Improved lipidomic profile mediates the effects of adherence to healthy lifestyles on coronary heart disease

Si, Jiahui; Li, Jiachen; Yu, Canqing; Guo, Yu; Zheng, Bin; Millwood, Iona Y.; Yang, Ling; Walters, Robin; Du, Huaidong; Li, Yin; Chen, Jianwei; Chen, Junshi; Chen, Zhengming; Li, Liming; Liang, Liming; Lv, Jun

doi:10.7554/elife.60999

Cited by 18 publications

(12 citation statements)

References 40 publications

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“…Together with the other studies in clinical populations, the findings from this study, which was focused on individuals with elevated lipid levels without overt dyslipidemia, underscore the potential usefulness of lifestyle interventions, especially when delivered digitally, for both the primary and secondary prevention of cardiometabolic risk. In fact, effective digital lifestyle interventions appear to magnify the therapeutic benefit of cholesterol-lowering medication in those already past the clinical threshold and receiving medication, because of the complementary effects of the pharmacological and lifestyle interventions [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort

Forte¹,

Gannamani²,

Folkertsma³

et al. 2022

JMIR Cardio

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Background Despite widespread education, many individuals fail to follow basic health behaviors such as consuming a healthy diet and exercising. Positive changes in lifestyle habits are associated with improvements in multiple cardiometabolic health risk factors, including lipid levels. Digital lifestyle interventions have been suggested as a viable complement or potential alternative to conventional health behavior change strategies. However, the benefit of digital preventive interventions for lipid levels in a preventive health context remains unclear. Objective This observational study aimed to determine how the levels of lipids, namely total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, non-HDL cholesterol, and triglycerides, changed over time in a Dutch general population cohort undergoing a digital preventive health program. Moreover, we looked to establish associations between lifestyle factors at baseline and lipid levels. Methods We included 348 adults from the Dutch general population who underwent a digitally enabled preventive health program at Ancora Health between January 2020 and October 2021. Upon enrollment, participants underwent a baseline assessment involving a comprehensive lifestyle questionnaire, a blood biochemistry panel, physical measurements, and cardiopulmonary fitness measurements. Thereafter, users underwent a lifestyle coaching program and could access the digital application to register and track health behaviors, weight, and anthropometric data at any time. Lipid levels were categorized as normal, elevated, high, and clinical dyslipidemia according to accepted international standards. If at least one lipid marker was high or HDL was low, participants received specific coaching and advice for cardiometabolic health. We retrospectively analyzed the mean and percentage changes in lipid markers in users who were remeasured after a cardiometabolic health–focused intervention, and studied the association between baseline user lifestyle characteristics and having normal lipid levels. Results In our cohort, 199 (57.2%) participants had dyslipidemia at baseline, of which 104 participants were advised to follow a cardiometabolic health–focused intervention. Eating more amounts of favorable food groups and being more active were associated with normal lipid profiles. Among the participants who underwent remeasurement 9 months after intervention completion, 57% (17/30), 61% (19/31), 56% (15/27), 82% (9/11), and 100% (8/8) showed improvements at remeasurement for total, LDL, HDL, and non-HDL cholesterol, and triglycerides, respectively. Moreover, between 35.3% and 77.8% showed a return to normal levels. In those with high lipid levels at baseline, total cholesterol decreased by 0.5 mmol/L (7.5%), LDL cholesterol decreased by 0.39 mmol/L (10.0%), non-HDL cholesterol decreased by 0.44 mmol/L (8.3%), triglycerides decreased by 0.97 mmol/L (32.0%), and HDL increased by 0.17 mmol/L (15.6%), after the intervention. Conclusions A cardiometabolic screening program in a general population cohort identified a significant portion of individuals with subclinical and clinical lipid levels. Individuals who, after screening, actively engaged in a cardiometabolic health–focused lifestyle program improved their lipid levels.

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Section: Discussionmentioning

confidence: 99%

Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort

Forte¹,

Gannamani²,

Folkertsma³

et al. 2022

JMIR Cardio

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“…A case-cohort study showed that drinking was inversely associated with non-fatal CHD risk, but positively associated with the risk of different stroke subtypes. A multivariable mendelian randomization study found that smoking was a risk factor for CVD even after adjusting for drinking [ 37 ]. Studies have shown that smoking is closely associated with the occurrence of carotid plaques, especially in current smokers [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Low−/high-density lipoprotein cholesterol ratio and carotid plaques in patients with coronary heart disease: a Chinese cohort study

Cheng

Liu

et al. 2021

Lipids Health Dis

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Background Evidence on the relationship between the low−/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and carotid plaques remains limited. This study aimed to examine the association between LDL-C/HDL-C and carotid plaques in participants with coronary heart disease (CHD) and to further explore the extent to which a healthy lifestyle reduces the risk of LDL-C/HDL-C-related carotid plaques. Methods This large-scale and multi-centre retrospective study included 9426 CHD patients (aged 35–75 years) between January 1, 2014 and September 30, 2020. The LDL-C/HDL-C values were converted to the following tertiles: lowest (< 2.15), middle (2.15–3), and highest (> 3). Healthy lifestyle-related factors referred to whether or not the participant was a non-smoker and non-drinker. Participants were divided into an unfavourable group (those who did not adhere to healthy lifestyle factors), intermediate (only one unhealthy factor), and favourable (neither of the two unhealthy factors). Logistic regression was used for statistical analyses. Results Of the 9426 participants, 6989 (74.15%) CHD patients had carotid plaques. After adjustment for confounders, each unit increase in the LDL-C/HDL-C was significantly associated with carotid plaques (OR: 1.61; 95%CI: 1.43–1.84; P < 0.001). Multivariate logistic regression revealed that carotid plaques risk for the highest tertile (> 3) was 1.18 times that of the lowest quartile (< 2.15). Compared with an unfavourable lifestyle, an intermediate or a favourable lifestyle was associated with a significant 30% (OR: 0.70; 95%CI: 0.64–0.78; P < 0.001) or 67% (OR: 0.33; 95%CI: 0.29–0.37; P < 0.001) reduction in carotid plaques risk, respectively, among CHD patients with high LDL-C/HDL-C. There were significantly additive and multiplicative interactions between lifestyle and LDL-C/HDL-C with regards to carotid plaques. Conclusion A high LDL-C/HDL-C is associated with a risk of carotid plaques developing in CHD patients. Adhering to a healthy lifestyle has additive beneficial effects on reducing the risk of carotid plaques, especially in relation to the highest LDL-C/HDL-C. Graphical abstract

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“…A case-cohort study showed that drinking was inversely associated with non-fatal CHD risk but positively associated with the risk of different stroke subtypes. A multivariable Mendelian randomization study found smoking was a risk factor for CVD even after adjusting for drinking [33][34] . Accordance with our results that lifestyle interventions, being no smoking and no drinking may greatly reduce the risk of carotid plaques in CHD.…”

Section: Discussionmentioning

confidence: 99%

LDL-C/HDL-C and carotid plaques in patients with coronary heart disease: A Chinese cohort study

Cheng

Yi-jia

et al. 2021

Preprint

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Background: Evidence of the association the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) with the carotid plaques remains limited. The purpose of this study is to examine the association between LDL-C/HDL-C and carotid plaques of coronary heart disease (CHD), and to study what extent a healthy lifestyle reduces the risk of carotid plaques.Methods: In this large-scale and multi-center retrospective study, a total of 9,426 participants to explore the association between LDL-C/HDL-C and carotid plaques. No smoking and no drinking were considered healthy lifestyle. Generalised estimating equation models and conditional logistic regressions were used in statistical analyses.Results: In all the 9,426 participants, there were 6,989 (74.15%) patients having identified carotid plaques. High levels of LDL-C/HDL-C had a higher risk of carotid plaques than other lipid variables (OR:1.63; 95%CI:1.43-1.86). In stratified analyses by LDL-C/HDL-C triplet, participants in the LDL-C/HDL-C (＞3mmol/L) group had a higher risk of carotid plaques compared to other two groups. Compared with the unfavourable lifestyle, intermediate lifestyle or favourable lifestyle was associated with a significant 30% or 67% decrease in carotid plaques risk among patients with the LDL-C/HDL-C(＞3mmol/L) respectively. There were significantly additive and multiplicative interactions between lifestyle and LDL-C/HDL-C on carotid plaques.Conclusion: Our findings provide evidence that a high level of LDL-C/HDL-C can increase the risk of carotid plaques in patients with CHD. And adhering to a healthy lifestyle has additive beneficial effects on reducing the risk of carotid plaques.

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Improved lipidomic profile mediates the effects of adherence to healthy lifestyles on coronary heart disease

Cited by 18 publications

References 40 publications

Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort

Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort

Low−/high-density lipoprotein cholesterol ratio and carotid plaques in patients with coronary heart disease: a Chinese cohort study

LDL-C/HDL-C and carotid plaques in patients with coronary heart disease: A Chinese cohort study

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