Remnant Cholesterol and Ischemic Cardiovascular Disease: A Cross-Sectional Study in Northern China

Abstract Background:Heterogeneity exists in the relationship of remnant cholesterol (RC) with cardiovascular disease. In this study, we examined the association between RC and ischemic cardiovascular disease (ICVD) risks and the RC-related risk beyond low-density lipoprotein cholesterol (LDL-C) among people in northern China.Methods:We determined the lipid profile among 65,236 people aged 35–75 years, enrolled between 2015 and 2017, who lived in Inner Mongolia for more than 6 months. Adjusted logistic regression models were used to assess the associations between RC concentration and ICVD risks. Results:In total, 2350 ICVD events were included in the study. RC was significantly associated with the risk of ICVD, CHD events, and ischemic stroke (IS) (ICVD odds ratio [OR] fourth quartile vs first quartile( Q4 vs Q1) 1.253, 95% confidence interval [CI] 1.104–1.421, P trend<0.001; CHD events ORQ4 vs Q1 1.222, 95% CI 1.018–1.466, P trend=0.034; IS ORQ4 vs Q1 1.288, 95% CI 1.090–1.522, P trend=0.001). This association remained significant after including LDL-C and high-density lipoprotein cholesterol (HDL-C). Moreover, the discordant high RC/low LDL-C groupwas associated with increased ICVD risk compared with the low RC/low LDL-C group (OR 1.174, 95% CI 1.029–1.339). Similar results were obtained when adjusting for traditional risk factors of ICVD. Conclusions: We found that RC was associated with an increased risk of ICVD independent of traditional risk factors, LDL-C, and HDL-C levels. The interaction of RC and LDL-C was associated with the risk of ICVD risks.