Nonlinear connection between remnant cholesterol and stroke risk: evidence from the China health and retirement longitudinal study

• Published in: Lipids in health and disease Vol. 22; no. 1; pp. 1 - 12
• Main Authors: Wang, Yuanqing, Zha, Fubing, Han, Yong, Cai, Ying, Chen, Miaoling, Yang, Cui, Cai, Xiaodong, Hu, Haofei, Cao, Changchun, Luo, Jiao
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 25.10.2023; BioMed Central; BMC
• Subjects: Age; Alcoholic beverages; Blood cholesterol; Blood pressure; Cardiovascular disease; Cholesterol; Diabetes; Exercise; Gender; Generalized additive model; Health aspects; Heart; Hypertension; Lipids; Lipoproteins; Longitudinal studies; Measurement; Medicine, Chinese; Missing data; Mortality; Nonlinear relationship; Physiological aspects; Prevention; Remnant cholesterol; Retirement; Retirement age; Risk factors; Sensitivity analysis; Smoothed curve fitting; Stroke; Stroke (Disease); Variables; China
• ISSN: 1476-511X; 1476-511X
• DOI: 10.1186/s12944-023-01943-8

Objective The evidence on the relationship between remnant cholesterol (RC) and stroke remains controversial. Therefore, this study aimed to explore the relationship between RC and stroke risk in a Chinese population of middle-aged and elderly individuals. Methods The present study included 10067 Chinese subjects of middle-aged and elderly individuals. The connection between RC and incident stroke was investigated using the multivariate Cox proportional hazards regression model, several sensitivity analyses, generalized additive models, and smoothed curve fitting. Results A total of 1180 participants with stroke were recorded during the follow-up period. The multivariate Cox proportional hazards regression model identified a positive connection between RC and stroke risk (hazard ratio (HR) = 1.087, 95% confidence interval (CI): 1.001-1.180). In addition, the current study discovered a nonlinear connection between RC and incident stroke, and the point of inflection for RC was 1.78 mmol/L. The risk of stroke increased by 25.1% with each unit increase in RC level when RC was < 1.78 mmol/L (HR:1.251, 95%CI: 1.089-1.437, P = 0.0015). The results were not affected by sensitivity tests. Conclusion The current study showed a positive and nonlinear connection between RC and stroke risk in a middle-aged and elderly Chinese population. These findings provided new information to help researchers better understand the relationship between RC levels and incident stroke. Keywords: Stroke, Remnant cholesterol, Nonlinear relationship, Generalized additive model, Smoothed curve fitting