Low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol and the incidence of cardiovascular disease in an urban Japanese cohort study: The Suita study

• Published in: Atherosclerosis Vol. 203; no. 2; pp. 587 - 592
• Main Authors: Okamura, Tomonori, Kokubo, Yoshihiro, Watanabe, Makoto, Higashiyama, Aya, Miyamoto, Yoshihiro, Yoshimasa, Yasunao, Okayama, Akira
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.04.2009; Elsevier
• Subjects: Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood. Blood coagulation. Reticuloendothelial system; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cholesterol - blood; Cholesterol, LDL - blood; Cohort Studies; Female; Humans; Incidence; Japan; Low-density lipoprotein cholesterol; Male; Medical sciences; Middle Aged; Myocardial infarction; Non-high-density lipoprotein cholesterol; Pharmacology. Drug treatments; Predictive Value of Tests; Risk; Stroke; Urban Population; Japan; Myocardial infarction; Stroke; Non-high-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; Cohort studies; Nervous system diseases; Lipids; Cardiovascular disease; Urban area; Lipoprotein; Coronary heart disease; Myocardial disease; Japanese; Cholesterol; Cerebral disorder; Incidence; Vascular disease; Cohort study; Central nervous system disease; Atherosclerosis; Cerebrovascular disease
• ISSN: 0021-9150; 1879-1484; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2008.07.020

Only a small number of population-based cohort studies have directly compared the predictive value of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDLC) for coronary artery disease in Asian populations, such as Japan. We performed an 11.9-year cohort study of 4694 men and women, aged 30–74 years, selected randomly from an urban general population in Japan. Baseline LDL-C levels were estimated using the Friedewald formula. The predictive values of LDL-C and non-HDLC for myocardial infarction (MI) and stroke were compared. During the follow-up period, there were 80 incident cases of MI and 139 of stoke, comprised of 23 intracerebral hemorrhages, 85 cerebral infarctions and 31 other types of stroke. The Hazard ratio (HR) for MI was highest in the top quintile of LDL-C (HR: 3.03, 95% CI, 1.32–6.96) when male and female data were combined. The HR for MI was also highest in the top quintile of non-HDLC (HR: 2.97, 95% CI, 1.26–6.97). Analysis of trends showed a significant positive relationship between MI incidence and serum LDL-C and non-HDLC levels (both P = 0.02). However, there was no relationship between the incidence of any subtype of stroke and either LDL-C or non-HDLC. The predictive value of LDL-C and non-HDLC for MI, assessed by calculating the differences in the −2 logarithm likelihood (−2 ln [L]) and area under the curve (AUC), were almost similar.