Association Of Cardiovascular Risk Predictors With Overweight And Obesity In Patients With Familial Hypercholesterolemia

Objective: Familial hypercholesterolemia（FH）is an autosomal codominant disease associated with a high risk of cardiovascular and cerebrovascular events.The correlation of body mass index（BMI）,waist-to-hip Ratio（WHR）and waist-to-height Ratio（WHt R）with plasma atherogenic index（AIP）,apolipoprotein B/apolipoprotein A1 Ratio（BAR）and atherogenic coefficient（AC）in patients with FH is not clear.Therefore,this study aims to analyze FH patients physical indexes（BMI,WHR,WHt R）and cardiovascular risk predictors（AIP,BAR and AC）,the relationship between the performance evaluation of the each other between the two types of indicators.Methods: Clinical data of 103 patients with FH from 2004 to 2017 were retrospectively analyzed.Pearson correlation analysis and multiple linear regression analysis were used to evaluate the correlation between serum physique indexes and cardiovascular risk predictors in patients with FH.Canonical correlation analysis was performed to investigate the correlation between physique indexes and cardiovascular risk predictors.Receiver operating characteristic（ROC）curve was used to analyze the identification performance of cardiovascular risk predictors for overweight and central obesity,and the predictive performance of physique indexes for different risk categories of AIP.Results: 1)Pearson correlation analysis showed that BMI was negatively correlated with HDL-C and Apo A1（P < 0.01）,and was significantly positively correlated with AIP,BAR and AC（P < 0.01）;WHR was negatively correlated with HDL-C and Apo A1（P < 0.01）,and was significantly positively correlated with TG,AIP and BAR（P < 0.01）;WHt R was negatively correlated with HDL-C and Apo A1（P < 0.05）,and was significantly positively correlated with TG,LDL-C,AIP,BAR and AC（P < 0.01）.2)Independent correlation analysis based on multiple stepwise linear regression showed that AIP（β = 0.020,P < 0.05）and BAR（β = 0.015,P < 0.01）were independently correlated with BMI.AIP（β = 1.176,P < 0.01）was independently correlated with WHR.AIP（β = 1.575,P < 0.01）,BAR（β = 0.661,P< 0.05）and AC（β = 0.427,P < 0.05）were independently correlated with WHt R.3)Canonical correlation analysis showed that there was a significant overall correlation between physical indexes and atherogenic indexes（P < 0.001）.4)ROC curve analysis showed that the area under ROC（AUC）of overweight corresponding to AIP,BAR and AC were 0.695（95% CI = 0.593-0.797,P < 0.01）and 0.660（95%CI =0.555-0.766,respectively.P < 0.01）and 0.632（95% CI = 0.525-0.740,P < 0.05）,the AUC corresponding to AIP,BAR and AC were 0.757（95% CI = 0.656-0.857,P< 0.001）,0.654（95% CI = 0.536-0.771,P < 0.05）and 0.651（95% CI = 0.538-0.764,P < 0.05）;The AUC of AIP risk corresponding to BMI,WHR and WHt R was 0.709（95% CI = 0.608-0.811,P < 0.001）,0.773（95% CI = 0.678-0.867,P < 0.001）,and0.739（95% CI = 0.641-0.836,P < 0.001）,respectively;AUC corresponding to BMI,WHR and WHt R were 0.691（95% CI = 0.585-0.797,P < 0.01）and 0.734（95% CI =0.632-0.835,P < 0.001）,0.706（95% CI = 0.603-0.810,P < 0.01）,respectively.Conclusion: BMI,WHR and WHt R in FH patients were significantly correlated with AIP,BAR and AC.There was an independent positive linear correlation between AIP and FH patients’ physique indexes.AIP exhibited well predictive performance for overweight and obesity in FH patients,and WHR exhibited well identification performance for intermediate-risk and high-risk in AIP in patients with FH.