The Association of Remnant Cholesterol with Endothelial Dysfunction and Subclinical Atherosclerosis in a Check-Up Population in China

Abstract

Aim: Vascular endothelial function and atherosclerosis are known to be important risk factors for cardiovascular disease. However, it remains unknown whether remnant cholesterol (RC) correlates with vascular endothelial function and atherosclerosis as represented by flow-mediated vasodilation (FMD) and brachial-ankle pulse wave velocity (baPWV). Therefore, in this study, we aimed to investigate this in the general population. Methods:In this study, we examined 13,237 subjects who have undergone blood lipid, FMD, and baPWV measurements. Participants were divided into four groups based on RC quartiles. Multivariable linear regression models were used to calculate odds ratios for FMD and baPWV according to the RC levels.Results: A significant negative relationship was found between RC and FMD (β=−0.14, p=0.014), whereas RC was positively associated with baPWV (β=21.42, p＜0.001), especially in the male and without chronic disease medication populations. The population was divided into three groups according to their lipids: dyslipidemia group, nondyslipidemia but RC increased group (RC ＞0.78 mmol/L), and nondyslipidemia and RC normal group (RC ≤ 0.78 mmol/L). The FMD of the three groups was 7.09%±3.36%, 7.39%±3.38%, and 7.57%± 3.54%, respectively. The baPWV of the three groups was 1445.26±261.56 cm/s, 1425.04±265.24 cm/s, and 1382.73±267.75 cm/s. Significant differences were noted between the groups. Conclusions:The findings indicated that a higher RC was an independent predictive factor for participants with endothelial function and atherosclerosis. It is important to use RC as a risk management indicator of vascular function, especially for those with normal conventional lipid parameters but increased RC.

Remnant Cholesterol, a Valuable Biomarker for Assessing Arteriosclerosis and Cardiovascular Risk: A Systematic Review

“…Excessive lipids and cholesterol bind to the arterial intima and accumulate in the arterial wall, causing oxidative and nitrosative stress that leads to chronic inflammation of the vascular wall and other mechanisms that increase vascular resistance, thereby causing or accelerating arteriosclerosis [ 7 , 37 ]. Yang et al's study found that RC was negatively correlated with flow-mediated vasodilation (FMD), representing endothelial function, and positively correlated with brachial-ankle pulse wave velocity, indicating that RC causes ED and subsequent arteriosclerosis [ 5 , 38 , 39 ]. In a study of patients with familial dysbetalipoproteinemia (FD) that increases RC levels, it was found that arterial wall and cell inflammation increased in FD patients.…”

“…Remnant cholesterol (RC) has emerged as a potential cause of this residual risk [4]. The relationship between RC, arteriosclerosis, and CVD is well-established [2,3,5,6]. Lifestyle interventions and drug therapies have proven effective in reducing RC levels, providing a new therapeutic approach for the prevention and treatment of related CVD.…”

Relationship between sedentary behavior and endothelial dysfunction in a cross-sectional study in China

“…FMD = [(maximum brachial artery diameter—resting brachial artery diameter)/resting brachial artery diameter] × 100%. This method has been validated previously ( 17 ).…”