Lipids, Lipoproteins, and Metabolites and Risk of Myocardial Infarction and Stroke
Michael V. Holmes, Iona Y. Millwood, Christiana Kartsonaki, Michael R. Hill, Derrick A. Bennett, Ruth Boxall, Yu Guo, Xin Xu, Zheng Bian, Ruying Hu, Robin G. Walters, Junshi Chen, Mika Ala-Korpela, Sarah Parish, Robert J. Clarke, Richard Peto, Rory Collins, Liming Li, Zhengming Chen and on behalf of the China Kadoorie Biobank Collaborative Group
Lipoprotein Lipids and Other Metabolic Markers With Risk of Incident MI, IS, and ICH
We assessed the associations of metabolic markers measured by nuclear magnetic resonance (NMR) spectroscopy with risk of incident myocardial infarction (MI), ischemic stroke (IS), and intracerebral hemorrhage (ICH). The study demonstrated that lipoprotein subclasses and their lipid constituents shared associations with both risk of MI and IS, but not with risk of ICH. For MI and IS, cholesterol (orange squares and horizontal lines) and triglycerides (green squares and horizontal lines) in apolipoprotein B–containing lipoproteins (very low-density lipoprotein [VLDL], intermediate-density lipoprotein [IDL], and low-density lipoprotein [LDL]) were positively associated with risk of both diseases. In contrast, cholesterol in large and medium high-density lipoprotein (HDL) particles was inversely associated with risk of MI and IS, whereas triglycerides in HDL particles were positively associated with disease risk. Neither lipoproteins nor lipid constituents showed associations with risk of ICH. In contrast, glucose and the inflammation marker glycoprotein acetyls were both associated with higher risks of all 3 diseases. Thus, although lipids and lipoproteins appear to be less relevant to ICH than MI or IS, the association of some metabolites with MI, IS, and ICH indicates shared pathways for all 3 subtypes of vascular disease.