Target non-HDL cholesterol for atherosclerosis prevention
MedWire News: Physical activity and levels of non-high-density (HDL) lipoprotein cholesterol each independently predict subclinical atherosclerosis in healthy middle-aged men, data from a cross-sectional study suggest.
The men were participating in the Prospective Army Coronary Calcium (PACC) project, which is following up 1639 active-duty army personnel aged 40-50 years. They were healthy at baseline in 1998-2003 and underwent electron-beam computed tomography as part of comprehensive evaluation of cardiovascular risk.
The men's mean age at baseline was 42.9 years, 71.7% were White, and the mean 10-year Framingham score was 4.6% (range 0.5-22.0%), indicating a low risk for coronary heart disease.
Coronary artery calcium (CAC) - considered a surrogate for subclinical atherosclerosis - was detected in 22.4% of participants and the mean CAC score was 20, report Allen Taylor (Georgetown University, Washington, DC, USA) and fellow researchers in the Journal of Clinical Lipidology.
With regard to lipid levels, mean low-density lipoprotein (LDL) cholesterol was 128 mg/dL, mean HDL cholesterol was 50 mg/dL, mean triglycerides were 130 mg/dL, and mean non-HDL cholesterol was 154 mg/dL.
Interestingly, men with CAC had significantly higher levels of LDL cholesterol, triglycerides, and non-HDL cholesterol than those without, at 135 versus 127 mg/dL, 148 versus 124 mg/dL, and 164 versus 151 mg/dL, respectively.
Men with CAC also reported significantly less habitual physical activity than those without CAC, as indicated by Baecke Sport Index scores of 2.9 versus 3.1.
Multivariate logistic regression analysis identified just two baseline variables that were significantly and independently associated with the presence of CAC: non-HDL cholesterol and age, at odds ratios of 1.012 per mg/dL and 1.119 per year, respectively.
In addition, exercise was significantly and independently associated with the absence of CAC, at an odds ratio of 0.808.
Taylor and co-authors say their findings support guideline recommendations on non-HDL cholesterol as a secondary target of lipid-lowering therapy.
"Targeting non-HDL cholesterol even at lower triglyceride concentrations deserves further study as a method to treat atherosclerosis and its attendant cardiovascular risk," they conclude.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Joanna Lyford