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. 2024 Oct 15;13(20):e035764.
doi: 10.1161/JAHA.124.035764. Epub 2024 Oct 11.

Intraindividual Discordance Between Remnant Cholesterol and Low-Density Lipoprotein Cholesterol Associated With Incident Stroke: Results From 2 National Cohorts

Cancan Cui  1 , Pingan Li  2 , Yitian Qi  1 , Jiayin Song  1 , Tianjiao Han  1 , Xinyun Shang  1 , Lois Balmer  3 , Chen Sheng  4 , Yining Zha  4 , Zhonghang Xu  1 , Xu Wang  1 , Zhiyuan Wu  3   4
Affiliations

Intraindividual Discordance Between Remnant Cholesterol and Low-Density Lipoprotein Cholesterol Associated With Incident Stroke: Results From 2 National Cohorts

Cancan Cui et al. J Am Heart Assoc. .

Abstract

Background: The atherogenic effect of remnant cholesterol is being increasingly acknowledged. This study aimed to explore the association of discordance between remnant cholesterol and low-density lipoprotein cholesterol with stroke onset using 2 Chinese national cohorts.

Methods and results: We studied 11 139 participants from CHARLS (China Health and Retirement Longitudinal Study) and 5993 participants from CHNS (China Health and Nutrition Survey) aged 45 years or older. The discordance between remnant cholesterol and low-density lipoprotein cholesterol was defined using the difference in percentile units (>15 units). There were 988 (8.9%) and 128 (2.1%) stroke events reported during follow-up in the 2 cohorts. Elevated remnant cholesterol was significantly associated with a higher risk of total stroke in 2 cohorts. After adjusting for remnant cholesterol level, the discordantly high remnant cholesterol group was significantly associated with an increased stroke risk (CHARLS: subdistribution hazard ratio [sHR], 1.31 [95 CI, 1.10-1.55]; CHNS: sHR, 1.84 [95 CI, 1.15-3.08]) compared with the discordantly low group. Consistent results were shown even among those with optimal low-density lipoprotein cholesterol level.

Conclusions: The discordance between remnant cholesterol and low-density lipoprotein cholesterol, representing the intraindividual discrepancy, is significantly associated with stroke onset among Chinese adults.

Keywords: LDL‐C; discordance analysis; remnant cholesterol; stroke.

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Figures

Figure 1
Figure 1. The distribution of remnant cholesterol based on incident stroke status among participants from CHNS (A) and CHARLS (B).
CHNS indicates China Health and Nutrition Survey; and CHARLS, China Health and Retirement Longitudinal Study.
Figure 2
Figure 2. Dose–response relationship of the discordance between remnant cholesterol and LDL‐C with stroke onset.
A, CHNS, China Health and Nutrition Survey; B, CHARLS, China Health and Retirement Longitudinal Study; LDL‐C, low‐density lipoprotein cholesterol.
See this image and copyright information in PMC

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