Non-HDL cholesterol vs. Apo B for risk of coronary heart disease in healthy individuals: The EPIC-Norfolk prospective population study

Abstract

Background: There is an ongoing debate about the performance of non-high-density lipoprotein cholesterol (non-HDL-C) compared with apolipoprotein B (apo B) in the prediction of coronary heart disease (CHD) risk. Therefore, we compared the associations between non-HDL-C and apo B in regard to CHD among apparently healthy Western European individuals. Design: In the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk prospective population study, 25 639 men and women aged 45-79 years were followed for 11.4 ± 2.8 years. Those with diabetes or prevalent CHD at baseline were excluded. A total of 2066 (12.1%) participants developed CHD during 195 692 person-years follow-up. Results: The multivariable-adjusted hazard ratio [HR] of future CHD per one standard deviation increase was 1.22 [95% confidence interval (CI): 1.17-1.27] for LDL-C, 1.26 (95% CI 1.20-1.31) for non-HDL-C and 1.19 (95% CI 1.14-1.24) for apo B, respectively. The multivariable-adjusted HR of future CHD in the highest quartile LDL-C was 1.67 (95% CI: 1.47-1.91). For non-HDL-C and apo B, these respective HRs were 1.87 (95% CI: 1.62-2.15) and 1.56 (95% CI: 1.36-1.78). Kaplan-Meier survival analyses showed that there was incremental and comparable increase in risk of CHD with increasing quartiles of both non-HDL-C and apo B. Conclusions: In this prospective study, non-HDL-C and apo B were comparable in their ability to predict risk of future CHD. © 2013 Stichting European Society for Clinical Investigation Journal Foundation.