Serum folate modified the association between low-density lipoprotein cholesterol and carotid intima-media thickness in Chinese hypertensive adults |
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| Affiliation: | 1. Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China;2. People''s Hospital of Rongcheng, Shandong Province, China;3. Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China;4. Shenzhen Evergreen Medical Institute, Shenzhen, China;5. Institute of Biomedicine, Anhui Medical University, Hefei, China;6. Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Institute of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China;7. Department of Cardiology, Peking University First Hospital, Beijing, China;8. Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA;1. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China;2. Tongzhou Maternal and Child Health Hospital of Beijing, 101101, China;3. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China;1. Dipartimento di Farmacia, Università degli Studi di Napoli “Federico II”, Napoli, Italy;2. Fondazione Edmund Mach Research and Innovation Centre, Food Quality and Nutrition Department, S. Michele all'' Adige, Trento, Italy;3. Centro Cardiologico Monzino, IRCCS, Milano, Italy;4. Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy;5. Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy;1. Istanbul Education and Research Hospital, Department of Internal Medicine, Istanbul, Turkey;2. Istanbul Education and Research Hospital, Department of Cardiology, Istanbul, Turkey;1. Deutsches Herzzentrum München, Technische Universität, Munich, Germany;2. Institut für Laboratoriumsmedizin, Deutsches Herzzentrum München, Technische Universität, Munich, Germany;3. 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany;4. DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany;1. College of Pharmacy, Jinan University, Guangzhou, China;2. International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Jinan University, Guangzhou, China;3. Department of Pharmacy, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China;4. Guangzhou Huabo Biopharmaceutical Research Institute, Guangzhou, China;5. Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China;6. Institute of Dongguan-Jinan University, Dongguan, China;1. Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece;2. Faculty of Health, University of Canberra, Canberra, Australia;3. First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece;4. School of Medicine, The University of Notre Dame, Sydney, Australia;5. Medical School, Australian National University, Canberra, Australia |
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| Abstract: | Background and aimsWhile 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 resultsThis 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).ConclusionsAmong 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. |
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| Keywords: | Low-density lipoprotein cholesterol Folate Carotid intima-media thickness Hypertension |
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