DOI: 10.57760/sciencedb.o00130.04953
title: Non-HDL-C as a dynamic prediction marker of carotid intima-media thickening in health checkup people
title: 非高密度脂蛋白胆固醇动态变化对颈动脉内中膜增厚的预测价值研究

description: Objective To explore the association between non-high-density lipoprotein cholesterol(nHDL-C) trajectories and carotid intima-media thickening, and to predict its risk in a health checkup population.Methods An ambispective cohort study was conducted using data from individuals who underwent health checkups at a hospital in Beijing from 2013 to 2023. Joint latent class models (JLCMs) were applied separately for males and females to examine the longitudinal trajectories of nHDL-C. The association between different nHDL-C trajectory patterns and carotid intima-media thickening was analyzed. Additionally, dynamic risk predictions for carotid intima-media thickening were made based on the measured nHDL-C values. Cox regression models were fitted using either baseline nHDL-C values or the longitudinal nHDL-C trajectory patterns. The predictive accuracy of the models was evaluated using area under the curve (AUC) and concordance index (C-index).Results The study included 5,741 participants aged 18–60 years(mean age: 34.80 ± 8.27 years), comprising 2,487 males(mean age: 35.41 ± 8.45 years) and 3,252 females(mean age: 36.48 ± 8.11 years). Three nHDL-C trajectories were identified in males and four in females, each associated with different risks of carotid intima-media thickening. BMI was significantly associated with increased nHDL-C levels in both males(β= 2.952, P&lt; 0.001) and females (β= 2.327, P&lt; 0.001). In the male population, the Cox model with baseline nHDL-C values yielded a C-index of 0.749, while the model based on nHDL-C trajectory had a C-index of 0.826. The combined model, using both baseline values and trajectory, achieved a C-index of 0.832. In females, the Cox model with baseline nHDL-C values had a C-index of 0.796, and the trajectory-based model had a C-index of 0.822. The combined model reached a C-index of 0.824. nHDL-C trajectory provided superior predictive accuracy for carotid intima-media thicknening compared to baseline nHDL-C values. Compared to the low-stable group, males in the slow-rising and rapid-rising groups had hazard ratios(HRs) of 10.51(95% CI: 7.90–13.98) and 23.25(95% CI: 10.40–51.98), respectively, for carotid intima-media thickening. In females, the low-stable rising group had an HR of 3.69(95% CI: 2.27–5.99), the medium-stable group had an HR of 15.48(95% CI: 10.56–22.70), and the rapid-rising group had an HR of 13.93(95% CI: 5.44–35.69).Conclusion Distinct nHDL-C trajectories in the health checkup population are linked to varying risks of carotid intima-media thickening, with trajectory-based classifications providing more accurate risk predictions compared to baseline nHDL-C values.
description: Objective To explore the association between non-high-density lipoprotein cholesterol(nHDL-C) trajectories and carotid intima-media thickening, and to predict its risk in a health checkup population.Methods An ambispective cohort study was conducted using data from individuals who underwent health checkups at a hospital in Beijing from 2013 to 2023. Joint latent class models (JLCMs) were applied separately for males and females to examine the longitudinal trajectories of nHDL-C. The association between different nHDL-C trajectory patterns and carotid intima-media thickening was analyzed. Additionally, dynamic risk predictions for carotid intima-media thickening were made based on the measured nHDL-C values. Cox regression models were fitted using either baseline nHDL-C values or the longitudinal nHDL-C trajectory patterns. The predictive accuracy of the models was evaluated using area under the curve (AUC) and concordance index (C-index).Results The study included 5,741 participants aged 18–60 years(mean age: 34.80 ± 8.27 years), comprising 2,487 males(mean age: 35.41 ± 8.45 years) and 3,252 females(mean age: 36.48 ± 8.11 years). Three nHDL-C trajectories were identified in males and four in females, each associated with different risks of carotid intima-media thickening. BMI was significantly associated with increased nHDL-C levels in both males(β= 2.952, P&lt; 0.001) and females (β= 2.327, P&lt; 0.001). In the male population, the Cox model with baseline nHDL-C values yielded a C-index of 0.749, while the model based on nHDL-C trajectory had a C-index of 0.826. The combined model, using both baseline values and trajectory, achieved a C-index of 0.832. In females, the Cox model with baseline nHDL-C values had a C-index of 0.796, and the trajectory-based model had a C-index of 0.822. The combined model reached a C-index of 0.824. nHDL-C trajectory provided superior predictive accuracy for carotid intima-media thicknening compared to baseline nHDL-C values. Compared to the low-stable group, males in the slow-rising and rapid-rising groups had hazard ratios(HRs) of 10.51(95% CI: 7.90–13.98) and 23.25(95% CI: 10.40–51.98), respectively, for carotid intima-media thickening. In females, the low-stable rising group had an HR of 3.69(95% CI: 2.27–5.99), the medium-stable group had an HR of 15.48(95% CI: 10.56–22.70), and the rapid-rising group had an HR of 13.93(95% CI: 5.44–35.69).Conclusion Distinct nHDL-C trajectories in the health checkup population are linked to varying risks of carotid intima-media thickening, with trajectory-based classifications providing more accurate risk predictions compared to baseline nHDL-C values.