| Objective Coronary heart disease(CHD)is one of the most important diseases that damage human beings health.It is well established that low-density lipoprotein cholesterol(LDL-C)is a key factor in the development of atherosclerosis.Lowering serum LDL-C level can significantly reduce the risk of cardiovascular events.Despite aggressive lipid-lowering therapy and LDL-C have already reached the corresponding standard that lipid guidelines recommendation,patients continue to be at significantly residual risk of coronary heart disease.It suggests that if only considering the level of LDL-C may underestimate the risk of cardiovascular disease.non–HDL-C provides a measure of all atherogenic lipoprotein in serum,more and more attention has been paid to the prevention and treatment of cardiovascular disease in recent years.In this study,we sought to evaluate the clinical value of non-HDL-C for predicting coronary heart disease in populations with desirable LDL-C,and provide new ideas for the diagnosis and treatment of CHD in this part of the population.Methods It is a retrospective study.we selected totally 278 suspected CHD individuals who were not receiving any lipid-lowering therapy and had desirable plasma LDL-C concentrations,who were in the Affiliated Hospital of Qingdao University between July 2016 to July 2017.They were assigned into CHD group and control group based on the results of coronary angiograpy.The CHD group was defined as at least one of the major vascular diameter stenosis is more than 50%(n=210,male166(79%),average age 61.39±9.7),the others are control group(n=68,male 32(47.1%),average age59.32±8.11).General information and blood biochemical data were collected.Fasting blood samples were collected from each patient and the indexes were measured at the Clinical Laboratory of the Affiliated Hospital of Qingdao University,including: Liver function,Renal function,Glucose,Uric acid,total cholesterol(TC),LDL-C,HDL-C,triglyceride(TG),apolipoprotein A1(apoA1),apolipoprotein B(apoB),apoB/A1,Lp(a),et al.non-HDL-C is calculated by formula: non-HDL-C=TC-HDL-C.The collection of data is compared between groups,Pearson’s coefficient of correlation was used to identify the degree of linear association between non-HDL-C and other lipid parameters.Binary Logistic regression analysis was used to select the risk factors of CHD.Recevier operating characteristic(ROC)curve of non-HDL-C,Lp(a),apoB/apoA1 and for predicting CHD was analyzed.Results The constituent ratio of male,Hypertension,smoking,and fasting blood glucose were significantly higher in CHD group(P<0.05).Age,diabetes,BMI and uricacid levels have no significant difference between the two groups(P > 0.05).Comparison of lipid parameters,the concentrations of serum non-HDL-C,Lp(a)and the apoB/A1 were significantly higher in CHD group than in control group(P < 0.05),Total cholesterol(TC),triglyceride(TG),LDL-C,apoB have no significant difference in the two groups(P>0.05).Correlation analysis showed that there was a linear correlation between non-HDL-C and TC,TG,LDL-C,apoB and apoB/A1,and the linear correlation with TC was the most significant(r=0.819,P=0.000).Logistic analysis indicated that non-HDL-C and Lp(a)were both important risk factors of CHD.The area under the ROC curve(AUC)of non-HDL-C for predicting CHD was 0.661(P=0.000),which was slightly higher than that of Lp(a)(AUC=0.621,P=0.003)and apoB/apoA1(AUC=0.595,P=0.020).When the cutoff point of non-HDL-C is 3.375mmol/L,the diagnosis of CHD is of the highest value which sensitivity is 81.1% and the specificity is 41.2%.Conclusions The study indicated that non-HDL-C has positive correlation with CHD in populations with desirable LDL-C.Compared to LDL-C and other traditional blood lipid indicators,non-HDL-C can stable reflect the risk of coronary heart disease.non-HDL-C may be a better marker of cardiovascular risk than LDL-C and should work as an important index for the prevention of cardiovascular disease. |
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