Relación colesterol total a HDL y colesterol no HDL: los mejores indicadores lipídicos de aumento de grosor íntima media carotideo

Resumen

TOTAL/HDL CHOLESTEROL RATIO AND NON HDL CHOLESTEROL AS PREDICTORS FOR INCREASED INTIMA MEDIA THICKNESS.

Background: LDL, HDL cholesterol and triglycerides, are the most commonly used lipid cardiovascular risk predictor indicators. However population based studies have shown that non-HDL cholesterol and total/HDL cholesterol ratio are better predictors, are easy to measure and do not require fasting. Aim: To determine which lipid indicators are better determinants of subclinical atherosclerosis, measured by intima media thickness (IMT) among subjects without demonstrated atherosclerosis. Material and methods: Lipid profile, height, weight, blood pressure and bilateral IMT, measured by ultrasound with  automatic border recognition software, were assessed in 770 men and 854 women aged 45±11 years, in Santiago de Chile.  Results: Mean total cholesterol was 202, HDL 50, LDL 121, triglycerides 157 and non-HDL cholesterol 152 mg/dl. Total/HDL cholesterol ratio was 4.3. Mean IMT was 0.62 mm. All lipid markers were significantly correlated with IMT. This correlation was higher for non-HDL cholesterol (r=0.24, p<0.0001) and total/HDL cholesterol ratio(r=0.23, p<0.0001). In both men and women, total/HDL cholesterol ratio was the best predictor of having an IMT over the 75^th percentile (odds ratio 1.21, 95% confidence intervals 1.09-1.35, p<0.01). Conclusions: Total/HDL cholesterol ratio was the best determinant of subclinical atherosclerosis.