摘要
Objective To explore the correlations of high-density lipoprotein cholesterol(HDL-C)/low-density lipoprotein cholesterol(LDL-C)with myocardial infarction(MI),all-cause mortality,haemorrhagic stroke and ischaemic stroke,as well as the joint association of genetic susceptibility and HDL-C/LDL-C with the MI risk.Methods and results This study selected 384093 participants from the UK Biobank(UKB)database.First,restricted cubic splines indicated non-linear associations of HDL-C/LDL-C with MI,ischaemic stroke and all-cause mortality.Second,a Cox proportional-hazards model indicated that compared with HDL-C/LDL-C=0.4-0.6,HDL-C/LDL-C<0.4 and>0.6 were correlated with all-cause mortality(HR=0.97 for HDL-C/LDL-C<0.4,95%CI=0.939 to 0.999,p<0.05;HR=1.21 for HDL-C/LDL-C>0.6,95%CI=1.16 to 1.26,p<0.001)after full multivariable adjustment.HDL-C/LDL-C<0.4 was correlated with a higher MI risk(HR=1.36,95%CI=1.28 to 1.44,p<0.05)and ischaemic stroke(HR=1.12,95%CI=1.02 to 1.22,p<0.05)after full multivariable adjustment.HDL-C/LDL-C>0.6 was associated with higher risk haemorrhagic stroke risk after full multivariable adjustment(HR=1.25,95%CI=1.03 to 1.52,p<0.05).Third,after calculating the coronary heart disease Genetic Risk Score(CHD-GRS)of each participant,the Cox proportional-hazards model indicated that compared with low CHD-GRS and HDL-C/LDL-C=0.4-0.6,participants with a combination of high CHD-GRS and HDL-C/LDL-C<0.4 were associated with the highest MI risk(HR=2.45,95%CI=2.15 to 2.8,p<0.001).Participants with HDL-C/LDL-C<0.4 were correlated with a higher MI risk regardless of whether they had a high,intermediate or low CHD-GRS.Conclusion In UKB participants,HDL-C/LDL-C ratio of 0.4-0.6 was correlated with lower MI risk,all-cause mortality,haemorrhagic stroke and ischaemic stroke.Participants with HDL-C/LDL-C<0.4 were correlated with a higher MI risk regardless of whether they had a high,intermediate or low CHD-GRS.The clinical significance and impact of HDL-C/LDL-C need to be further verified in future studies.
