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].
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 ].
Publisher Copyright:
© 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University
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
SN - 0939-4753
VL - 30
SP - 2303
EP - 2311
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
IS - 12
ER -