Optimal cutoff value of high-density lipoprotein cholesterol for predicting coronary artery disease in Taiwanese population

Abstract 

The aim of this study was to determine if an optimal cutoff value for high-density lipoprotein cholesterol (HDL-C) can be obtained for predicting the risk of coronary artery disease (CAD) in Taiwanese population. We conducted a hospital-based case-control study. Patients identified by cardiac catheterization as having at least 70% stenosis of one major coronary artery and without diabetes were assigned to the case group (n = 184). The control group (n = 516) was composed of healthy individuals with normal blood biochemical values. The multiple logistic regression analysis was used to evaluate linear association between low-density lipoprotein cholesterol (LDL-C), HDL-C, or LDL-C/HDL-C ratio and CAD while adjusting for confounders. Furthermore, receiver operating characteristic curve analyses were constructed. Individuals with an HDL-C value less than or equal to 60 mg/dL had the significantly highest odds ratio (7.72; 95% confidence interval, 2.70-22.07) after adjusting for LDL-C, LDL-C/HDL-C ratio, and other potential confounders. The areas under the curves were 0.85 and 0.61 for HDL-C and LDL-C, respectively. The optimal cutoff value of HDL-C for predicting the presence of CAD was 46 mg/dL. Sensitivity and specificity using this cutoff value were 71.74% and 81.40%, respectively. Our findings suggest that subjects with lower levels of HDL-C have a much higher risk of CAD than those with higher levels of LDL-C. The optimal cutoff value for HDL-C in predicting the risk of CAD is considered as 46 mg/dL in the Taiwanese population.

Abbreviations: ATP, Adult Treatment Panel, AUCs, areas under the curves, BMI, body mass index, CAD, coronary artery disease, CI, confidence interval, HDL-C, high-density lipoprotein cholesterol, hs-CRP, high-sensitivity C-reactive protein, LDL-C, low-density lipoprotein cholesterol, NECP, National Cholesterol Education Program, OR, odds ratio, PLP, pyridoxal-5′-phosphate, ROC, receiver operating characteristic, SBP, systolic blood pressure, TC, total cholesterol, TG, triglycerides.

Keywords: High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, Receiver operating characteristic curve, Optimal cutoff value, Coronary artery disease, Human