Usefulness of Low-Density Lipoprotein Cholesterol and Non–High-Density Lipoprotein Cholesterol as Predictors of Cardiovascular Disease in Chinese

The predictive effect of non–high-density lipoprotein cholesterol (non-HDL-C) for cardiovascular disease (CVD) in Chinese general population has not been well demonstrated. The aim of our study was to examine the relation between non-HDL-C and CVD and compare the predictive effect of non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for CVD in Chinese population. The baseline examination of 27,020 participants aged 35 to 74 years from the China Cardiovascular Health Study and the China Multicenter Collaborative Study of Cardiovascular Epidemiology was conducted in 1998 to 2001. Follow-up evaluation was conducted in 2007 to 2008 with a response rate of 79.8%. Cox proportional hazards regression models were used to obtain the multivariable-adjusted hazard ratios and 95% confidence intervals (CIs) for CVD. Compared with those with non-HDL-C level of <130 mg/dl, multivariable-adjusted hazard ratios of CVD were 1.30 (95% CI 1.04 to 1.62) and 1.93 (95% CI 1.50 to 2.47) in participants with non-HDL-C levels of 160 to 189.9 and ≥190 mg/dl, respectively. An increase of 30 mg/dl in non-HDL-C level would correspond to 15%, 24%, and 12% increase in risk of CVD, coronary heart disease, and stroke, respectively. Using likelihood ratio tests, non-HDL-C appeared to be a similar predictor for CVD incidence as LDL-C (chi-square for non-HDL-C, 18.02, p <0.001; chi-square for LDL-C, 18.90, p <0.001). In conclusion, higher non-HDL-C level is associated with the increased CVD incidence and has a similar effect as LDL-C on predicting CVD risk in Chinese.