Effect of cumulative exposure to different lipid profiles on carotid intima-media thickness in an asymptomatic population

Background: Carotid intima-media thickness (CIMT) is considered as a marker for the early stage of atherosclerosis. The exploration focus has shifted from one single lipoprotein assessment to the cumulative exposure of lipoproteins, we thus aimed to investigate the relationship between cumulative exposure to different lipid parameters and CIMT. Methods 2,348 participants with lipid parameters measured biennially since 2006 were enrolled from the Asymptomatic Polyvascular Abnormalities Community study. Cumulative lipid burden was calculated by adding the weighted sum of the difference between the measured value and the cutoff value of each parameter, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), and non-HDLC. CIMT was detected by carotid ultrasound. Linear and logistic analyses were applied to evaluate the association between cumulative lipid burden and CIMT. Results The results of linear and logistic analyses were essentially the same, as TC and LDLC burden were significantly associated with thickening CIMT ( p  < 0.05). A 2.65-fold, 1.67-fold increased risk of abnormal CIMT was documented in the highest quartile of these two lipid burdens. For TG and HLDC burden, no consistent association was obtained. Notably, a dose-dependent relationship was observed in the overall population when taking non-HDLC burden as a continuous variable (fully-adjusted β coefficient = 0.0013, 95%CI 0.0004–0.0022). Conclusions Among the five lipid parameters, TC and LDLC burden were independently associated with abnormal CIMT. Achieving optimal lipid levels is of great importance for the prevention and management of subclinical atherosclerosis.