Apolipoprotein B and non-high density lipoprotein cholesterol and the risk of coronary heart disease in Chinese

The aim of our study was to compare apolipoprotein B ( apoB), non-high density lipoprotein cholesterol ( nonHDL-C), low density lipoprotein cholesterol ( LDL-C), and other lipid markers as predictors of coronary heart disease ( CHD) in Chinese. Overall, 122 individuals developed CHD during a median 13.6 years of follow-up in 3,568 adult participants from a community-based cohort. The multivariate relative risk of CHD in the highest quintile compared with the lowest quintile was 2.74 [95% confidence interval ( CI), 1.45-5.19] for apoB, 1.98 ( 95% CI, 1.00-3.92) for nonHDL-C, and 1.86 ( 95% CI, 1.00-3.49) for LDL-C ( all tests for trend, P < 0.05). ApoB also had the highest receiver operator characteristic curve area ( 0.63; 95% CI, 0.58-0.68) in predicting CHD. When apoB and nonHDL-C were mutually adjusted, only apoB was predictive; the relative risk was 2.80 ( 95% CI, 1.31-5.96; P = 0.001) compared with 1.09 ( 95% CI, 0.49-2.40; P = 0.75) for nonHDL-C. Compared with the lowest risk, participants with the highest apoB and total cholesterol/HDL-C had a 3-fold increased risk of developing CHD ( relative risk = 3.21; 95% CI, 1.45-7.14). These data provide strong evidence that apoB concentration was a better predictor of CHD than other lipid markers in Chinese.