Lipid assessment, metabolic syndrome and coronary heart disease risk

P>Background Although the total to high-density lipoprotein cholesterol ratio (TC/HDL-C) has been used for decades to identify individuals at risk for coronary heart disease (CHD), apolipoprotein-based (apolipoprotein B/apolipoprotein A-I [apoB/apoA-I]) and nuclear magnetic resonance spectroscopy (NMR)-based lipoprotein concentrations (low-density lipoprotein(NMR)/high-density lipoprotein(NMR) [LDL(NMR)/HDL(NMR)]) may also be useful for CHD risk stratification. Materials and methods In a case-control study conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study population, 870 individuals who developed CHD during a 6-year follow-up were matched to 1659 controls on the basis of gender, age and enrolment time. LDL(NMR) and HDL(NMR) were measured by proton NMR spectroscopy. Results After adjusting for traditional CHD risk factors, men in the top quintile of the various lipoprotein ratios proved to be at increased CHD risk (OR = 2 center dot 59 [95% IC, 1 center dot 76-3 center dot 83] for TC/HDL-C ratio, 2 center dot 59 [1 center dot 75-3 center dot 83] for apoB/apoA-I ratio and 2 center dot 78 [1 center dot 86-4 center dot 17] for LDL(NMR)/HDL(NMR) ratio) compared with men in the bottom quintile. Similar associations were observed in women (OR = 2 center dot 86 [1 center dot 71-4 center dot 80] for TC/HDL-C ratio, 2 center dot 94 [1 center dot 74-4 center dot 97] for apoB/apoA-I ratio and 2 center dot 03 [1 center dot 21-3 center dot 43] for LDL(NMR)/HDL(NMR) ratio). Compared with participants with only one component of the metabolic syndrome, those who had five had an increased TC/HDL-C ratio (73 center dot 0% and 80 center dot 4% in men and women respectively), apoB/apoA-I ratio (58 center dot 0% and 62 center dot 9% in men and women respectively) and for LDL(NMR)/HDL(NMR) ratio (52 center dot 6% and 54 center dot 1% in men and women respectively). Conclusion In this European study population, the TC/HDL-C, apoB/apoA-I and LDL(NMR)/HDL(NMR) ratios were similarly associated with components of the metabolic syndrome and CHD risk.