Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2018

Open Access 01-12-2018 | Research article

The impact of nontraditional lipid profiles on left ventricular geometric abnormalities in general Chinese population

Authors: Haoyu Wang, Zhao Li, Xiaofan Guo, Yintao Chen, Ye Chang, Shuang Chen, Yingxian Sun

Published in: BMC Cardiovascular Disorders | Issue 1/2018

Login to get access

Abstract

Background

Despite current interest in the unfavorable impact of nontraditional lipid profiles on cardiovascular disease, information regarding its relations to abnormal left ventricular (LV) geometry has not been systemically elucidated. This study sought to understand predictive implication of nontraditional lipid profiles in specific LV geometric patterns in the general population of rural China.

Methods

Analyses were based upon a cross-sectional study of 10,756 participants (mean age 53.8 years; 54.0% females) who underwent assessment of biochemical, anthropometric, and blood pressure variables in rural areas of China. Participants were classified into four groups of LV morphologic pattern according to left ventricular mass index (LVMI) and relative wall thickness with quantitative echocardiographic data.

Results

By multivariable-adjusted linear regression models, nontraditional lipid profiles were positive determinants of concentricity index and LV wall thickness (all P < 0.05), with modest effects on LVMI. Non-high-density lipoprotein cholesterol (non-HDL-C) emerged as an independent correlate of concentric LV hypertrophy (LVH) (adjusted odds ratio [OR]: 1.174 per 1 SD increment in non-HDL-C, 95% confidence interval [CI]: 1.075–1.281), followed by low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio (1.158 [1.059–1.266]), total cholesterol (TC)/HDL-C ratio (1.150 [1.050–1.260]), and triglyceride (TG)/HDL-C ratio (1.134 [1.030–1.249]). The ORs for concentric LVH by tertiles further provided insight into that excess risk was associated with the highest tertile of nontraditional lipid profiles. The areas under the ROC curves to predict concentric LVH were statistically identical among nontraditional lipid parameters.

Conclusion

Nontraditional lipid profiles, easily measured in the everyday routine examination, were responsible for increased risk of concentric LVH, potentially providing enhanced clinical utility at no additional cost, which emphasized the beneficial effect of these markers to supplement and improve CVD risk stratification.
Literature
1.
Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham heart study. N Engl J Med. 1990;322(22):1561–6.CrossRefPubMed
2.
Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med. 1991;114(5):345–52.CrossRefPubMed
3.
Verdecchia P, Angeli F, Achilli P, Castellani C, Broccatelli A, Gattobigio R, Cavallini C. Echocardiographic left ventricular hypertrophy in hypertension: marker for future events or mediator of events? Curr Opin Cardiol. 2007;22(4):329–34.CrossRefPubMed
4.
Lavie CJ, Patel DA, Milani RV, Ventura HO, Shah S, Gilliland Y. Impact of echocardiographic left ventricular geometry on clinical prognosis. Prog Cardiovasc Dis. 2014;57(1):3–9.CrossRefPubMed
5.
Milani RV, Drazner MH, Lavie CJ, Morin DP, Ventura HO. Progression from concentric left ventricular hypertrophy and normal ejection fraction to left ventricular dysfunction. Am J Cardiol. 2011;108(7):992–6.CrossRefPubMed
6.
Lavie CJ, Milani RV, Ventura HO, Cardenas GA, Mehra MR, Messerli FH. Disparate effects of left ventricular geometry and obesity on mortality in patients with preserved left ventricular ejection fraction. Am J Cardiol. 2007;100(9):1460–4.CrossRefPubMed
7.
Tsao CW, Gona PN, Salton CJ, Chuang ML, Levy D, Manning WJ, O'Donnell CJ. Left ventricular structure and risk of cardiovascular events: a Framingham heart study cardiac magnetic resonance study. J Am Heart Assoc. 2015;4(9):e002188.CrossRefPubMedPubMedCentral
8.
Horio T, Miyazato J, Kamide K, Takiuchi S, Kawano Y. Influence of low high-density lipoprotein cholesterol on left ventricular hypertrophy and diastolic function in essential hypertension. Am J Hypertens. 2003;16(11 Pt 1):938–44.CrossRefPubMed
9.
Anan F, Yonemochi H, Masaki T, Takahashi N, Fukunaga N, Teshima Y, Iwao T, Kaneda K, Eshima N, Saikawa T, et al. High-density lipoprotein cholesterol and insulin resistance are independent and additive markers of left ventricular hypertrophy in essential hypertension. Hypertens Res. 2007;30(2):125–31.CrossRefPubMed
10.
Schillaci G, Vaudo G, Reboldi G, Verdecchia P, Lupattelli G, Pasqualini L, Porcellati C, Mannarino E. High-density lipoprotein cholesterol and left ventricular hypertrophy in essential hypertension. J Hypertens. 2001;19(12):2265–70.CrossRefPubMed
11.
Velagaleti RS, Pencina MJ, Vasan RS, Benjamin EJ, Massaro JM, Pencina K, Levy D. Cross-sectional relations of lipid concentrations to left ventricular structural attributes. Am J Cardiol. 2010;105(9):1297–9.CrossRefPubMedPubMedCentral
12.
Nham E, Kim SM, Lee SC, Chang SA, Sung J, Cho SJ, Jang SY, Choe YH. Association of cardiovascular disease risk factors with left ventricular mass, biventricular function, and the presence of silent myocardial infarction on cardiac MRI in an asymptomatic population. Int J Cardiovasc Imaging. 2016;32(Suppl 1):173–81.CrossRefPubMed
13.
Ferrara LA, Cardoni O, Mancini M, Zanchetti A. Metabolic syndrome and left ventricular hypertrophy in a general population. Results from the Gubbio study. J Hum Hypertens. 2007;21(10):795–801.CrossRefPubMed
14.
Jullien V, Gosse P, Ansoborlo P, Lemetayer P, Clementy J. Relationship between left ventricular mass and serum cholesterol level in the untreated hypertensive. J Hypertens. 1998;16(7):1043–7.CrossRefPubMed
15.
Gardin JM, Wagenknecht LE, Anton-Culver H, Flack J, Gidding S, Kurosaki T, Wong ND, Manolio TA. Relationship of cardiovascular risk factors to echocardiographic left ventricular mass in healthy young black and white adult men and women. The CARDIA study. Coronary artery risk development in young adults. Circulation. 1995;92(3):380–7.CrossRefPubMed
16.
Jorgensen PG, Jensen MT, Biering-Sorensen T, Mogelvang R, Galatius S, Fritz-Hansen T, Rossing P, Vilsboll T, Jensen JS. Cholesterol remnants and triglycerides are associated with decreased myocardial function in patients with type 2 diabetes. Cardiovasc Diabetol. 2016;15(1):137.CrossRefPubMedPubMedCentral
17.
Bittner V, Johnson BD, Zineh I, Rogers WJ, Vido D, Marroquin OC, Bairey-Merz CN, Sopko G. The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia: a report from the Women's ischemia syndrome evaluation (WISE). Am Heart J. 2009;157(3):548–55.CrossRefPubMedPubMedCentral
18.
Ingelsson E, Schaefer EJ, Contois JH, McNamara JR, Sullivan L, Keyes MJ, Pencina MJ, Schoonmaker C, Wilson PW, D'Agostino RB, et al. Clinical utility of different lipid measures for prediction of coronary heart disease in men and women. JAMA. 2007;298(7):776–85.CrossRefPubMed
19.
Barzi F, Patel A, Woodward M, Lawes CM, Ohkubo T, Gu D, Lam TH, Ueshima H. A comparison of lipid variables as predictors of cardiovascular disease in the Asia Pacific region. Ann Epidemiol. 2005;15(5):405–13.CrossRefPubMed
20.
Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005;294(3):326–33.CrossRefPubMed
21.
Arsenault BJ, Rana JS, Stroes ES, Despres JP, Shah PK, Kastelein JJ, Wareham NJ, Boekholdt SM, Khaw KT. Beyond low-density lipoprotein cholesterol: respective contributions of non-high-density lipoprotein cholesterol levels, triglycerides, and the total cholesterol/high-density lipoprotein cholesterol ratio to coronary heart disease risk in apparently healthy men and women. J Am Coll Cardiol. 2009;55(1):35–41.CrossRefPubMed
22.
Elshazly MB, Quispe R, Michos ED, Sniderman AD, Toth PP, Banach M, Kulkarni KR, Coresh J, Blumenthal RS, Jones SR, et al. Patient-level discordance in population percentiles of the Total cholesterol to high-density lipoprotein cholesterol ratio in comparison with low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol: the very large database of lipids study (VLDL-2B). Circulation. 2015;132(8):667–76.CrossRefPubMedPubMedCentral
23.
Mathews SC, Mallidi J, Kulkarni K, Toth PP, Jones SR. Achieving secondary prevention low-density lipoprotein particle concentration goals using lipoprotein cholesterol-based data. PLoS One. 2012;7(3):e33692.CrossRefPubMedPubMedCentral
24.
Kastelein JJ, van der Steeg WA, Holme I, Gaffney M, Cater NB, Barter P, Deedwania P, Olsson AG, Boekholdt SM, Demicco DA, et al. Lipids, apolipoproteins, and their ratios in relation to cardiovascular events with statin treatment. Circulation. 2008;117(23):3002–9.CrossRefPubMed
25.
Salazar MR, Carbajal HA, Espeche WG, Leiva Sisnieguez CE, Balbin E, Dulbecco CA, Aizpurua M, Marillet AG, Reaven GM. Relation among the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio, insulin resistance, and associated cardio-metabolic risk factors in men and women. Am J Cardiol. 2012;109(12):1749–53.CrossRefPubMed
26.
Bhalodkar NC, Blum S, Enas EA. Accuracy of the ratio of triglycerides to high-density lipoprotein cholesterol for predicting low-density lipoprotein cholesterol particle sizes, phenotype B, and particle concentrations among Asian Indians. Am J Cardiol. 2006;97(7):1007–9.CrossRefPubMed
27.
Kunutsor SK, Zaccardi F, Karppi J, Kurl S, Laukkanen JA. Is high serum LDL/HDL cholesterol ratio an emerging risk factor for sudden cardiac death? Findings from the KIHD study. J Atheroscler Thromb. 2017;24(6):600–8.CrossRefPubMedPubMedCentral
28.
Katakami N, Kaneto H, Osonoi T, Saitou M, Takahara M, Sakamoto F, Yamamoto K, Yasuda T, Matsuoka TA, Matsuhisa M, et al. Usefulness of lipoprotein ratios in assessing carotid atherosclerosis in Japanese type 2 diabetic patients. Atherosclerosis. 2011;214(2):442–7.CrossRefPubMed
29.
Di Bonito P, Moio N, Scilla C, Cavuto L, Sibilio G, Sanguigno E, Forziato C, Saitta F, Iardino MR, Di Carluccio C, et al. Usefulness of the high triglyceride-to-HDL cholesterol ratio to identify cardiometabolic risk factors and preclinical signs of organ damage in outpatient children. Diabetes Care. 2012;35(1):158–62.CrossRefPubMed
30.
Li Z, Bai Y, Guo X, Zheng L, Sun Y, Roselle AM. Alcohol consumption and cardiovascular diseases in rural China. Int J Cardiol. 2016;215:257–62.CrossRefPubMed
31.
Zhang N, Chen Y, Guo X, Sun G, Dai D, Sun Y. Metabolic abnormalities, but not metabolically healthy obesity, are associated with left ventricular hypertrophy. Heart, lung & circulation. 2017;26(3):251–7.CrossRef
32.
Li T, Yang J, Guo X, Chen S, Sun Y. Geometrical and functional changes of left heart in adults with prehypertension and hypertension: a cross-sectional study from China. BMC Cardiovasc Disord. 2016;16:114.CrossRefPubMedPubMedCentral
33.
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63.CrossRefPubMed
34.
Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57(6):450–8.CrossRefPubMed
35.
Marwick TH, Gillebert TC, Aurigemma G, Chirinos J, Derumeaux G, Galderisi M, Gottdiener J, Haluska B, Ofili E, Segers P, et al. Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE). J Am Soc Echocardiogr. 2015;28(7):727–54.CrossRefPubMed
36.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet (London, England). 2004, 363(9403):157-63.
37.
Elshazly MB, Nicholls SJ, Nissen SE, St John J, Martin SS, Jones SR, Quispe R, Stegman B, Kapadia SR, Tuzcu EM, et al. Implications of Total to high-density lipoprotein cholesterol ratio discordance with alternative lipid parameters for coronary atheroma progression and cardiovascular events. Am J Cardiol. 2016;118(5):647–55.CrossRefPubMed
38.
Kimura T, Itoh T, Fusazaki T, Matsui H, Sugawara S, Ogino Y, Endo H, Kobayashi K, Nakamura M. Low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol ratio predicts lipid-rich coronary plaque in patients with coronary artery disease--integrated-backscatter intravascular ultrasound study. Circ J. 2010;74(7):1392–8.CrossRefPubMed
39.
Di Bonito P, Valerio G, Grugni G, Licenziati MR, Maffeis C, Manco M, Miraglia del Giudice E, Pacifico L, Pellegrin MC, Tomat M, et al. Comparison of non-HDL-cholesterol versus triglycerides-to-HDL-cholesterol ratio in relation to cardiometabolic risk factors and preclinical organ damage in overweight/obese children: the CARITALY study. Nutr Metab Cardiovasc Dis. 2015;25(5):489–94.CrossRefPubMed
40.
Sundstrom J, Lind L, Vessby B, Andren B, Aro A, Lithell H. Dyslipidemia and an unfavorable fatty acid profile predict left ventricular hypertrophy 20 years later. Circulation. 2001;103(6):836–41.CrossRefPubMed
41.
Maczewski M, Maczewska J. Hypercholesterolemia exacerbates ventricular remodeling in the rat model of myocardial infarction. J Card Fail. 2006;12(5):399–405.CrossRefPubMed
42.
Huang Y, Walker KE, Hanley F, Narula J, Houser SR, Tulenko TN. Cardiac systolic and diastolic dysfunction after a cholesterol-rich diet. Circulation. 2004;109(1):97–102.CrossRefPubMed
43.
Velagaleti RS, Massaro J, Vasan RS, Robins SJ, Kannel WB, Levy D. Relations of lipid concentrations to heart failure incidence: the Framingham heart study. Circulation. 2009;120(23):2345–51.CrossRefPubMedPubMedCentral
44.
Ebong IA, Goff DC Jr, Rodriguez CJ, Chen H, Sibley CT, Bertoni AG. Association of lipids with incident heart failure among adults with and without diabetes mellitus: multiethnic study of atherosclerosis. Circulation Heart failure. 2013;6(3):371–8.CrossRefPubMedPubMedCentral
45.
Rijzewijk LJ, van der Meer RW, Smit JW, Diamant M, Bax JJ, Hammer S, Romijn JA, de Roos A, Lamb HJ. Myocardial steatosis is an independent predictor of diastolic dysfunction in type 2 diabetes mellitus. J Am Coll Cardiol. 2008;52(22):1793–9.CrossRefPubMed
46.
Dahiya R, Shultz SP, Dahiya A, Fu J, Flatley C, Duncan D, Cardinal J, Kostner KM, Byrne NM, Hills AP, et al. Relation of reduced preclinical left ventricular diastolic function and cardiac remodeling in overweight youth to insulin resistance and inflammation. Am J Cardiol. 2015;115(9):1222–8.CrossRefPubMed
47.
Cockerill GW, Huehns TY, Weerasinghe A, Stocker C, Lerch PG, Miller NE, Haskard DO. Elevation of plasma high-density lipoprotein concentration reduces interleukin-1-induced expression of E-selectin in an in vivo model of acute inflammation. Circulation. 2001;103(1):108–12.CrossRefPubMed
48.
Barter PJ, Baker PW, Rye KA. Effect of high-density lipoproteins on the expression of adhesion molecules in endothelial cells. Curr Opin Lipidol. 2002;13(3):285–8.CrossRefPubMed
49.
Zhou YT, Grayburn P, Karim A, Shimabukuro M, Higa M, Baetens D, Orci L, Unger RH. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci U S A. 2000;97(4):1784–9.CrossRefPubMedPubMedCentral
50.
Utz W, Engeli S, Haufe S, Kast P, Hermsdorf M, Wiesner S, Pofahl M, Traber J, Luft FC, Boschmann M, et al. Myocardial steatosis, cardiac remodelling and fitness in insulin-sensitive and insulin-resistant obese women. Heart. 2011;97(19):1585–9.CrossRefPubMed
51.
Roman MJ, Pickering TG, Schwartz JE, Pini R, Devereux RB. Association of carotid atherosclerosis and left ventricular hypertrophy. J Am Coll Cardiol. 1995;25(1):83–90.CrossRefPubMed
Metadata
Title
The impact of nontraditional lipid profiles on left ventricular geometric abnormalities in general Chinese population
Authors
Haoyu Wang
Zhao Li
Xiaofan Guo
Yintao Chen
Ye Chang
Shuang Chen
Yingxian Sun
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2018
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-018-0829-x

Other articles of this Issue 1/2018

BMC Cardiovascular Disorders 1/2018 Go to the issue

Research article

Whole-exome sequencing identifies R1279X of MYH6 gene to be associated with congenital heart disease

Case report

Acute coronary syndrome secondary to allergic coronary vasospasm (Kounis Syndrome): a case series, follow-up and literature review

Research article

Burden of Ischaemic heart disease and attributable risk factors in China from 1990 to 2015: findings from the global burden of disease 2015 study

Research article

Genomic analysis in patients with myxomatous mitral valve prolapse: current state of knowledge

Research article

Association of rs662799 in APOA5 with CAD in Chinese Han population

Research article

Primary results of abdominal aortic aneurysm screening in the at-risk residents in middle China

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits