TY - JOUR
T1 - Serum folate modified the association between low-density lipoprotein cholesterol and carotid intima-media thickness in Chinese hypertensive adults
AU - Ding, Congcong
AU - Bi, Chonglei
AU - Lin, Tengfei
AU - Hu, Lihua
AU - Huang, Xiao
AU - Liu, Lishun
AU - Liu, Chengzhang
AU - Song, Yun
AU - Tang, Genfu
AU - Wang, Binyan
AU - Qin, Xianhui
AU - Yang, Ying
AU - Zhang, Yan
AU - Li, Jianping
AU - Li, Ping
AU - Bao, Huihui
AU - Wang, Xiaobin
AU - Xu, Xiping
AU - Huo, Yong
AU - Cheng, Xiaoshu
N1 - Funding Information:
We thank the investigators and participants of the China Stroke Primary Prevention Trial (CSPPT), the parent study, who made this report possible. The study was supported by funding from the following: the National Key Research and Development Program of China [ 2016YFE0205400 , 2018ZX09739010 , 2018ZX09301034003 ], the Science and Technology Planning Project of Guangzhou , China [ 201707020010 ]; the Science, Technology and Innovation Committee of Shenzhen , China [ GJHS20170314114526143 , JSGG20180703155802047 ]; the Economic, Trade and Information Commission of Shenzhen Municipality , China [ 20170505161556110 , 20170505160926390 ]; the National Natural Science Foundation of China [ 81730019 , 81960074 , 81500233 ]; Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University [ 2019J004 ]; Jiangxi Outstanding Person Foundation , China [ 20192BCBL23024 ] and the Major projects of the Science and Technology Department, Jiangxi , China [ 20171BAB205008 ].
PY - 2020/11/27
Y1 - 2020/11/27
N2 - Background and aims: While folate is known for its importance in cardiovascular health, it is unknown whether folate status can modify the association between low-density lipoprotein cholesterol (LDL-C) and carotid intima-media thickness (CIMT). We aimed to investigate this question in a Chinese hypertensive population, who are at high-risk of low folate and atherosclerosis. Methods and results: This report included 14,970 hypertensive adults (mean age 64.5 years; 40.3% male) from the China Stroke Primary Prevention Trial (CSPPT) and analyzed the fasting serum LDL-C and folate, and CIMT data obtained at the last follow-up visit. LDL-C was calculated using the Friedewald equation. Serum folate levels were measured by chemiluminescent immunoassay. CIMT was measured by ultrasound. Non-parametric smoothing plots, multivariate linear regression analysis, subgroup analyses and interaction testing were performed to examine the LDL-C–CIMI relationship and effect modification by folate. Consistent with graphic plots, multivariate linear regression showed that LDL-C levels were independently and positively associated with CIMT (β = 7.69, 95%CI: 5.76–9.62). More importantly, the relationship between LDL-C and CIMT was significantly attenuated with increasing serum folate levels (1st tertile: β = 10.06, 95%CI: 6.67–13.46; 2nd tertile: β = 6.81, 95%CI: 3.55–10.07; 3rd tertile: β = 5.96, 95%CI: 2.55–9.36; P-interaction = 0.045). Subgroup analyses showed the association between LDL-C and CIMT across serum folate tertiles was robust among various strata (all P-interaction >0.05). Conclusions: Among Chinese hypertensive adults, the serum folate levels could modify the association between LDL-C and CIMT. Our findings, if further confirmed, have important clinical implications.
AB - Background and aims: While folate is known for its importance in cardiovascular health, it is unknown whether folate status can modify the association between low-density lipoprotein cholesterol (LDL-C) and carotid intima-media thickness (CIMT). We aimed to investigate this question in a Chinese hypertensive population, who are at high-risk of low folate and atherosclerosis. Methods and results: This report included 14,970 hypertensive adults (mean age 64.5 years; 40.3% male) from the China Stroke Primary Prevention Trial (CSPPT) and analyzed the fasting serum LDL-C and folate, and CIMT data obtained at the last follow-up visit. LDL-C was calculated using the Friedewald equation. Serum folate levels were measured by chemiluminescent immunoassay. CIMT was measured by ultrasound. Non-parametric smoothing plots, multivariate linear regression analysis, subgroup analyses and interaction testing were performed to examine the LDL-C–CIMI relationship and effect modification by folate. Consistent with graphic plots, multivariate linear regression showed that LDL-C levels were independently and positively associated with CIMT (β = 7.69, 95%CI: 5.76–9.62). More importantly, the relationship between LDL-C and CIMT was significantly attenuated with increasing serum folate levels (1st tertile: β = 10.06, 95%CI: 6.67–13.46; 2nd tertile: β = 6.81, 95%CI: 3.55–10.07; 3rd tertile: β = 5.96, 95%CI: 2.55–9.36; P-interaction = 0.045). Subgroup analyses showed the association between LDL-C and CIMT across serum folate tertiles was robust among various strata (all P-interaction >0.05). Conclusions: Among Chinese hypertensive adults, the serum folate levels could modify the association between LDL-C and CIMT. Our findings, if further confirmed, have important clinical implications.
KW - Carotid intima-media thickness
KW - Folate
KW - Hypertension
KW - Low-density lipoprotein cholesterol
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U2 - 10.1016/j.numecd.2020.07.021
DO - 10.1016/j.numecd.2020.07.021
M3 - Article
C2 - 32912792
AN - SCOPUS:85090479861
VL - 30
SP - 2303
EP - 2311
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
SN - 0939-4753
IS - 12
ER -