The aim of this study was to compare the ability of the different ratios (cholesterol/HDL cholesterol ratio, apolipoprotein B/apolipoprotein AI [apo B/apo AI] and nuclear magnetic resonance spectroscopy [NMR]-based lipoprotein concentrations [LDLNMR/HDLNMR]) to predict coronary heart disease (CHD) risk. This case-control study was conducted among participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study. The cohort included 870 apparently healthy individuals (547 men and 323 women) who developed CHD during a 6-year follow-up and they were matched to 1,659 controls (1,046 men and 613 women) on the basis of gender, age and enrolment time. Analyses showed that the different lipid ratios were similarly associated with incident CHD. It was also found that lipoprotein ratios of NMR-related, apolipoprotein-related and standard lipoprotein-related parameters were positively and similarly associated with components of the metabolic syndrome. Moreover, in men without the metabolic syndrome, any lipoprotein ratio appeared to be able to predict CHD risk, whereas in women, the NMR-based ratio was more strongly associated with CHD risk than the apo B/apo AI or the cholesterol/HDL cholesterol ratio. In participants with the metabolic syndrome, the diagnosis of metabolic syndrome appeared to be enough to identify individuals at increased CHD risk, but the presence of elevated lipid ratios increased even more the CHD risk compared to those with lower lipid ratios. These results suggest that in order to better identify individuals at increased CHD risk, lipids should be studied as ratios.
Documentation centre