Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators
Abstract Purpose Cholesterol metabolism is a risk factor for cardiovascular disease, and recent studies have shown that cholesterol metabolism poses a residual risk of cardiovascular disease even when conventional lipid risk factors are in the optimal range. The association between remnant cholester...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-09-01
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| Series: | Lipids in Health and Disease |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12944-023-01915-y |
| _version_ | 1797556782897299456 |
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| author | Yuxuan Wu Qinfei Wei Husheng Li Han Yang Yuying Wu Yiming Yu Qiansi Chen Baochang He Fa Chen |
| author_facet | Yuxuan Wu Qinfei Wei Husheng Li Han Yang Yuying Wu Yiming Yu Qiansi Chen Baochang He Fa Chen |
| author_sort | Yuxuan Wu |
| collection | DOAJ |
| description | Abstract Purpose Cholesterol metabolism is a risk factor for cardiovascular disease, and recent studies have shown that cholesterol metabolism poses a residual risk of cardiovascular disease even when conventional lipid risk factors are in the optimal range. The association between remnant cholesterol (RC) and cardiovascular disease has been demonstrated; however, its association with hypertension, type 2 diabetes mellitus (T2DM), and the concomitance of the two diseases requires further study. This study aimed to evaluate the association of RC with hypertension, T2DM, and both in a large sample of the U.S. population, and to further explore the potential mechanisms involved. Methods This cross-sectional study used data from the 2005—2018 cycles of the National Health and Nutrition Examination Survey (N = 17,749). Univariable and multivariable logistic regression analyses were performed to explore the relationships of RC with hypertension, T2DM, and both comorbidities. A restricted cubic spline regression model was used to reveal the dose effect. Mediation analyses were performed to explore the potential mediating roles of inflammation-related indicators in these associations. Results Of the 17,749 participants included (mean [SD] age: 41.57 [0.23] years; women: 8983 (50.6%), men: 8766 (49.4%)), the prevalence of hypertension, T2DM, and their co-occurrence was 32.6%, 16.1%, and 11.0%, respectively. Higher RC concentrations were associated with an increased risk of hypertension, T2DM, and their co-occurrence (adjusted odds ratios for per unit increase in RC were 1.068, 2.259, and 2.362, and 95% confidence intervals were 1.063–1.073, 1.797–2.838, and 1.834–3.041, respectively), with a linear dose–response relationship. Even when conventional lipids were present at normal levels, positive associations were observed. Inflammation-related indicators (leukocytes, lymphocytes, monocytes, and neutrophils) partially mediated these associations. Among these, leukocytes had the greatest mediating effect (10.8%, 14.5%, and 14.0%, respectively). Conclusion The results of this study provide evidence that RC is associated with the risk of hypertension, T2DM, and their co-occurrence, possibly mediated by an inflammatory response. |
| first_indexed | 2024-03-10T17:07:52Z |
| format | Article |
| id | doaj.art-631cca4f2e63435aa5cd7c36fb2ee5d8 |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-03-10T17:07:52Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj.art-631cca4f2e63435aa5cd7c36fb2ee5d82023-11-20T10:45:41ZengBMCLipids in Health and Disease1476-511X2023-09-0122111210.1186/s12944-023-01915-yAssociation of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicatorsYuxuan Wu0Qinfei Wei1Husheng Li2Han Yang3Yuying Wu4Yiming Yu5Qiansi Chen6Baochang He7Fa Chen8Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityDepartment of Preventive Medicine, School of Public Health, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical UniversityAbstract Purpose Cholesterol metabolism is a risk factor for cardiovascular disease, and recent studies have shown that cholesterol metabolism poses a residual risk of cardiovascular disease even when conventional lipid risk factors are in the optimal range. The association between remnant cholesterol (RC) and cardiovascular disease has been demonstrated; however, its association with hypertension, type 2 diabetes mellitus (T2DM), and the concomitance of the two diseases requires further study. This study aimed to evaluate the association of RC with hypertension, T2DM, and both in a large sample of the U.S. population, and to further explore the potential mechanisms involved. Methods This cross-sectional study used data from the 2005—2018 cycles of the National Health and Nutrition Examination Survey (N = 17,749). Univariable and multivariable logistic regression analyses were performed to explore the relationships of RC with hypertension, T2DM, and both comorbidities. A restricted cubic spline regression model was used to reveal the dose effect. Mediation analyses were performed to explore the potential mediating roles of inflammation-related indicators in these associations. Results Of the 17,749 participants included (mean [SD] age: 41.57 [0.23] years; women: 8983 (50.6%), men: 8766 (49.4%)), the prevalence of hypertension, T2DM, and their co-occurrence was 32.6%, 16.1%, and 11.0%, respectively. Higher RC concentrations were associated with an increased risk of hypertension, T2DM, and their co-occurrence (adjusted odds ratios for per unit increase in RC were 1.068, 2.259, and 2.362, and 95% confidence intervals were 1.063–1.073, 1.797–2.838, and 1.834–3.041, respectively), with a linear dose–response relationship. Even when conventional lipids were present at normal levels, positive associations were observed. Inflammation-related indicators (leukocytes, lymphocytes, monocytes, and neutrophils) partially mediated these associations. Among these, leukocytes had the greatest mediating effect (10.8%, 14.5%, and 14.0%, respectively). Conclusion The results of this study provide evidence that RC is associated with the risk of hypertension, T2DM, and their co-occurrence, possibly mediated by an inflammatory response.https://doi.org/10.1186/s12944-023-01915-yHypertensionType 2 diabetesComorbidityRemnant cholesterolInflammation |
| spellingShingle | Yuxuan Wu Qinfei Wei Husheng Li Han Yang Yuying Wu Yiming Yu Qiansi Chen Baochang He Fa Chen Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators Lipids in Health and Disease Hypertension Type 2 diabetes Comorbidity Remnant cholesterol Inflammation |
| title | Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators |
| title_full | Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators |
| title_fullStr | Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators |
| title_full_unstemmed | Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators |
| title_short | Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators |
| title_sort | association of remnant cholesterol with hypertension type 2 diabetes and their coexistence the mediating role of inflammation related indicators |
| topic | Hypertension Type 2 diabetes Comorbidity Remnant cholesterol Inflammation |
| url | https://doi.org/10.1186/s12944-023-01915-y |
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