Long-term coronary heart disease risk associated with very-low-density lipoprotein cholesterol in Chinese: The results of a 15-Year Chinese Multi-Provincial Cohort Study (CMCS)
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Abstract
Few studies have examined very-low-density lipoprotein (VLDL) cholesterol as an independent
risk factor of coronary heart disease (CHD) or its combined effects with coexisting
cardiac risk factors. The current study examined the association between VLDL cholesterol
and the risk of future CHD events.
This study reports the association of VLDL cholesterol level and long-term CHD risk,
as well as the combined effects of VLDL cholesterol and LDL cholesterol with other
cardiovascular disease (CVD) risk factors. The cohort comprises 30,378 participants
aged 35-64 years from 11 Chinese provinces. All participants were followed up annually
until 2007. We found 20% of the sample population had elevated VLDL cholesterol>or=30
mg/dL. Elevated VLDL cholesterol levels were found to increase CHD risk by 2.19-3.36-fold
in people with LDL cholesterol within the normal range and presenting no other major
risk factors. This effect was exacerbated in those with elevated LDL cholesterol levels,
and further increased CHD risk in those displaying three or more risk factors. The
population-attributable risk proportion (PAR%) of CHD associated with VLDL cholesterol
was calculated to be 17.3%, higher than that associated with LDL cholesterol alone.
In a large Chinese cohort, elevated VLDL cholesterol was found to be significantly
associated with elevated CHD risk, similar to that observed with LDL cholesterol.
CHD risk was further amplified when elevated VLDL cholesterol was combined with elevated
LDL cholesterol and/or the presence of major CVD risk factors.
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