Abstract:Aim To investigate the effect of cumulative non-high density lipoprotein cholesterol/high density lipoprotein cholesterol (non-HDLC/HDLC) exposure on atherosclerotic cardiovascular disease(ASCVD). Methods A prospective cohort study was conducted. A total of 50 777 employees of Kailuan Group who participated in three physical examinations in 2006—7,8—2009 and 2010—2011 were selected as the study subjects. Groups were divided into Q1, Q2, Q3 and Q4 according to the cumulative non-HDLC/HDLC exposure quartiles. Kaplan-Meier curve was used to calculate the cumulative incidence of ASCVD in different cumulative non-HDLC/HDLC groups, and Log-rank test was used to compare the differences among groups. Cox proportional risk model was used to analyze the effect of cumulative non-HDLC/HDLC exposure on ASCVD. Results The average follow-up was (10.19±2.21) years, and 5 003 new cases of ASCVD occurred. The cumulative incidence of ASCVD in groups Q1 to Q4 was 6.49%, 8.71%, 10.86% and 14.85%, respectively(Log-rank P＜0.01). Multivariate Cox regression analysis showed that compared with group Q1, the HR(95%CI) of ASCVD in groups Q2, Q3 and Q4 were 1.13(1.03～1.24), 1.18(1.07～1.29), 1.22(1.12～1.34), respectively; the HR(95%CI) of myocardial infarction were 1.15(0.87～1.53), 1.44(1.10～1.88), 1.67 (1.29～2.17), respectively; the HR(95%CI) of revascularization were 1.21 (0.99～1.49), 1.31 (1.07～1.60) and 1.49(1.22～1.81), respectively; the HR(95%CI) of ischemic stroke were 1.17 (1.03～1.32), 1.17 (1.04～1.33) and 1.21 (1.06～1.37), respectively; but the above association was not found when heart failure and atrial fibrillation were used as the outcome events. The restricted cubic spline showed that cumulative non-HDLC/HDLC values were linearly associated with the risk of ASCVD. Conclusion Cumulative non-HDLC/HDLC exposure was positively associated with the risk of ASCVD.

Abstract:Aim To explore the serum non-high density lipoprotein cholesterol (non-HDLC) level in patients with depression and analyze the related factors. Methods 150 depression patients were tested in Affiliated Kailuan Mental Health Center, North China University of Science and Technology from June 2014 to November 2015, testing the total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), and measuring the depressive symptoms through the self-rating depression scale (SDS). Using SPSS 17.0 software, the data was tested by independent sample t test, single factor variance analysis, partial correlation analysis and stepwise multiple regression analysis. Results There was statistical significance about differences between depression and healthy people on the serum non-HDLC level (P＜0.05). There was statistical significance about the differences on the serum non-HDLC level of depression in different gender, age, education level and depression severity (P＜0.05). After controlling the gender, age and education level, the standard score of SDS in depression had a significantly negative correlation with the TC, TG, LDLC and non-HDLC level (P＜0.05). The standard score of SDS in depression had significantly negative predictive power on the non-HDLC level (β＝－0.682, P＜0.05). Conclusion Depression is related to the non-HDLC level, and the risk and mechanism of cardiovascular disease in patients with depressive disorder should be paid attention to.

Abstract:Aim The purpose of this study was to explore the influence of serum non-high-density lipoprotein cholesterol (non-HDLC) on neurologic impairment in patients with acute ischemic stroke and its clinical value in disease risk assessment. Methods A total of 611 cases of acute ischemic stroke patients were recruited in this study. NIHSS(National Institute of Health stroke scale), CSS(China Stroke scale), ESS(Europe Stroke Scale) and BI(Barthel Index) were used to evaluate the degree of neurologic impairments. Fasting plasma glucose(FPG), hypersensitive c-reactive protein(hs-CRP), glycosylated hemoglobin (HbA1c), homocysteine (Hcy), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDLC) and low density lipoprotein cholesterol (LDLC) were measured in all the patients. Then the density of non-HDLC were calculated with the formula of TC minus HDLC. Results Patients with high level of serum non-HDLC had bigger body mass index, higher NIHSS, CSS and BI scores, lower ESS and elevated TC, TG, LDLC, Hcy, FPG, HbA1c, lower HDLC levels. The NIHSS scores changed corresponding with serum non-HDLC level in acute ischemic stroke patients, the total scores of NIHSS, CSS were positively correlated with the serum non-HDLC level, and the total scores of ESS, and BI were negatively correlated with it. High serum level of non-HDLC was an independent risk factor for neurologic impairment in patients with acute ischemic stroke, when serum non-HDLC elevated to borderline high level, the risk of neurologic impairment significantly increased. Conclusion Increased serum non-HDLC level was an independent risk factor of neurologic impairment in patients with acute cerebral ischemia, it would be an effective indicator, and target of the prevention and treatment as well, of risk prediction for neurologic impairment in patients with acute cerebral ischemia.

Abstract:Aim To investigate the correlation between non-high density lipoprotein cholesterol level and severity coronary heart disease(CHD). Methods 522 cases of coronary angiography were retrospectively analyzed, according to the results of coronary angiography combined with clinical features, electrocardiogram and myocardial enzyme, which were divided into non-CHD group, angina pectoris group, myocardial infarction group. The average age is 60.00±10.02 years. Gensini score was used to evaluate the degree of coronary artery lesions in patients with coronary heart disease, the clinical data of all patients were collected, and the serum lipid levels were measured and non-high density lipoprotein cholesterol was calculated. The correlation between non-high density lipoprotein cholesterol and coronary heart disease was analyzed. Results Gensini levels had statistically significant differences in the three groups (P<0.05); In angina pectoris group, non-high density lipoprotein cholesterol level and Gensini score are positively correlated (r=0.130, P=0.022); In myocardial infarction group, non-high density lipoprotein cholesterol level and Gensini score are positively correlated (r=0.213, P=0.048); Logistic regression analysis showed that age, gender and non high density lipoprotein cholesterol level were risk factors for coronary heart disease (P<0.05). Conclusion Non-high density lipoprotein cholesterol is an important index to reflect the condition of patients with coronary heart disease.

Abstract:Aim To evaluate the relation between non-high density lipoprotein cholesterol （non-HDLC）/HDLC and early carotid plaque in type 2 diabetes patients. Methods 1021 type 2 diabetes patients without history of cardiovascular disease were retrospectively analyzed. Carotid plaque and plaque area were measured by B ultrasound. The general data, duration of diabetes, glycosylated hemoglobin, low density lipoprotein cholesterol （LDLC）, HDLC, non-HDLC and the lipid ratios were compared in the group with carotid plaques and without plaques. The relation between serum lipid parameters and carotid artery plaque was analysed. The prediction power of the lipid parameters on carotid artery plaque were analysed by receiver operating characteristic curve （ ROC ）. In the group with carotid plaques, the correlation of the lipid parameters and plaque area were anayzed. Results The male ratio, age, duration of diabetes, systolic blood pressure, non-HDLC levels, non-HDL/HDLC, total cholesterol（TC）/HDLC and LDLC/HDLC were significantly higher in the group with paques than the group without plaques. However, the HDLC level was significantly lower in the group with plaques than the group without plaques. The difference of the above was statistically significant （P<0.05）. Logistc regression analysis showed that non-HDLC levels, non-HDLC/HDLC, TC/HDLC and LDLC/HDLC were independent risk factors for carotid plaque （P<0.05）. There were no correlation between LDLC levels and carotid plaques after adjustment for confounding factors. The area under ROC curve of non-HDLC/HDLC and other lipid parameters were compared: non-HDLC/HDLC was higher than that of LDLC/HDLC, TC/HDLC, but the difference was close to statistical significance （P0.052 and 0.058）. Non-HDLC/HDLC was significantly higher than that of HDLC and LDLC （P<0.001）. In the group with plaques, multiple regression analysis showed non-HDLC/HDLC and LDLC/HDLC were the independent impact factors （P<0.05） for plaque area. Non-HDLC and TC/HDLC were in no correlation with plaque area after adjusting for confoundings. Conclusion Non-HDLC/HDLC is a useful lipid parameter to assess the risk of early carotid plaque and plaque area in type 2 diabetes.

Abstract:Aim Except high density lipoprotein cholesterol(HDLC), all the atherogenic lipoprotein cholesterol [including Iow density lipoprotein cholesterol (LDLC), cholesterol of lipoprotein riched triglycerides(TG) and lipoprotein (a) cholesterol] are included in the non-HDLC, which can be used in prediction of the atherogenic cardio vascular risk and as secondary target of lipid lowering therapy. The non-HDLC level can be simply estimated by subtract HDLC from total cholesterol(TC). This study was to provide the reference values and its distribution of serum non-HDLC data of Beijing populations. Methods 28 161 Beijing institutional employees (including those retired, but physical workers were excluded), male/female 6∶4, aged 20～85 years were enrolled in this study. All the subjects participated regular physical examination and well standardized lipid analysis with fasting blood samples (including TC, HDLC and TG. LDLC was calculated by Friedewald formula). Results Non-HDLC levels elevated gradually with increase in age. Male groups had higher average non-HDLC than female groups before age 50, but it was reversed due to much more increase in non-HDLC levels in women after age 50. Age adjusted mean non-HDLC were 3.47 mmol/L in men and 3.29 mmol/L in women. However, in the elderly men and women, the corresponding mean levels were 3.90 and 4.21 mmol/L respectively. It was supposed that the cutoff point of normal TG is 1.7 mmol/L, then the non-HDLC should be 0.77 mmol/L higher then LDLC at that point. But the TG level of most subjects in this study were lower then 1.7 mmol/L, the differences in the level between non-HDLC and LDLC were more or less lower then 0.77 mmol/L in different age groups, the non-HDLC level in this study was 20% lower than the report of Third National Health and Nutrition Examination Survey of US. It indicates that the atherogenic cardiovascular risk is much lower in the subjects of this studied group. Conclusion In the case of higher TG levels (>2.3 mmol/L), non-HDLC will better represent the concentrations of all atherogenics lipoproteins then LDLC alone. The method of non-HDLC estimation is simple and accurate.