Dyslipidemia and cardiovascular disease risk among the MASHAD study population

TLDR

Dyslipidemia, defined by elevated total cholesterol, LDL‑C, triglycerides or low HDL‑C, is a well‑established risk factor for cardiovascular disease. The study aimed to examine the relationship between dyslipidemia and cardiovascular events in a population from Mashhad, Iran. A prospective cohort of 8,698 adults aged 35–65 was followed for six years, with baseline socioeconomic, anthropometric, laboratory, lifestyle, and medical data collected and Cox regression used to assess dyslipidemia components’ association with CVD incidence. After adjustment for confounders, only baseline total cholesterol remained significantly linked to myocardial infarction risk in men (HR 2.71), while other lipid measures were not independently predictive of total CVD events.

Abstract

Abstract Introduction Dyslipidemia may be defined as increased levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), or a decreased serum high-density lipoprotein cholesterol (HDL-C) concentration. Dyslipidemia is an established risk factor for cardiovascular disease (CVD). We aimed to investigate the association of dyslipidemia and CVD events among a population sample from Mashhad, in northeastern Iran. Material and methods This prospective cohort study comprised a population of 8698 men and women aged 35–65 years who were recruited from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. Socioeconomic and demographic status, anthropometric parameters, laboratory evaluations, lifestyle factors, and medical history were gathered through a comprehensive questionnaire and laboratory and clinical assessment for all participants. Cox regression model and 95% confidence interval (CI) were used to evaluate the association of dyslipidemia and its components with CVD incidence. Results After 6 years of follow-up, 233 cases of CVD (including 119 cases of unstable angina [US], 74 cases of stable angina [SA], and 40 cases of myocardial infarction [MI]) were identified in the study population. Unadjusted baseline serum LDL-C, TC, and TG levels were positively associated with the risk of total CVD events among the entire population (HR: 1.54, 95% CI: 1.19–2; P -value< 0.01; HR: 1.53; 95% CI: 1.18–1.98; P < 0.01; HR: 1.57; 95% CI: 1.27–2.03; P < 0.01, respectively). However, after adjusting for confounding factors (age, body mass index [BMI], family history of CVD, smoking status [non-smoker, ex-smoker and current smoker], lipid lowering drug treatment, anti-hypertensive drug treatment, hypertension, healthy eating index [HEI], total energy intake, and presence of diabetes mellitus), a significant direct association only remained between TC and MI risk in men (HR: 2.71; 95%CI: 1.12–6.57; P -value< 0.05). Conclusion In the present study, TC baseline level was significantly associated with the risk of MI among men.