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GW24-e3099 Association between very low-density lipoprotein cholesterol level and 5-year progression of carotid plaque
  1. Zhao Fan,
  2. Yue Qi,
  3. Jing Liu,
  4. Jun Liu,
  5. Wei Wang,
  6. Wuxiang Xie,
  7. Miao Wang,
  8. Lanping Qin,
  9. Jiayi Sun,
  10. Dong Zhao
  1. Department of Epidemiology, Beijing an Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases

Abstract

Objectives To explore the association between baseline very low-density lipoprotein cholesterol level (VLDL-C) and 5-year progression of carotid plaque.

Methods Study subjects were recruited from two Chinese cohorts [the People’s Republic of China - United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS)]. A total of 2030 subjects, aged 38 to 74 years, who had complete blood lipids information and B-mode ultrasound of carotid artery examination for both the baseline survey in 2002 and reexamination in 2007 were included in this analysis. Baseline VLDL-C was categorised into three groups according to ATP III criteria: optimal level (VLDL-C < 20 mg/dL), elevated level (VLDL-C = 20∼29 mg/dL) and high level (VLDL-C ≥30 mg/dL). The progression of carotid plaque was defined as the appearance of at least one plaque at reexamination in a previously plaque-free arterial segment.

Results The 5-year progression rate of carotid plaque was 48.5% in all 2030 subjects (men 52.9% vs. women 45.6%). The rates increased with the levels of VLDL-C (43.3%, 50.0%, and 53.9% for the optimal, elevated, and high level group, respectively, P < 0.001). In subjects with normal LDL-C level, the progression rates of carotid plaque also increased with VLDL-C level (38.8%, 41.6%, and 48.9% respectively for the optimal, elevated, and high level group, P = 0.015). In multivariate logistic analysis, the odds ratio for the progression of carotid plaque was 1.40 (95%CI = 1.13-1.74, P = 0.002) after adjusting for age and sex, and 1.29 (95%CI = 1.03-1.61, P = 0.025) after adjusting for other non-lipid risk factors (hypertension, diabetes, obesity and smoking) for high level of VLDL-C compared to low level group. However, the association between VLDL-C and progression of carotid plaque was attenuated and became nonsignificant after further adjustment for LDL-C and/or HDL-C (P > 0.05).

Conclusions The progression rate of carotid plaque was high in the middle-aged and elderly population, and higher rate was found for those with higher baseline VLDL-C, even in subjects with normal LDL-C level. Given the complex relationship among serum lipid components, the role of VLDL-C in the development of atherosclerosis needs further investigation.

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