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Observational Study
. 2024 Jun 24;24(1):318.
doi: 10.1186/s12872-024-03977-x.

The association of cumulative low-density lipoprotein cholesterol exposure and carotid intima-media thickness in a young adulthood population

Wei Huang  1 , Weiqi Nie  2 , Jianqiu Zhao  3 , Zhihui Fan  1 , Dan Wang  1 , Xia Wu  1 , Yujing Hao  1 , Shouling Wu  4
Affiliations
Observational Study

The association of cumulative low-density lipoprotein cholesterol exposure and carotid intima-media thickness in a young adulthood population

Wei Huang et al. BMC Cardiovasc Disord. .

Abstract

Objective: To investigate the association between cumulative exposure to low-density lipoprotein cholesterol (LDL-C) and carotid intima-media thickness (IMT) in the young adulthood population.

Methods: Young adult subject (18-45 year old) from the Kailuan Study group who participated in the same period of follow-up and received carotid artery ultrasound were selected as the observation subjects. Among them, 3651 cases met the inclusion criteria, which required that carotid artery color ultrasound examinations be completed from 2010 to 2016, with complete IMT measurements, LDL-C data collected at least twice before carotid ultrasound, and participants' age to be ≤ 45 years at the time of carotid artery color ultrasound examination. Linear regression was used to analyze the correlation between time-weighted average (TWA) to LDL-C cumulative exposure and IMT the young population. Logistic regression was used to analyze the effects of different TWA groups on IMT thickening. Considering that the use of anti hypertensive drugs and lipid-lowering drugs may affect TWA LDL-C, this study excluded people taking antihypertensive drugs and lipid-lowering drugs, and conducted a repeat analysis of the main results.

Results: There was a positive correlation between TWA LDL-C and IMT, with IMT increasing by 0.017 mm when TWA LDL-C increased by 1 mmol/L * year. The TWA LDL-C in the highest group was identified as a risk factor for IMT thickening, with odds ratio (OR) values of 1.812(1.027 ~ 3.200) in the T3 group. After excluding patients taking antihypertensive drugs and lipid-lowering drugs, the results still showed that the T3 group with the highest TWA LDL-C was a risk factor for IMT thickening, with an OR value of 1.850(0.988-3.464), P for trend is 0.043.

Conclusion: This cohort study revealed that TWA LDL-C is positively correlated with IMT in young adulthood for risk stratification, and control LDL-C levels at an earlier age may reduce the lifetime risk of developing atherosclerotic disease.

Trial registration: ChiCTR-TNC-11001489.

Keywords: Atherosclerotic cardiovascular disease; Carotid diamantine thickness; Low density lipoprotein cholesterol cumulative exposure; Time-weighted average; Young adulthood population.

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Conflict of interest statement

The authors declare no competing interests.

Figures

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Fig. 1
Flowchart of the study participants
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