Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：frontiers in neurology

Publication type: Original Articles

IF(IF): 4.003

PMID: 34744959 Link To Pubmed Full text Download

Peripheral artery disease (PAD) is a common atherosclerotic disease which could lead to severe cardiovascular and cerebrovascular events[1-3]. There is evidence that PAD patients exert worse lipid profile as compared to those without PAD. Non-high-density lipoprotein cholesterol (non-HDLC) contains all atherogenic lipoproteins, including low-density lipoprotein (LDL-C), inter-mediate-density lipoprotein, very-low-density lipoprotein and lipoprotein(a), it has a strong correlation with the process of atherosclerosis[4]. Cumulative effect of lipid carrying lipoproteins on the risk of cardiovascular disease was described by JACC Health Promotion Series, measured in either mg-years (age* non-HDLC measured in mg/dl) or mmol- years (age* non-HDLC measured in mg/dl)[5]. We should not only focus on the absolute value of risk factors at a certain timing, but also pay attention to the cumulative impact of these risk factors with the extension of time. Futhermore, it is unknown whether the burden of non-HDLC can predict new occurrence of peripheral artery disease. We aim to explore the association between cumulative exposure to non-HDLC and new occurrence of peripheral artery disease.

Pressures in each leg were determined and the ABI was calculated separately for each leg. An ABI < 0.90 in either leg was considered as marker for the presence of a PAD, and an ABI ≥ 0.90 was considered normal. Elevated ABI values of ≥1.40 suggested poorly compressible leg arteries and were excluded. We measured the ABI both at baseline and first follow-up visit to defined the disease of PAD among participants. LDL-C burden2006-2008=[( LDL-C 2006-5.2) + (LDL-C 2008-5.2)]/2*time2006-2008 non-HDLC burden2006-2008 = (non-HDLC2006 + non-HDLC2008)/2*time2006-2008 （LDL-C or non-HDLC）burden2006-2012=（LDL-C or non-HDLC）burden2006-2008+ （LDL-C or non-HDLC）burden2008-2010+（LDL-C or non-HDLC）burden2010-2012 The association between cumulative exposure to non-HDLC and new occurrence of PAD was investigated with logistic regression by adjusting for different cardiovascular risk factors. LDL-C burden and non-HDLC burden from 2006 to 2012 were all divided into four groups according to their quartiles, the lowest quartile was defined as the reference group. Univariate and multivariate analysis were described by odds ratios (ORs) and 95% confidence interval (CI). Sensitivity analysis was also performed to test whether the results would change after excluding participants aged over 65 years old or with history of hypertension, diabetes mellites and hyperlipidemia. Additionally, gender and other potential indicators were also evaluated in subgroups, to assess if there was any significant interaction between these variables and the relationship between non-HDLC and new occurrence of PAD.