Association of cumulative low-density lipoprotein cholesterol exposure with vascular function

Takayuki Yamaji; Farina Mohamad Yusoff; Shinji Kishimoto; Masato Kajikawa; Kenichi Yoshimura; Yukiko Nakano; Chikara Goto; Takahiro Harada; Aya Mizobuchi; Shunsuke Tanigawa; Tatsuya Maruhashi; Yukihito Higashi

doi:10.1016/j.jacl.2023.12.006

Association of cumulative low-density lipoprotein cholesterol exposure with vascular function

J Clin Lipidol. 2023 Dec 25:S1933-2874(23)00356-2. doi: 10.1016/j.jacl.2023.12.006. Online ahead of print.

Affiliations

¹ Center for Radiation Disaster Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan (Drs Yamaji and Higashi); Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan (Drs Yamaji, Yusoff, Kishimoto, Harada, Mizobuchi, Tanigawa, Maruhashi, and Higashi).
² Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan (Drs Yamaji, Yusoff, Kishimoto, Harada, Mizobuchi, Tanigawa, Maruhashi, and Higashi).
³ Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan (Drs Kajikawa, Yoshimura, and Higashi).
⁴ Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan (Dr Nakano).
⁵ Hiroshima International University, Hiroshima, Japan (Dr Goto).
⁶ Center for Radiation Disaster Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan (Drs Yamaji and Higashi); Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan (Drs Yamaji, Yusoff, Kishimoto, Harada, Mizobuchi, Tanigawa, Maruhashi, and Higashi); Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan (Drs Kajikawa, Yoshimura, and Higashi). Electronic address: yhigashi@hiroshima-u.ac.jp.

PMID: 38185588
DOI: 10.1016/j.jacl.2023.12.006

Abstract

Background: The relationship between cumulative low-density lipoprotein cholesterol (LDL-C) exposure and progression of atherosclerosis remains uncertain.

Objective: The aim of this study was to determine the relationship between cumulative LDL-C level and flow-mediated vasodilation (FMD), nitroglycerine-induced vasodilation (NID) and the presence of plaque in the common carotid artery (CCA).

Methods: This was a cross-sectional study. We measured FMD in 8208 subjects, NID in 1822 subjects, and CCA plaque in 591 subjects who were not taking lipid-lowering drugs. The subjects were divided into four groups based on cumulative LDL-C exposure: <4000 mg·year/dL, 4000-4999 mg·year/dL, 5000-5999 mg·year/dL, and ≥6000 mg·year/dL.

Results: The odds ratio of the lower quartile of FMD in the cholesterol-year-score <4000 mg·year/dL group was significantly higher than the odds ratios in the other groups. The odds ratio of the lower quartile of NID in the <4000 mg·year/dL group was significantly higher than the odds ratios in the 5000-5999 mg·year/dL and ≥6000 mg·year/dL groups. The odds ratio of the prevalence of CCA plaque in the <4000 mg·year/dL group was significantly higher than that in the ≥6000 mg·year/dL group.

Conclusions: Endothelial dysfunction occurred from cumulative LDL-C exposure of 4000 mg·year/dL, vascular smooth muscle dysfunction occurred from cumulative LDL-C exposure of 5000 mg·year/dL, and prevalence of CCA plaque occurred from cumulative LDL-C exposure of 6000 mg·year/dL. CLINICAL TRIAL REGISTRY INFORMATION: http://www.umin.ac.jp (UMIN000012950, UMIN000012951, and UMIN000012952, UMIN000003409).

Keywords: Atherosclerosis; Carotid artery plaque; Cumulative low-density lipoprotein cholesterol; Flow-mediated vasodilation; Intima media thickness; Nitroglycerine-induced vasodilation.