OBJECTIVETo evaluate the relationship between serum non-HDL-C and incidence of various cardiovascular disease (CVD) in Chinese population aged 35-64 years.

METHODSThis prospective study was performed from 1992 to 2004 in 11 provinces of China and the association between baseline non-HDL-C level with the risk of various CVD events was analyzed in 29 937 subjects aged 35-64 years using Cox multivariate proportional hazards regression. CVD events in this study including acute coronary events (ACE), ischemic stroke, hemorrhagic stroke and ischemic cardiovascular disease (ICVD).

RESULTS(1) Adjusted for age, gender, smoking status, diabetes, body mass index and blood pressure, the relative risk of ACE, ischemic stroke and ICVD in groups of non-HDL-C 3.37 - 4.13 mmol/L (130 - 159 mg/dl), 4.14 - 4.91 mmol/L (160 - 189 mg/dl) and ≥ 4.92 mmol/L (190 mg/dl) was 1.24 (0.91 - 1.70), 1.78 (1.25 - 2.53), 2.23 (1.48 - 3.35); 1.34 (1.07 - 1.68), 1.38 (1.04 - 1.83), 1.38 (0.97 - 1.94) and 1.37 (1.12 - 1.63), 1.52 (1.22 - 1.90), 1.70 (1.30 - 2.22), respectively. The risk of hemorrhagic stroke was declined obviously in group > 4.92 mmol/L (190 mg/dl). (2) The correlation between VLDL-C and ACE was the strongest in four CVD events when VLDL-C and LDL-C were joint analyzed, ICVD events ranked the second. The risk for ischemic stroke also borderline increased with increasing VLDL-C and LDL-C (P > 0.05).

CONCLUSIONIncreased non-HDL-C is associated with increased risk of suffering ACE, ischemic stroke and ICVD and VLDL-C plays a critical role in the development of ICVD events, especially ACS, in middle aged Chinese population.