Study On The Relationship Between Lipids Ratio And Carotid Atherosclerosis In The Elderly With Normal LDL-C Levels

BackgroundIn recent years,with the improvement of people's living standard and the change of lifestyle,the incidence rate and mortality rate of cardiovascular disease are increasing.Especially in the elderly,cardiovascular diseases have become an important disease threatening life and affecting the quality of life.Carotid atherosclerosis is a common vascular problem in the elderly.Coronary heart disease,cerebral infarction and transient ischemic attack are closely related to the formation of atherosclerosis.According to the guidelines for the management of dyslipidemia of the European Society of Cardiology/European Society of atherosclerosis in 2019(hereinafter referred to as the guidelines for the management of dyslipidemia in 2019),the first-class prevention population of patients with familial hypercholesterolemia with significant plaque and other major risk factors detected by carotid ultrasound is listed as the extremely high-risk population.The most important and common type of atherosclerosis is atherosclerosis.Atherosclerosis starts from the intima of the involved artery,and there are many kinds of lesions,including local complex sugar accumulation,lipid deposition,calcium deposition and fibrous tissue hyperplasia,and accompanied by middle-level degeneration of the artery,and its secondary lesions include local thrombosis,plaque rupture,bleeding in the plaque,etc.The common carotid artery,internal carotid artery and external carotid artery constitute the carotid artery.The common carotid artery is the main artery of the head and neck,which supplies blood to the head and the common carotid artery is divided into external carotid artery and internal carotid artery at the upper edge of thyroid cartilage.The location of carotid artery is superficial.Carotid artery ultrasound can effectively,quickly and economically detect whether there is atherosclerosis in carotid artery.Carotid artery is called the window of systemic blood vessels.Many studies have shown that carotid atherosclerosis is one of the most important predictors of incidence rate and mortality of cardiovascular disease,and it is of great significance in predicting the occurrence and development of coronary heart disease.Therefore,it is of great significance to identify the serum biomarkers related to the formation of carotid atherosclerotic plaque for the prevention of atherosclerosis and cardiovascular disease.Early detection and treatment of carotid plaque is conducive to the prevention of cardiovascular disease.As we all know,age,gender,history of hypertension,history of diabetes and dyslipidemia are the risk factors of atherosclerosis,and dyslipidemia is the most important risk factor.The increase of Low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(apoB),total cholesterol(TC),triglyceride(TG),lipoprotein(a)[Lp(a)]and the decrease of high density lipoprotein cholesterol(HDL-C),apolipoprotein A1(apoAl)could promote the formation of atherosclerotic sclerosis.Among them,the increase of LDL-C is considered to be the most important risk factor.The decrease of LDL-C level is used as a blood lipid prevention and control target for coronary heart disease.However,in clinical work,we found that some people with LDL-C in the normal range still have cardiovascular events,such as myocardial infarction,sudden cardiac death and so on.It has been reported that the risk of cardiovascular events in this population may be related to the increase of apoB,non-HDL-C and TG.In our daily work,we found that the results of carotid ultrasound in some people with normal LDL-C level indicated carotid atherosclerosis,which was more significant in the elderly.No relevant reports were found in previous literature.Some studies have shown that compared with a single lipid index,lipid ratio can better reflect the occurrence and development of atherosclerosis.Therefore,in this study,the elderly people with normal LDL-C level were taken as the research object to study the relationship between lipids ratio and carotid atherosclerosis,and to explore the significance and value of LDL-C/HDL-C ratio and other lipids or lipids ratio in the clinical application of carotid atherosclerosis.ObjectiveTo explore the relationship between lipids ratio and carotid atherosclerosis in the elderly with normal LDL-C level and its clinical application value.Method142 cases were collected from the Department of Cardiology for the elderly in our hospital.The venous blood was drawn in the morning of the second day of admission.LDL-C,HDL-C,apoB,apoAl,TC,TG,LP(a)were measured by automatic biochemical instrument.The non-high density lipoprotein cholesterol(non-HDL-C),LDL-C/HDL-C ratio,TC/HDL-C ratio,TG/HDL-C ratio and apoB/apoAl ratio were calculated.The ultrasonic examination of carotid artery was improved,and the patients were divided into the carotid atherosclerosis group and the non-catherosclerosis group according to the results.The patients' age,gender,history of hypertension and history of diabetes were recorded.Result1.The age of carotid atherosclerosis group was 60-85 years old.The age of non-carotid atherosclerosis group was 60-77 years old.The difference between the two groups was statistically significant(P=0.000).The difference of hypertension history between the two groups was statistically significant(P=0.002).There was no significant difference in gender and diabetes history between the two groups(P>0.05).2.In the carotid atherosclerosis group,LDL-C/HDL-C ratio,TC/HDL-C ratio and apoB/apoAl ratio were higher than those in the non-carotid atherosclerosis group,while HDL-C and ApoAl were lower than those in the non-carotid atherosclerosis group(P<0.05).There was no significant difference in TC,TG,LDL-C,apoB,LP(a),non-HDL-C,TG/HDL-C ratio between the two groups(P>0.05).3.Logistic regression analysis was performed on the factors with statistical differences such as age,history of hypertension,LDL-C/HDL-C ratio,TC/HDL-C ratio,apoB/apoAl ratio,HDL-C,apoAl and so on.The results showed that TC/HDL-C ratio,apoB/apoAl ratio,HDL-C and apoAl could not be used as independent risk factors for carotid atherosclerosis in the elderly with normal LDL-C level(P>0.05).High LDL-C/HDL-C ratio,age,and hist ory of hypertension can be used as independent risk factors for carotid atherosclerosis in elderly people with normal LDL-C levels(P<0.05).ConclusionIn the elderly with normal LDL-C level,age,hypertension and high LDL-C/HDL-C ratio can be regarded as independent risk factors of carotid atherosclerosis,and high LDL-C/HDL-C ratio can be used as a predictor of carotid atherosclerosis.