Abstract 401: Relative Population Percentiles of LDL Cholesterol, Non-HDL Cholesterol and Total Cholesterol to HDL Cholesterol Ratio: The Very Large Database of Lipids Study (VLDL-2)
Background Non-HDL cholesterol (non-HDL-C) and the total cholesterol to HDL cholesterol ratio (TC/HDL-C) are alternatives to LDL cholesterol (LDL-C) in risk assessment and decision-making for lipid-lowering therapy.
Methods We assigned population percentiles to non-HDL-C, TC/HDL-C and LDL-C in 1,340,614 U.S. adults from the Very Large Database of Lipids (VLDL). The distributions of TC, HDL-C, LDL-C and TG in the VLDL were nearly identical to those in the NHANES 2007-2008 survey. Lipids were measured by ultracentrifugation (Atherotech; Birmingham, AL). LDL-C was estimated by the Friedewald method, excluding patients with TG ≥400 mg/dL (2.3% of sample). We examined the relative values of these lipid markers across equivalent population percentiles.
Results Spearman correlation (ρ) between non-HDL-C and LDL-C percentiles was high overall, ρ=0.94 but lower in patients with LDL-C <70 mg/dL, ρ=0.51; similar for TC/HDL-C and LDL-C percentiles, ρ=0.56; lower in patients with LDL-C<70 mg/dL ρ=0.13. The equivalent non-HDL-C percentile to LDL-C of 70 mg/dL was 93 mg/dL (guidelines recommend 100 mg/dL); equivalent TC/HDL-C of 2.6, the 15th percentile. Similarly, the equivalent non-HDL-C percentile to LDL-C of 100 mg/dL was 125 mg/dL (guidelines recommend 130 mg/dL); equivalent TC/HDL-C of 3.3, the 44th percentile (Table).
Conclusion Selection of treatment targets based on consistent population percentiles may have implications in risk stratification and selection of guideline target values.
- © 2013 by American Heart Association, Inc.