Preventive CardiologyUsefulness of Non–High-Density Lipoprotein Cholesterol as a Predictor of Cardiovascular Disease Mortality in Men in 22-Year Follow-Up
Section snippets
Methods
The Cardiovascular Occupational Risk Factor Determination in Israel Study (CORDIS) cohort included male workers recruited from 21 industrial plants (metal work, textiles, light industry, electronics, food manufacturing, and plywood production) throughout Israel for on-site screening of cardiovascular risk factors. The current analysis was restricted to a working population of Jewish men aged 20 to 70 years at baseline. Arab men (n = 357) were excluded from the current analysis because of
Results
The baseline characteristics of the study participants are presented in Table 1. A total of 4,832 men were included in the analysis with a mean age of 42.1 ± 12.1 years. The mean follow-up time was 22.1 ± 3.2 years (median 22 years). One man with an unknown mortality date and 22 men with missing non-HDL-C tests were excluded from the study. Most workers did not report any history of hypertension (90%), diabetes (96.7%), or family history of MI (76%).
Non-HDL-C levels were positively associated
Discussion
In this male prospective cohort study, higher levels of non-HDL-C at baseline were associated with a significantly increased risk of CVD mortality, independently of a wide range of potential confounders, including lifestyle parameters, socioeconomic status, education, and medical history. Furthermore, non-HDL-C appeared to be a stronger predictor of CVD and all-cause mortality than LDL-C, which is the main treatment goal according to National Cholesterol Education Program guidelines.3
Disclosures
The authors have no conflicts of interest to disclose.
References (28)
- et al.
Targeting cholesteryl ester transfer protein for the prevention and management of cardiovascular disease
J Am Coll Cardiol
(2006) - et al.
National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1-executive summary
J Clin Lipidol
(2014) - et al.
Friedewald-estimated versus directly measured low-density lipoprotein cholesterol and treatment implications
J Am Coll Cardiol
(2013) - et al.
Non-high-density lipoprotein and very-low-density lipoprotein cholesterol and their risk predictive values in coronary heart disease
Am J Cardiol
(2006) - et al.
Associations of serum high density lipoprotein and total cholesterol with total, cardiovascular, and cancer mortality in a 7-year prospective study of 10 000 men
Lancet
(1981) - et al.
Meta-analysis of the relationship between non-high-density lipoprotein cholesterol reduction and coronary heart disease risk
J Am Coll Cardiol
(2009) - et al.
The importance of non-HDL cholesterol reporting in lipid management
J Clin Lipidol
(2008) - et al.
Usefulness of non-high-density lipoprotein cholesterol determinations in the diagnosis and treatment of dyslipidemia
Am J Cardiol
(2003) - et al.
Healthy volunteer effect in industrial workers
J Clin Epidemiol
(1999) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report
Circulation
(2002)
Major lipids, apolipoproteins, and risk of vascular disease
JAMA
A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk
Circ Cardiovasc Qual Outcomes
Calculated values for low-density lipoprotein cholesterol in the assessment of lipid abnormalities and coronary disease risk
Clin Chem
Non-high-density lipoprotein cholesterol level as a predictor of cardiovascular disease mortality
Arch Intern Med
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Low-density lipoprotein cholesterol-to-apolipoprotein B ratio as a potential indicator of LDL particle size and plasma atherogenicity in type 2 diabetes
2021, Diabetes Research and Clinical PracticeCitation Excerpt :Each LDL particle contains one molecule of apolipoprotein B (ApoB); therefore, the plasma ApoB level corresponds with the number of LDL particles and thereby plasma atherogenicity [3,4]. Plasma levels of nonhigh-density lipoprotein-cholesterol (non-HDL-c) reflect the amount of cholesterol transported by ApoB-containing atherogenic lipoproteins, representing total plasma atherogenicity independent of the variability of plasma TG levels [5]. These specific properties of non-HDL-c predetermine its role in the prediction of plasma atherogenicity and atherosclerosis-related cardiovascular disease [6].
Triglycerides, HDL cholesterol and atherogenic dyslipidaemia in the 2019 European guidelines for the management of dyslipidaemias
2020, Clinica e Investigacion en ArteriosclerosisNon-high-density lipoprotein cholesterol and risk of cardiovascular disease in the general population and patients with type 2 diabetes: A systematic review and meta-analysis
2019, Diabetes Research and Clinical PracticeCitation Excerpt :Subsequently, 19 full-text articles were further removed mainly because they were conference abstracts or reviews, irrelevant outcomes or participants from other disease-specific populations. Finally, 13 studies [8–20] were included in the meta-analysis. The main characteristics of the 13 included studies are summarized in Table 1.
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