Abstract
BACKGROUND: Dyslipidemia contributes to the progression of arterial stiffness (AS). The purpose of this study was to investigate the association of the different lipid parameters with arterial stiffness index (ASI) in a middle-aged population free of cardiovascular (CV) disease. METHODS: Among 71,326 volunteers from the UK Biobank population, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), lipoprotein (a) [Lp(a)], apolipoproteins A and B (Apo A and Apo B), and ASI were measured. Values for non-HDL, TC/HDL, TG/HDL, and LDL/HDL were calculated. AS was defined as an ASI > 10 m/s. Associations between lipid parameters and ASI were performed using multiple linear logistic regressions. The results reported from univariate models were the squared partial correlation coefficient, r (2), and from multivariate models, the adjusted coefficient of determination, R (2), to describe the contribution of ASI variability for each lipid parameter. RESULTS: We found that TG/HDL was mainly associated with ASI [β = 0.53 (0.01), r (2) = 3.66%, p < 0.001 and adjusted β = 0.21 (0.01), R (2) = 13.58%, p < 0.001] and AS [odds ratio (OR) = 1.86 (1.80-1.92), r (2) = 1.65%, p < 0.001 and adjusted OR = 1.15 (1.13-1.17), R (2) = 8.54%, p < 0.001] rather than the others. TG/HDL remained the only lipid parameter that showed added value in linear multivariate models. TG/HDL remained less associated with AS than age (r (2) = 5.55%, p < 0.001), mean blood pressure (BP; r (2) = 5.31%, p < 0.001), and gender (r (2) = 4.44%, p < 0.001), but more highly associated than body mass index (BMI; r (2) = 1.95%, p < 0.001), heart rate (HR; r (2) = 0.81%, p < 0.001), fasting glucose (r (2) = 0.18%, p < 0.001), tobacco (r (2) = 0.05%, p < 0.001), and glomerular filtration rate (GFR; r (2) = 0.01%, p < 0.001). CONCLUSIONS: In primary CV prevention, lipids, especially through the TG/HDL ratio, could be more instructive in preventing the increase in AS than other modifiable factors.