Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study
The aim of this study was to investigate associations of cardiovascular outcomes with lipid variability across body mass index categories. We identified 6689 participants (57.1% women) enrolled in the Atherosclerosis Risk In Communities (ARICs) study who had ≥ 3 measurements of total cholesterol (TC...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-01-01
|
| Series: | Journal of Nutrition and Metabolism |
| Online Access: | http://dx.doi.org/10.1155/jnme/8858333 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850073250766258176 |
|---|---|
| author | Tianyu Xu Chang Chen De-Wei An Yuanyuan Zhou Zhongping Yu Yuzhong Wu Dexi Wu Xin He Jiangui He Yugang Dong Jan A. Staessen Chen Liu Fang-Fei Wei |
| author_facet | Tianyu Xu Chang Chen De-Wei An Yuanyuan Zhou Zhongping Yu Yuzhong Wu Dexi Wu Xin He Jiangui He Yugang Dong Jan A. Staessen Chen Liu Fang-Fei Wei |
| author_sort | Tianyu Xu |
| collection | DOAJ |
| description | The aim of this study was to investigate associations of cardiovascular outcomes with lipid variability across body mass index categories. We identified 6689 participants (57.1% women) enrolled in the Atherosclerosis Risk In Communities (ARICs) study who had ≥ 3 measurements of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). Cox regression models were used to compute hazard ratios (HRs)-associated heart failure (HF), myocardial infarction (MI), and mortality with 1-SD increase in lipid variability captured by SD and variability independent of the mean (VIM). We also assessed whether adding lipid variability would improve the cardiovascular risk prediction beyond the conventional risk factors. Among 2130 (31.8%) obese patients, 1907 (89.5%) had obesity classes I and II and 223 (10.5%) had obesity class III. In multivariable-adjusted analyses, TC and LDL-C variabilities were significantly (p≤0.047) associated with HF in overweight (HRs ranging from 1.10 to 1.17), obesity classes I and II (1.11–1.14), and obesity class III (1.21–1.39). Higher TC and LDL-C variabilities conferred higher risk of MI and mortality in obesity classes I and II (p≤0.007). Adding TC–VIM and LDL-C–VIM rather than the lipid level to a conventional risk model significantly improved risk prediction of HF with net reclassification improvement amounting to 8.95% for TC–VIM (p=0.006) and 8.09% for LDL-C–VIM (p=0.012). Elevated TC and LDL-C variabilities were associated with the increased risk of cardiovascular outcomes, particularly in obesity. Our observations highlight the importance of lipid variability in obesity-associated dyslipidemia. |
| format | Article |
| id | doaj-art-746d7d00a50a4e79bf3dfdc864c6edf5 |
| institution | DOAJ |
| issn | 2090-0732 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Nutrition and Metabolism |
| spelling | doaj-art-746d7d00a50a4e79bf3dfdc864c6edf52025-08-20T02:46:53ZengWileyJournal of Nutrition and Metabolism2090-07322025-01-01202510.1155/jnme/8858333Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC StudyTianyu Xu0Chang Chen1De-Wei An2Yuanyuan Zhou3Zhongping Yu4Yuzhong Wu5Dexi Wu6Xin He7Jiangui He8Yugang Dong9Jan A. Staessen10Chen Liu11Fang-Fei Wei12Department of CardiologyDepartment of CardiologyBiomedical Science GroupDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyBiomedical Science GroupDepartment of CardiologyDepartment of CardiologyThe aim of this study was to investigate associations of cardiovascular outcomes with lipid variability across body mass index categories. We identified 6689 participants (57.1% women) enrolled in the Atherosclerosis Risk In Communities (ARICs) study who had ≥ 3 measurements of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). Cox regression models were used to compute hazard ratios (HRs)-associated heart failure (HF), myocardial infarction (MI), and mortality with 1-SD increase in lipid variability captured by SD and variability independent of the mean (VIM). We also assessed whether adding lipid variability would improve the cardiovascular risk prediction beyond the conventional risk factors. Among 2130 (31.8%) obese patients, 1907 (89.5%) had obesity classes I and II and 223 (10.5%) had obesity class III. In multivariable-adjusted analyses, TC and LDL-C variabilities were significantly (p≤0.047) associated with HF in overweight (HRs ranging from 1.10 to 1.17), obesity classes I and II (1.11–1.14), and obesity class III (1.21–1.39). Higher TC and LDL-C variabilities conferred higher risk of MI and mortality in obesity classes I and II (p≤0.007). Adding TC–VIM and LDL-C–VIM rather than the lipid level to a conventional risk model significantly improved risk prediction of HF with net reclassification improvement amounting to 8.95% for TC–VIM (p=0.006) and 8.09% for LDL-C–VIM (p=0.012). Elevated TC and LDL-C variabilities were associated with the increased risk of cardiovascular outcomes, particularly in obesity. Our observations highlight the importance of lipid variability in obesity-associated dyslipidemia.http://dx.doi.org/10.1155/jnme/8858333 |
| spellingShingle | Tianyu Xu Chang Chen De-Wei An Yuanyuan Zhou Zhongping Yu Yuzhong Wu Dexi Wu Xin He Jiangui He Yugang Dong Jan A. Staessen Chen Liu Fang-Fei Wei Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study Journal of Nutrition and Metabolism |
| title | Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study |
| title_full | Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study |
| title_fullStr | Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study |
| title_full_unstemmed | Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study |
| title_short | Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study |
| title_sort | cardiovascular outcomes and variability in plasma lipid levels across body mass index categories the aric study |
| url | http://dx.doi.org/10.1155/jnme/8858333 |
| work_keys_str_mv | AT tianyuxu cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT changchen cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT deweian cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT yuanyuanzhou cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT zhongpingyu cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT yuzhongwu cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT dexiwu cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT xinhe cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT jianguihe cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT yugangdong cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT janastaessen cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT chenliu cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy AT fangfeiwei cardiovascularoutcomesandvariabilityinplasmalipidlevelsacrossbodymassindexcategoriesthearicstudy |