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Atherosclerosis. 2014 Jan;232(1):65-71. doi: 10.1016/j.atherosclerosis.2013.10.011. Epub 2013 Oct 26.

HDL-C, triglycerides and carotid IMT: a meta-analysis of 21,000 patients with automated edge detection IMT measurement.

Author information

1
From INSERM U 698, Paris, France; Paris Diderot - Sorbonne Paris City University, Paris, France; Department of Neurology and Stroke Centre, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: pjtw@Noos.Pa.
2
From INSERM U 698, Paris, France; Department of Neurology and Stroke Centre, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.
3
Department of Endocrinology, Pitié-Salpêtrière University Hospital, Pierre and Marie Curie University, Paris, France.
4
Department of Cardiology, Buenos Aires Italian Hospital, Buenos Aires, Argentina.
5
Department of Neurology, "Gervasutta" Hospital ASS 4, Udine, Italy.
6
Department of Hematology, S. Bortolo Hospital, Vicenza, Italy.
7
Hypertension and Cardiovascular Risk Factors Clinic, Clinical Pharmacology Unit, School of Medicine, Universidad Centroccidental Lisandro Alvarado, Barquisimeto, Venezuela.
8
School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
9
Department of Cardiology, Buenos Aires Italian Hospital, Buenos Aires, Argentina; InterAmerican Foundation for Clinical Research, New York, USA.
10
Paris Diderot - Sorbonne Paris City University, Paris, France; Department of Biostatistics, Fernand Widal Hospital, Paris, France.
11
From INSERM U 698, Paris, France; Paris Diderot - Sorbonne Paris City University, Paris, France; Department of Neurology and Stroke Centre, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: pierre.amarenco@bch.aphp.fr.

Abstract

OBJECTIVE:

Common carotid artery (CCA) intima-media thickness (IMT), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), but not triglyceride levels, are markers of future cardiovascular events. The relationship between these three factors is, however, unclear.

METHODS:

We included six large observational studies that used the same harmonized, B-mode ultrasound protocol, the same software for IMT measurement by automatic edge detection on CCA in a plaque-free region, following the Mannheim consensus, and certification of all sonographers. Using the best view of the CCA, the sonographer had to confirm that the quality index was ≥ 0.5 on a measurement performed on 10-mm length. We used individual data meta-analysis to estimate the cross-sectional associations of lipids with CCA-IMT.

RESULTS:

Overall, 21,587 patients with complete information on lipids and CCA-IMT were available. Age- and sex-adjusted CCA-IMT differed by -7.8 μm (95% CI -9.1 to -6.5 μm, P < 0.001) per 1 SD higher HDL-C level. After further adjustment for other atherosclerosis risk factors, the relationship was attenuated, but remained significant (regression coefficient, -3.7 μm; P < 0.001). This was found regardless of LDL-C levels (P for heterogeneity = 0.70). After adjustment for age and sex, triglycerides were positively associated with CCA-IMT, overall and in each LDL-C subgroup, but not after further adjustments for other risk factors.

CONCLUSIONS:

Relationships between HDL-C and triglyceride levels and CCA-IMT were consistent with that previously observed with clinical events by the Emergency Risk Collaboration group, including at low LDL-C levels. This reinforces the need to verify whether raising HDL-C levels decreases both CCA-IMT and future clinical events.

KEYWORDS:

Carotid arteries; Lipids; Meta-analysis

[Indexed for MEDLINE]

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