The blood level of lipids, apolipoproteins, and lipid ratios are important predictors of some chronic diseases. However, their association with cardiometabolic multimorbidity (CMM) is less known. We evaluated a wide range of lipid profiles and lipid ratios, including low-density lipoprotein-cholesterol (LDL-C), very-low-density lipoprotein-cholesterol (VLDL-C), high-density lipoprotein-cholesterol (HDL-C), and apoA1 and B, as well triglyceride and total cholesterol with risk of incident CMM. In 1728 men aged 52.5 ± 5.2 years from the Kuopio Ischaemic Heart Disease were included in this study. We defined CMM as coexisting of two or more of stroke, type 2 diabetes mellitus (T2D), coronary heart disease (CHD). A Cox proportional hazard regression method was applied to evaluate the risk of CMM against the exposures. During the mean follow-up of 22.4 years, 335 men suffered from CMM conditions. Higher serum triglyceride and VLDL concentrations were associated with a higher risk of coexisting T2D-CHD (HRs 1.99 (95% CI, 1.12–3.53) and HRs 1.79 (95% CI, 1.04–3.11), respectively. Whereas higher HDL was associated with lower incident [HRs 0.49 (95% CI, 0.40–1.00)]. The HRs for coexisting T2D-CHD was 2.02 (95% CI, 1.01–3.07) for total cholesterol/HDL-C, 1.85 (95% CI, 1.04–3.29) for triglyceride/HDL-C, 1.69 (95% CI, 1.01–2.31) for Non-HDL-C/HDL-C, and 1.89 (95% CI, 1.03–2.46) for apoB/apoA1. In contrast, serum LDL-C/apoB ratios were inversely associated with the risk of coexisting T2D-CHD [HRs 0.50 (95% CI, 0.28–0.90)]. No associations were observed between our exposures and other CMM conditions. In conclusion, elevated triglyceride, VLDL-C, total cholesterol/HDL-C, TG/HDL-C, apoB/apoA1 as well as lower LDL-C/apoB were independently associated with the higher risk of T2D-CHD coexistence.

中文翻译：

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男性的血脂谱、血脂比率、载脂蛋白和心脏代谢多种疾病的风险：库奥皮奥缺血性心脏病危险因素研究

血液中脂质、载脂蛋白和脂质比率的水平是一些慢性疾病的重要预测指标。然而，它们与心脏代谢多病（CMM）的关联却鲜为人知。我们评估了各种脂质谱和脂质比率，包括低密度脂蛋白胆固醇 (LDL-C)、极低密度脂蛋白胆固醇 (VLDL-C)、高密度脂蛋白胆固醇 (HDL-C) 、apoA1 和 B，以及甘油三酯和总胆固醇，具有发生 CMM 的风险。本研究纳入了 1728 名年龄 52.5 ± 5.2 岁、患有库奥皮奥缺血性心脏病的男性。我们将CMM定义为中风、2型糖尿病(T2D)、冠心病(CHD)中两种或两种以上的疾病并存。应用 Cox 比例风险回归方法来评估 CMM 针对暴露的风险。在平均 22.4 年的随访期间，有 335 名男性患有 CMM 病症。较高的血清甘油三酯和 VLDL 浓度与较高的共存 T2D-CHD 风险相关（HR 分别为 1.99（95% CI，1.12–3.53）和 HR 1.79（95% CI，1.04–3.11）。而较高的 HDL 则与较高的 T2D-CHD 风险相关。较低的发生率 [HR 0.49 (95% CI, 0.40–1.00)]。共存 T2D-CHD 的 HR 为 2.02 (95% CI, 1.01–3.07)，总胆固醇/HDL-C 为 1.85 (95% CI, 1.04–甘油三酯/HDL-C 为 3.29)，非 HDL-C/HDL-C 为 1.69 (95% CI，1.01–2.31)，apoB/apoA1 为 1.89 (95% CI，1.03–2.46)。 LDL-C/apoB 比率与共存 T2D-CHD 的风险呈负相关 [HR 0.50 (95% CI, 0.28–0.90)]。在我们的暴露与其他 CMM 状况之间没有观察到任何关联。总之，甘油三酯、VLDL 升高-C、总胆固醇/HDL-C、TG/HDL-C、apoB/apoA1 以及较低的 LDL-C/apoB 与 T2D-CHD 共存的较高风险独立相关。