Association of remnant cholesterol and non-high density lipoprotein cholesterol with risk of cardiovascular mortality among US general population

Cheang, Iokfai; Zhu, Xu; Lu, Xinyi; Shi, Shi; Tang, Yuan; Yue, Xin; Liao, Shengen; Yao, Wenming; Zhou, Yanli; Zhang, Haifeng; Li, Yanxiu; Li, Xinli

doi:10.1016/j.heliyon.2022.e10050

Cited by 17 publications

(8 citation statements)

References 38 publications

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“…Overall, the results of recently published observational and genetic Mendelian randomization studies support a causal association between elevated remnant cholesterol and ASCVD (Table 1) [20 ▪▪ ,22 ▪▪ ,23–25,26 ▪ –28 ▪ ,29–32,33 ▪ ,34–39]. Furthermore, the results imply that remnant particles have a substantially greater per particle atherogenicity than LDL, most probably because remnants per particle carry substantially more cholesterol than LDL [20 ▪▪ ,21] (Fig.…”

Section: Recent Evidencementioning

confidence: 58%

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

Elías-López,

Doi,

Nordestgaard

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death despite the development of effective treatments. Recently, elevated remnant cholesterol and low-grade inflammation have emerged as factors explaining part of the residual ASCVD risk. Interestingly, the coexistence of both high remnant cholesterol and low-grade inflammation can further increase the risk of ASCVD. The aim of this review is to describe the role of elevated remnant cholesterol and low-grade inflammation, separately and combined, in ASCVD. Recent findings Results from recently published studies, including observational and genetic Mendelian randomization studies, support a causal relationship between elevated remnant cholesterol and low-grade inflammation on risk of ASCVD in both primary and secondary prevention settings. In addition, current evidence from observational studies suggests that the coexistence of elevated remnant cholesterol and low-grade inflammation further increases the risk of ASCVD. Summary Recent observational studies suggest that high remnant cholesterol combined with low-grade inflammation may confer a particular high risk for ASCVD. Attention on the dual threat from high remnant cholesterol and low-grade inflammation is necessary, and further research in this field is warranted. The effect of remnant cholesterol-lowering drugs and anti-inflammatory drugs on ASCVD risk alone and combined remains to be elucidated. Video abstract http://links.lww.com/COCN/A20

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Section: Recent Evidencementioning

confidence: 58%

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

Elías-López,

Doi,

Nordestgaard

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…Such results might be attributed to the limited number of events. Similarly, Cheang et al also found that in general population, non-HDL-C did not show significance in cardiovascular mortality, while showed a U-shape association with all-cause mortality after adjustment (32). Besides, Duncan et al found that individuals with increased concentrations of non-HDL-C were at an elevated risk of incident atherosclerotic cardiovascular diseases (ASCVD) and deaths (26).…”

Section: Discussionmentioning

confidence: 98%

The U-shaped association of non-high-density lipoprotein cholesterol with all-cause and cardiovascular mortality in general adult population

Huang

Yan²,

Zhou³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundNon-high-density lipoprotein cholesterol (non-HDL-C) has been associated with atherosclerosis. However, the association between non-HDL-C and mortality in adult population remains unclear. We intended to investigate the association of non-HDL-C with cardiovascular and all-cause mortality using national representative data.MethodsThe study included 32,405 participants from the National Health and Nutrition Examination Survey (1999–2014). Mortality outcomes were ascertained by linkage to National Death Index records through December 31, 2015. Multivariable-adjusted Cox regression models were used to evaluate hazard ratio (HR) and 95% confidence interval (CI) of non-HDL-C concentrations in quintiles. Two-piecewise linear regression and restricted cubic spline analyzes were performed to test dose–response associations.ResultsAfter a median follow-up of 98.40 months, 2,859 (8.82%) all-cause and 551 (1.70%) cardiovascular deaths occurred. Compared with the highest group, the multivariable-adjusted hazard ratio (HR) of the first quintile for all-cause mortality was 1.53 (95%CI, 1.35–1.74). Higher non-HDL-C above a cutoff value of 4.9 mmol/L was related with cardiovascular mortality (HR = 1.33, 95%CI, 1.13–1.57). A U-shaped relationship between non-HDL-C and all-cause mortality was found in spline analysis with a cutoff value around 4 mmol/L. Similar results in subgroups analyzes were found among male, non-white population, participants who were not taking lipid-lowering drugs, and with body mass index (BMI) <25 kg/m2.ConclusionOur findings suggest a U-shaped association between non-HDL-C and mortality among adult population.

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“…Lipids and lipid metabolites participate in multiple cellular processes and signaling pathways, that are associated with the immunologic and inflammatory response [ 50 , 51 ]. Accumulating evidence have shown that lipid profiles have a prognostic value in the development, disease activity, and progression of various clinical disorders including cardiovascular, metabolic, malignant, inflammatory, and infectious diseases [ [52] , [53] , [54] ]. TG/HDL ratio is a representative biomarker of atherogenic dyslipidemia and is closely associated with insulin resistance [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Association of triglyceride/high-density lipoprotein cholesterol ratio with severe complications of COVID-19

Jeon

Song

Kim

2023

Heliyon

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Association of remnant cholesterol and non-high density lipoprotein cholesterol with risk of cardiovascular mortality among US general population

Cited by 17 publications

References 38 publications

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

The U-shaped association of non-high-density lipoprotein cholesterol with all-cause and cardiovascular mortality in general adult population

Association of triglyceride/high-density lipoprotein cholesterol ratio with severe complications of COVID-19

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