Total/HDL cholesterol ratio and non HDL cholesterol as predictors for increased intima media thickness

Abstract
Background: LDL, HDL cholesterol and triglycerides, are the most commonly used lipid cardiovascular risk predictor indicators. However population based studies have shown that non-HDL cholesterol and total/HDL cholesterol ratio are better predictors, are easy to measure and do not require fasting. Aim: To determine which lipid indicators are better determinants of subclinical atherosclerosis, measured by intima media thickness (IMT) among subjects without demonstrated atherosclerosis. Material and Methods: Lipid profile, height, weight, blood pressure and bilateral IMT measured by ultrasound with automatic border recognition software, were assessed in 770 men and 854 women aged 45 +/- 11 years, in Santiago de Chile. Results: Mean total cholesterol was 202, HDL 50, LDL 121, triglycerides 157 and non-HDL cholesterol 152 mg/dl. Total/HDL cholesterol ratio was 4.3. Mean IMT was 0.62 mm. All lipid markers were significantly correlated with IMT This correlation was higher for non-HDL cholesterol (r = 0.24, p < 0.0001) and total/HDL cholesterol ratio(r = 0.23, p < 0.0001). In both men and women, total/HDL cholesterol ratio was the best predictor of having an IMT over the 75th percentile (odds ratio 1.21, 95% confidence intervals 1.09-1.35, p < 0.01). Conclusions: Total/HDL cholesterol ratio was the best determinant of subclinical atherosclerosis. (Rev Med Chile 2012; 140: 969-976).
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Keywords
Carotid intimae-media thickness, Cholesterol, Risk factors, DENSITY LIPOPROTEIN CHOLESTEROL, CARDIOVASCULAR-DISEASE, HEART-DISEASE, RISK-FACTORS, A-I, CORONARY, APOLIPOPROTEINS, ATHEROSCLEROSIS, PREVENTION, EVENTS
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