Appropriate LDL-C-to-HDL-C Ratio Cutoffs for Categorization of Cardiovascular Disease Risk Factors among Uygur Adults in Xinjiang, China
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Subject Recruitment
2.2. Baseline Examination and Laboratory Tests
2.3. Definition of Risk Factors
2.4. Statistical Analysis
3. Results
3.1. Age-Standardized CVD Risk Factors in Uygur by LDL-C/HDL-C Ratio Category
3.2. Prevalence of Risk Factors in Uygur by LDL-C/HDL-C Ratio Category
3.3. Sensitivity, Specificity, and Distance in the Receiver Operating Characteristic (ROC) Curve for LDL-C/HDL-C Ratio Cutoff Points in Uygur
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Sex/Age | 35–39 | 40–44 | 45–49 | 50–54 | 55–59 | 60–64 | 65–69 | 70–74 | 75–79 | 80–84 | 85–89 | Total |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Years | Years | Years | Years | Years | Years | Years | Years | Years | Years | Years | ||
Men | 187 | 257 | 229 | 236 | 226 | 236 | 168 | 115 | 51 | 19 | 19 | 1743 |
Women | 368 | 399 | 369 | 333 | 284 | 251 | 180 | 69 | 27 | 18 | 6 | 2304 |
LHR < 1.5 | 1.5 ≤ LHR < 2 | 2 ≤ LHR < 2.5 | 2.5 ≤ LHR < 3 | 3 ≤ LHR < 3.5 | 3.5 ≤ LHR < 4 | 4 ≤ LHR < 4.5 | 4.5 ≤ LHR < 5 | LHR ≥ 5 | p Value | |
---|---|---|---|---|---|---|---|---|---|---|
Men | ||||||||||
Population distribution (%) | 214 (11.4%) | 378 (20.2%) | 441 (23.5%) | 361 (19.3%) | 233 (12.4%) | 139 (7.4%) | 61 (3.3%) | 36 (1.9%) | 12 (0.6%) | |
Systolic blood pressure (mmHg) | 132.29 ± 20.04 | 131.18 ± 19.04 | 131.47 ± 19.34 | 132.09 ± 21.13 | 129.70 ± 17.68 | 132.57 ± 18.78 | 126.07 ± 16.27 | 133.37 ± 24.53 | 139.33 ± 29.58 | 0.285 |
Diastolic blood pressure (mmHg) | 81.57 ± 14.36 | 80.54 ± 14.35 | 79.84 ± 13.84 | 81.27 ± 15.07 | 79.48 ± 14.19 | 81.89 ± 14.63 | 76.82 ± 13.10 | 78.91 ± 17.47 | 81.75 ± 23.40 | 0.29 |
Total cholesterol (mmol/L) | 4.21 ± 1.03 | 4.34 ± 1.03 | 4.27 ± 1.10 | 4.25 ± 1.06 | 4.38 ± 1.11 | 4.42 ± 1.03 | 4.20 ± 0.97 | 4.25 ± 1.25 | 3.99 ± 0.96 | 0.44 |
HDL-C cholesterol (mmol/L) | 1.63 ± 0.45 | 1.43 ± 0.38 | 1.26 ± 0.32 | 1.20 ± 0.30 | 1.06 ± 0.27 | 0.97 ± 0.26 | 0.87 ± 0.25 | 0.81 ± 0.27 | 0.62 ± 0.21 | <0.001 |
LDL-C cholesterol (mmol/L) | 2.05 ± 0.57 | 2.47 ± 0.64 | 2.78 ± 0.72 | 3.18 ± 0.78 | 3.35 ± 0.84 | 3.57 ± 0.97 | 3.58 ± 0.98 | 3.70 ± 1.26 | 3.16 ± 1.03 | <0.001 |
Triglycerides (mmol/L) | 1.60 ± 1.26 | 1.66 ± 1.25 | 1.58 ± 1.08 | 1.62 ± 1.23 | 1.54 ± 0.92 | 1.83 ± 1.59 | 1.69 ± 1.09 | 2.09 ± 3.14 | 1.89 ± 0.79 | 0.22 |
Fasting glucose (mmol/L) | 4.91 ± 1.80 | 4.92 ± 1.71 | 4.81 ± 1.52 | 4.93 ± 1.98 | 4.79 ± 1.18 | 5.02 ± 1.94 | 5.80 ± 3.86 | 4.92 ± 1.08 | 4.92 ± 1.31 | 0.027 |
Women | ||||||||||
Population distribution (%) | 273 (10.8%) | 555 (21.9%) | 603 (23.8%) | 480 (19%) | 279 (11%) | 182 (7.2%) | 84 (3.3%) | 40 (1.6%) | 35 (1.4%) | |
Systolic blood pressure (mmHg) | 131.78 ± 24 | 131.86 ± 21.21 | 132.10 ± 21.88 | 129.56 ± 21.81 | 128.45 ± 21.37 | 132.54 ± 24.96 | 132.67 ± 24.02 | 129.28 ± 24.22 | 129.4 ± 17.91 | 0.272 |
Diastolic blood pressure (mmHg) | 80.98 ± 16.25 | 80.36 ± 14.98 | 80.05 ± 15.09 | 78.54 ± 15.09 | 77.91 ± 14.60 | 80.79 ± 16.85 | 79.49 ± 14.47 | 78.26 ± 15.24 | 77.8 ± 13.70 | 0.174 |
Total cholesterol (mmol/L) | 4.34 ± 1.19 | 4.46 ± 1.10 | 4.34 ± 1.11 | 4.36 ± 1.11 | 4.31 ± 1.23 | 4.45 ± 1.05 | 4.53 ± 1.21 | 4.33 ± 1.03 | 4.64 ± 1.08 | 0.352 |
HDL-C cholesterol (mmol/L) | 1.68 ± 0.45 | 1.43 ± 0.38 | 1.27 ± 0.32 | 1.14 ± 0.30 | 1.08 ± 0.30 | 0.99 ± 0.26 | 0.87 ± 0.25 | 0.78 ± 0.20 | 0.64 ± 0.22 | <0.001 |
LDL-C cholesterol (mmol/L) | 2.09 ± 0.58 | 2.46 ± 0.66 | 2.80 ± 0.70 | 3.04 ± 0.80 | 3.36 ± 0.94 | 3.60 ± 0.95 | 3.61 ± 1.03 | 3.70 ± 0.91 | 3.31 ± 1.13 | <0.001 |
Triglycerides (mmol/L) | 1.50 ± 1.01 | 1.61 ± 1.22 | 1.61 ± 1.16 | 1.60 ± 0.99 | 1.52 ± 0.94 | 1.62 ± 0.98 | 1.65 ± 1.07 | 1.62 ± 0.67 | 2.20 ± 1.44 | 0.075 |
Fasting glucose (mmol/L) | 5.02 ± 1.65 | 4.92 ± 1.49 | 4.83 ± 1.21 | 4.92 ± 1.62 | 4.94 ± 1.52 | 4.74 ± 1.44 | 4.76 ± 0.93 | 4.64 ± 0.75 | 4.95 ± 1.23 | 0.45 |
LHR < 1.5 | 1.5 ≤ LHR < 2 | 2 ≤ LHR < 2.5 | 2.5 ≤ LHR < 3 | 3 ≤ LHR < 3.5 | 3.5 ≤ LHR < 4 | 4 ≤ LHR < 4.5 | 4.5 ≤ LHR < 5 | LHR ≥ 5 | p Value | |
---|---|---|---|---|---|---|---|---|---|---|
Men | ||||||||||
Hypertension | 36.4% | 39.7% | 43.1% | 46.3% | 50.6% | 48.2% | 44.3% | 61.1% | 33.3% | 0.016 |
Diabetes | 5.0% | 6.1% | 5.4% | 6.8% | 4.8% | 8.8% | 8.3% | 5.9% | 8.3% | 0.85 |
Hypercholesterolemia | 12.4% | 14.5% | 16.3% | 16.1% | 20.3% | 19.1% | 15.0% | 20.6% | 16.7% | 0.53 |
High LDL cholesterol | 2.8% | 14.8% | 33.1% | 53.5% | 63.1% | 64.0% | 67.2% | 75.0% | 50.0% | <0.001 |
Low HDL cholesterol | 8.4% | 13.8% | 24.7% | 32.4% | 49.4% | 64.0% | 75.4% | 91.7% | 100.0% | <0.001 |
Hypertriglyceridemia | 26.9% | 34.2% | 31.9% | 31.7% | 30.4% | 36.0% | 35.0% | 35.3% | 50.0% | 0.57 |
Women | ||||||||||
Hypertension | 35.9% | 40.7% | 43.3% | 45.4% | 45.2% | 48.9% | 40.5% | 35.0% | 37.1% | 0.122 |
Diabetes | 6.8% | 6.1% | 4.4% | 4.5% | 5.8% | 2.8% | 2.4% | 0.0% | 14.7% | 0.049 |
Hypercholesterolemia | 19.5% | 19.6% | 17.4% | 17.8% | 18.2% | 19.3% | 22.9% | 23.7% | 23.5% | 0.904 |
High LDL cholesterol | 5.1% | 15.0% | 32.8% | 45.6% | 59.9% | 72.5% | 67.9% | 70.0% | 57.1% | <0.001 |
Low HDL cholesterol | 9.2% | 14.1% | 24.7% | 38.3% | 47.3% | 60.4% | 73.8% | 92.5% | 94.3% | <0.001 |
Hypertriglyceridemia | 29.3% | 30.3% | 34.2% | 35.4% | 30.8% | 33.1% | 39.8% | 44.7% | 44.1% | 0.168 |
LDL-C/HDL-C Ratio | LHR < 1.5 | 1.5 ≤ LHR < 2 | 2 ≤ LHR < 2.5 | 2.5 ≤ LHR < 3 | 3 ≤ LHR < 3.5 | 3.5 ≤ LHR < 4 | 4 ≤ LHR < 4.5 | 4.5 ≤ LHR < 5 | LHR ≥ 5 |
---|---|---|---|---|---|---|---|---|---|
Healthy subjects | 37.7% | 26.0% | 13.6% | 3.4% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% |
Subjects with CVD risk factors | 62.3% | 74.0% | 86.4% | 96.6% | 100.0% | 100.0% | 100.0% | 100.0% | 100.0% |
Odds Ratio | Proportion | Hypertension | Dyslipidemia | Diabetes | ≥2 Risk Factors | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
LDL-C/HDL-C Cutoffs | Percentile | Sens % | Spec % | Distance in ROC Curve | Sens % | Spec % | Distance in ROC Curve | Sens % | Spec % | Distance in ROC Curve | Sens % | Spec % | Distance in ROC Curve |
Men | |||||||||||||
1.5 | 12.3 | 89.9 | 14.2 | 0.87 | 94.6 | 31.7 | 0.69 | 90.9 | 12.3 | 0.88 | 95.4 | 16.8 | 0.83 |
2 | 33 | 70.2 | 36.3 | 0.70 | 79.6 | 69.8 | 0.36 | 70 | 33.2 | 0.73 | 80.6 | 41.4 | 0.62 |
2.5 | 57.1 | 46.9 | 60.5 | 0.66 | 56.6 | 95.6 | 0.44 | 49.1 | 57.1 | 0.67 | 59.2 | 66.5 | 0.53 |
3 | 75.7 | 27.5 | 78.4 | 0.76 | 32.8 | 100 | 0.67 | 28.2 | 75.8 | 0.30 | 35.4 | 82.2 | 0.67 |
3.5 | 87.2 | 14.1 | 88.3 | 0.87 | 17.3 | 100 | 0.83 | 18.2 | 87.4 | 0.83 | 18.6 | 90.6 | 0.82 |
4 | 94.6 | 5.8 | 95.2 | 0.94 | 7.2 | 100 | 0.93 | 7.3 | 94.8 | 0.93 | 7.8 | 96.2 | 0.92 |
4.5 | 97.9 | 2.2 | 98.1 | 0.98 | 2.8 | 100 | 0.97 | 2.7 | 98 | 0.97 | 3 | 98.5 | 1.00 |
5 | 99.5 | 0.4 | 99.4 | 1.00 | 0.7 | 100 | 0.99 | 0.9 | 99.5 | 0.99 | 0.6 | 99.6 | 0.99 |
Women | |||||||||||||
1.5 | 10.79 | 90.10 | 13.60 | 0.87 | 93.90 | 28.20 | 0.72 | 85.70 | 11.80 | 0.89 | 94.00 | 15.30 | 0.85 |
2 | 32.71 | 68.20 | 37.10 | 0.71 | 77.90 | 69.50 | 0.38 | 57.10 | 34.30 | 0.79 | 76.70 | 41.10 | 0.63 |
2.5 | 56.54 | 44.00 | 60.70 | 0.68 | 54.40 | 94.10 | 0.46 | 38.90 | 58.40 | 0.74 | 53.70 | 65.40 | 0.58 |
3 | 75.50 | 23.20 | 78.50 | 0.80 | 30.40 | 100.00 | 0.70 | 21.40 | 77.50 | 0.82 | 29.40 | 81.70 | 0.73 |
3.5 | 86.53 | 12.40 | 87.30 | 0.89 | 17.20 | 100.00 | 0.83 | 9.50 | 87.20 | 0.91 | 15.60 | 89.10 | 0.85 |
4 | 93.72 | 5.00 | 93.80 | 0.95 | 7.80 | 100.00 | 0.92 | 5.60 | 94.30 | 0.95 | 6.40 | 94.70 | 0.94 |
4.5 | 97.04 | 2.20 | 97.00 | 0.98 | 3.70 | 100.00 | 0.96 | 4.00 | 97.40 | 0.96 | 3.00 | 97.50 | 0.97 |
5 | 98.62 | 1.00 | 98.70 | 0.98 | 1.60 | 100.00 | 0.98 | 3.20 | 98.90 | 0.97 | 1.50 | 99.00 | 0.99 |
AUC | Men (95% CI) | Women (95% CI) |
---|---|---|
Hypertension | 0.544 (0.517, 0.572) | 0.523 (0.499, 0.546) |
Diabetes | 0.543 (0.486, 0.599) | 0.513 (0.478, 0.584) |
Dyslipidemia | 0.849 (0.831, 0.867) | 0.818 (0.801, 0.835) |
≥2 risk factors | 0.663 (0.637, 0.689) | 0.609 (0.586, 0.633) |
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Chen, Q.-J.; Lai, H.-M.; Chen, B.-D.; Li, X.-M.; Zhai, H.; He, C.-H.; Pan, S.; Luo, J.-Y.; Gao, J.; Liu, F.; et al. Appropriate LDL-C-to-HDL-C Ratio Cutoffs for Categorization of Cardiovascular Disease Risk Factors among Uygur Adults in Xinjiang, China. Int. J. Environ. Res. Public Health 2016, 13, 235. https://doi.org/10.3390/ijerph13020235
Chen Q-J, Lai H-M, Chen B-D, Li X-M, Zhai H, He C-H, Pan S, Luo J-Y, Gao J, Liu F, et al. Appropriate LDL-C-to-HDL-C Ratio Cutoffs for Categorization of Cardiovascular Disease Risk Factors among Uygur Adults in Xinjiang, China. International Journal of Environmental Research and Public Health. 2016; 13(2):235. https://doi.org/10.3390/ijerph13020235
Chicago/Turabian StyleChen, Qing-Jie, Hong-Mei Lai, Bang-Dang Chen, Xiao-Mei Li, Hui Zhai, Chun-Hui He, Shuo Pan, Jun-Yi Luo, Jing Gao, Fen Liu, and et al. 2016. "Appropriate LDL-C-to-HDL-C Ratio Cutoffs for Categorization of Cardiovascular Disease Risk Factors among Uygur Adults in Xinjiang, China" International Journal of Environmental Research and Public Health 13, no. 2: 235. https://doi.org/10.3390/ijerph13020235
APA StyleChen, Q.-J., Lai, H.-M., Chen, B.-D., Li, X.-M., Zhai, H., He, C.-H., Pan, S., Luo, J.-Y., Gao, J., Liu, F., Ma, Y.-T., & Yang, Y.-N. (2016). Appropriate LDL-C-to-HDL-C Ratio Cutoffs for Categorization of Cardiovascular Disease Risk Factors among Uygur Adults in Xinjiang, China. International Journal of Environmental Research and Public Health, 13(2), 235. https://doi.org/10.3390/ijerph13020235