The Relationship Between Blood Lipid Level And Coronary Atherosclerosis Heart Disease In Rural Areas Of North Henan

BackgroundCoronary atherosclerosis heart disease(CAD)is the main cause of high mortality and morbidity in China.Henan,which is the majority with the rural population,is one of the largest populous provinces in China.CAD has become a major public health problem affecting the economic development of the province.Dyslipidemia is one of the most important causes of atherosclerosis.However,the blood lipid levels of rural residents in north Henan is not yet clear.ObjectivesBy analyzing the relationship between blood lipid levels and the prevalence of coronary heart disease CAD and coronary artery lesions severity,the blood lipid levels of the population in rural areas of North Henan were clarified,which providedevidence for the prevention and treatment of CAD.MethodsA total of 1825 patients who underwent coronary angiography for the first time in rural areas in north Henan were selected from the Henan Engineering Research Center for Clinical Data and Biobank of Cardiovascular Diseases from January 2016 to June 2018.According to the diagnostic criteria of CAD,they were divided into CAD group(n = 1211)and control group(CG)(n = 614).Firstly,Spearman partial correlation coefficients(r)were calculated among total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(apo A1),apolipoprotein B(apo B),and non-high-density lipoprotein cholesterol(non-HDL-C).Secondly,the propensity score matching(PSM)method was used to exclude confounding factors,and the effects of different types of blood lipids on CAD were analyzed by binary logistic regression.And we also use the area under curve(AUC)to determine the cutoff values of TC,apo A1,non-HDL-C.Finally,according to the Gensini score,the degree of coronary artery disease was divided into mild,moderate and severe stenosis,and the correlation between blood lipid and the degree of CAD was analyzed by ordered multiple regression method.The degree of coronary artery lesion severity was divided into three different grades according to the Gensini score(GS),including mild,moderate,and severe stenosis.The ordered multiple logistic regression method was used to calculate the odds ratio(OR)and 95% confidence interval(CI).Results1.TC levels correlated strongly and positively with LDL-C,apo B,and non-HDL-C(r = 0.81;r = 0.742 and r = 0.954,respectively).LDL-C was strongly and positively correlated with non-HDL-C and apo B(r = 0.835 and r = 0.761).HDL-C was strongly and positively correlated with apo A1(r = 0.703).2.Before PSM,TC and non-HDL-C were independent risk factors for the incidence of CAD,HDL-C and apo A1 were their independent protective factors.After PSM,multiple logistic regression analysis showed that TC and non-HDL-C were still independent risk factors for the prevalence of CAD(P = 0.014,OR: 1.576,95% CI:1.097~2.265;P = 0.014,OR:1.577,95% CI:1.097~2.266),apo A1 is its independent protective factor(P < 0.001,OR: 0.335;95% CI: 0.163~0.687).3.In the analysis of blood lipid prediction of CAD,the cutoff value of TC is 4.33mmol/L(sensitivity is 63.2%,specificity is 46.6%),non-HDL-C is 2.94mmol/L(sensitivity is 73.4%,specificity is 37.8%),apo A1 is 2.02g/L(specificity is 99.3%,sensitivity is1.4%).4.At the above different levels of blood lipid,the people with dyslipidemia in this area are mostly concentrated between 50-59 years old,followed by 60-69 years old.WhenTC ≥ or < 4.33 mmol/L,the LDL-C level of the population in this region is concentrated between 1.8 and 3.0 mmol/L.While non-HDL-C ≥ 2.49 mmol/L and apo A1 < 2.02 g/L,the level of LDL-C is concentrated in the range of 1.8 to 2.6 mmol/L.5.Non-HDL-C was associated with an increasing risk in coronary artery lesion severity(P = 0.012,OR: 1.281,95% CI: 1.057~1.554).While apo A1 and HDL-C were associated with a reduction risk in coronary artery lesion severity(P = 0.019,OR: 0.506,95% CI: 0.285~0.896 and P = 0.001,OR: 0.389,95% CI: 0.22~0.688).ConclusionIn rural areas of North Henan,plasma cholesterol remains one of the major risk factors for CAD.There is a significant positively correlation between non-HDL-C and TC,which are independent risk factors for CAD and coronary artery lesion severity,while HDL-C and apo A1 are independent protective factors.The LDL-C levels of patients in rural areas of North Henan are mainly concentrated between 1.8 and 2.6 mmol/L.