…”