Frontiers in Cardiovascular Medicine (Nov 2023)

Association of remnant cholesterol with CVD incidence: a general population cohort study in Southwest China

  • Chengxi Liu,
  • Chengxi Liu,
  • Mi Dai,
  • Kunming Tian,
  • Kunming Tian,
  • Shiyu Zhou,
  • Lei Luo,
  • Zhiying Zeng,
  • Xuelian Yan,
  • Ying Xiao,
  • Yiying Wang,
  • Renli Deng,
  • Xiuhong Lei,
  • Tao Liu

DOI
https://doi.org/10.3389/fcvm.2023.1286286
Journal volume & issue
Vol. 10

Abstract

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BackgroundEmerging evidence has indicated that remnant cholesterol (RC) could predict cardiovascular disease (CVD) incidence. Nevertheless, the relationship between RC and CVD risk, especially within the general Chinese population, remains scarce.ObjectiveThe present research aimed to assess whether RC concentrations and CVD outcomes in general Chinese adults are related.MethodsThe Cox proportional hazard model was established to explore the relationship between RC and the outcomes of CVD and CVD subgroups. A restricted cubic spline (RCS) was utilized to investigate the dose–response connection between RC and the risk of CVD outcomes, and the ROC curve was used to calculate the corresponding cutoff values. Moreover, stratified analysis was conducted to investigate the potential effect modification in the association between RC and CVD outcomes.ResultsSignificant positive associations were found between elevated categorical RC and increased risk of CVD (HR Q4, 1.80; 95% CI 1.15–2.79; P-value = 0.008), atherosclerotic cardiovascular disease (HR Q4, 2.00; 95% CI 1.22–3.27; P-value = 0.007), stroke (HR Q4, 1.66; 95% CI 1.02–2.69; P-value = 0.040), and ischemic stroke (HR Q4, 1.87, 95% CI 1.08–3.25; P-value = 0.034), respectively. Our study suggested that the incidence of CVD outcomes increased when RC levels were above 0.75 mmol/L. Importantly, the CVD risks related to RC were more likely to be those found in subjects aged above 60 years, women, subjects with BMI <24 kg/m2, and subjects with hypertension and unhealthy diet patterns.ConclusionsAberrant high level of RC is associated with elevated CVD risk, independent of low-density lipoprotein cholesterol (LDL-C). Our data reveal urgent primary prevention for subjects with high RC levels to a low incidence of CVD, especially for the elderly, women, and those with hypertension and unhealthy diet patterns.

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