Utility of Non-High-Density Lipoprotein Cholesterol Versus Other
Lipoprotein Measures in Detecting Subclinical Atherosclerosis in Young
Adults (The Bogalusa Heart Study)

Frontini et al., Am J Cardiology, articles in press.

Direct comparative data on the utility of non-high-density lipoprotein
(HDL) cholesterol versus low-density lipoprotein cholesterol, HDL
cholesterol, triglycerides, apolipoprotein (apo) B, apo A-I, ratio to
total cholesterol to HDL cholesterol, and ratio of apo B to apo A-I in
detecting increased carotid intima-media thickness (IMT), a validated
measurement of subclinical atherosclerosis, in asymptomatic younger
adults are scant. This aspect was examined in 1,203 black and white
subjects (71% white, 43% men) 24 to 43 years of age. In multivariate
logistic regression analysis of each lipoprotein measurement (top
quartile vs lower 3 quartiles specific for age, race, and gender) for
detecting increased carotid IMT (top decile vs lower 9 deciles
specific for age, race, and gender), only non-HDL cholesterol, total
cholesterol/HDL cholesterol, and apo B emerged as significant
correlates with respective odds ratios of 1.75 (95% confidence
interval [CI] 1.10 to 2.78), 2.02 (95% CI 1.27 to 3.19), and 2.13 (95%
CI 1.38 3.29), after adjusting for body mass index, systolic blood
pressure, and other lipoprotein measurements. Regarding discriminating
values of different lipoprotein measurements in detecting increased
carotid IMT, area (c-value) under the receiver operating
characteristic curve analysis for each lipoprotein measurement
adjusted for age, race, gender, body mass index, and systolic blood
pressure indicated that the c-value for non-HDL cholesterol (0.73) was
similar to those for low-density lipoprotein cholesterol (0.76), total
cholesterol/HDL cholesterol (0.72), apo B/apo A-I (0.71), and HDL
cholesterol (0.70), but significantly (p <0.001) higher than that for
apo A-I (0.69), triglycerides (0.64), and apo B (0.64). In conclusion,
non-HDL cholesterol is as good as or better than other widely
recommended lipoprotein measurements in the identification of
subclinical atherosclerosis in young adults.

This study was supported by Grant AG-16592 from the National Institute
of Aging and Grant HL-38844 from the National Heart, Lung, and Blood
Institute, Bethesda, Maryland.
Corresponding author: Tel: 504-988-7197; fax: 504-988-7194.

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Marilyn