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Measurement of HDL, apolipoproteins sufficient to characterize vascular risk
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The association between blood lipids and vascular disease can be assessed without the need for fasting or the consideration of triglyceride levels, according to study results.
Researchers examined records on 302,430 individuals without initial vascular disease from 68 long-term prospective studies. During the 2.79 million person-years of follow-up, there were 3,928 CHD deaths, 8,857 nonfatal MI, 2,534 ischemic strokes, 513 hemorrhagic strokes and 2,536 unclassified strokes. The researchers then calculated HRs for 1-SD higher values for triglycerides, HDL, non-HDL, apolipoprotein A-I, ApoB and LDL.
Adjusted HRs for CHD were 0.99 (95% CI, 0.94-1.05) with triglycerides, 0.78 (95% CI, 0.74-0.82) with HDL and 1.50 (95% CI, 1.39-1.61) with non-HDL. The researchers also reported that HRs were at least as strong in those patients who fasted vs. those who did not fast. In the subset with apolipoproteins or directly measured LDL levels, the HR was 1.50 (95% CI, 1.38-1.62) with the ratio of non-HDL to HDL. The HR for ApoB to ApoA-I was 1.49 (95% CI, 1.39-1.60), 1.42 (95% CI, 1.06-1.91) with non-HDL and 1.38 (95% CI, 1.09-1.73) with directly measured LDL.
“Lipid assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride,” the researchers concluded.
Danesh J. JAMA. 2009;302:1993-2000.