Affiliation:
1. Vanderbilt Epidemiology Center and Division of Epidemiology Department of Medicine Vanderbilt University Medical Center Nashville TN USA
2. Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital Sichuan University Chengdu Sichuan China
3. Department of Chemistry and Center for Structural Biology Vanderbilt University Nashville TN USA
4. Vanderbilt Translational and Clinical Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA
Abstract
Background
Comprehensive blood lipoprotein profiles and their association with incident coronary heart disease (CHD) among racially and geographically diverse populations remain understudied.
Methods and Results
We conducted nested case–control studies of CHD among 3438 individuals (1719 pairs), including 1084 White Americans (542 pairs), 1244 Black Americans (622 pairs), and 1110 Chinese adults (555 pairs). We examined 36 plasma lipids, lipoproteins, and apolipoproteins, measured by nuclear magnetic resonance spectroscopy, with incident CHD among all participants and subgroups by demographics, lifestyle, and metabolic health status using conditional or unconditional logistic regression adjusted for potential confounders. Conventionally measured blood lipids, that is, total cholesterol, triglycerides, low‐density lipoprotein‐cholesterol, and high‐density lipoprotein‐cholesterol, were each associated with incident CHD, with odds ratios (ORs) being 1.33, 1.32, 1.24, and 0.79 per 1‐SD increase among all participants. Seventeen lipoprotein biomarkers showed numerically stronger associations than conventional lipids, with ORs per 1‐SD among all participants ranging from 1.35 to 1.57 and a negative OR of 0.78 (all false discovery rate <0.05), including apolipoprotein B100 to apolipoprotein A1 ratio (OR, 1.57 [95% CI, 1.45–1.7]), low‐density lipoprotein‐triglycerides (OR, 1.55 [95% CI, 1.43–1.69]), and apolipoprotein B (OR, 1.49 [95% CI, 1.37–1.62]). All these associations were significant and consistent across racial groups and other subgroups defined by age, sex, smoking, obesity, and metabolic health status, including individuals with normal levels of conventionally measured lipids.
Conclusions
Our study highlighted several lipoprotein biomarkers, including apolipoprotein B/ apolipoprotein A1 ratio, apolipoprotein B, and low‐density lipoprotein‐triglycerides, strongly and consistently associated with incident CHD. Our results suggest that comprehensive lipoprotein measures may complement the standard lipid panel to inform CHD risk among diverse populations.
Publisher
Ovid Technologies (Wolters Kluwer Health)