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Abstract：
BACKGROUND: The high-density lipoprotein cholesterol to apolipoprotein A-I index (HDL-C/ApoA-I) may be practical and useful in clinical practice as a marker of atherosclerosis. This study aimed to investigate the association between the HDL-C/ApoA-I index with cardiometabolic risk factors and subclinical atherosclerosis.
METHODS: In this cross-sectional sub-analysis of the GEA study, 1,363 individuals, women (51.3%) and men (48.7%) between 20 and 75 years old, without coronary heart disease or diabetes mellitus were included. We defined an adverse cardiometabolic profile as excess adipose tissue metrics, non-alcoholic liver fat measured by non-contrasted tomography, metabolic syndrome, dyslipidemias, and insulin resistance. The population was stratified by quartiles of the HDL-C/Apo-AI index, and its dose-relationship associations were analysed using Tobit regression, binomial, and multinomial logistic regression analysis.
RESULTS: Body mass index, visceral and pericardial fat, metabolic syndrome, fatty liver, high blood pressure, and CAC were inversely associated with the HDL-C/ApoA-I index. The CAC > 0 prevalence was higher in quartile 1 (29.2%) than in the last quartile (22%) of HDL-C/ApoA-I index (p = 0.035). The probability of having CAC > 0 was higher when the HDL-C/ApoA-I index was less than 0.28 (p < 0.001). This association was independent of classical coronary risk factors, visceral and pericardial fat measurements.
CONCLUSIONS: The HDL-C/ApoA-I index is inversely associated with an adverse cardiometabolic profile and CAC score, making it a potentially useful and practical biomarker of coronary atherosclerosis. Overall, these findings suggest that the HDL-C/ApoA-I index could be useful for evaluating the probability of having higher cardiometabolic risk factors and subclinical atherosclerosis in adults without CAD.
METHODS: In this cross-sectional sub-analysis of the GEA study, 1,363 individuals, women (51.3%) and men (48.7%) between 20 and 75 years old, without coronary heart disease or diabetes mellitus were included. We defined an adverse cardiometabolic profile as excess adipose tissue metrics, non-alcoholic liver fat measured by non-contrasted tomography, metabolic syndrome, dyslipidemias, and insulin resistance. The population was stratified by quartiles of the HDL-C/Apo-AI index, and its dose-relationship associations were analysed using Tobit regression, binomial, and multinomial logistic regression analysis.
RESULTS: Body mass index, visceral and pericardial fat, metabolic syndrome, fatty liver, high blood pressure, and CAC were inversely associated with the HDL-C/ApoA-I index. The CAC > 0 prevalence was higher in quartile 1 (29.2%) than in the last quartile (22%) of HDL-C/ApoA-I index (p = 0.035). The probability of having CAC > 0 was higher when the HDL-C/ApoA-I index was less than 0.28 (p < 0.001). This association was independent of classical coronary risk factors, visceral and pericardial fat measurements.
CONCLUSIONS: The HDL-C/ApoA-I index is inversely associated with an adverse cardiometabolic profile and CAC score, making it a potentially useful and practical biomarker of coronary atherosclerosis. Overall, these findings suggest that the HDL-C/ApoA-I index could be useful for evaluating the probability of having higher cardiometabolic risk factors and subclinical atherosclerosis in adults without CAD.
摘要：
背景：高密度脂蛋白胆固醇对载脂蛋白A-I指数（HDL-C/ApoA-I）在临床实践中作为动脉粥样硬化的标志物可能是实用且有用的。本研究旨在探讨HDL-C/ApoA-I指数与心脏代谢危险因素和亚临床动脉粥样硬化之间的关系。
方法：在GEA研究的横截面子分析中，1363人,20至75岁的女性(51.3%)和男性(48.7%)，纳入无冠心病或糖尿病的患者。我们将不良的心脏代谢谱定义为过量的脂肪组织指标，通过非对比断层扫描测量的非酒精性肝脏脂肪，代谢综合征,血脂异常,和胰岛素抵抗。按HDL-C/Apo-AI指数的四分位数对人群进行分层，并使用Tobit回归分析其剂量关系关联，二项式,和多项逻辑回归分析。
结果：体重指数，内脏和心包脂肪，代谢综合征,脂肪肝,高血压,和CAC与HDL-C/ApoA-I指数呈负相关。HDL-C/ApoA-I指数的四分位数1（29.2％）的CAC>0患病率高于最后四分位数（22％）（p=0.035）。当HDL-C/ApoA-I指数小于0.28时,CAC>0的概率更高(p<0.001)。这种关联独立于经典的冠状动脉危险因素，内脏和心包脂肪测量。
结论：HDL-C/ApoA-I指数与不良心脏代谢谱和CAC评分呈负相关，使其成为冠状动脉粥样硬化的潜在有用和实用的生物标志物。总的来说,这些研究结果表明,HDL-C/ApoA-I指数可用于评估无CAD的成人中更高的心脏代谢危险因素和亚临床动脉粥样硬化的可能性.
方法：在GEA研究的横截面子分析中，1363人,20至75岁的女性(51.3%)和男性(48.7%)，纳入无冠心病或糖尿病的患者。我们将不良的心脏代谢谱定义为过量的脂肪组织指标，通过非对比断层扫描测量的非酒精性肝脏脂肪，代谢综合征,血脂异常,和胰岛素抵抗。按HDL-C/Apo-AI指数的四分位数对人群进行分层，并使用Tobit回归分析其剂量关系关联，二项式,和多项逻辑回归分析。
结果：体重指数，内脏和心包脂肪，代谢综合征,脂肪肝,高血压,和CAC与HDL-C/ApoA-I指数呈负相关。HDL-C/ApoA-I指数的四分位数1（29.2％）的CAC>0患病率高于最后四分位数（22％）（p=0.035）。当HDL-C/ApoA-I指数小于0.28时,CAC>0的概率更高(p<0.001)。这种关联独立于经典的冠状动脉危险因素，内脏和心包脂肪测量。
结论：HDL-C/ApoA-I指数与不良心脏代谢谱和CAC评分呈负相关，使其成为冠状动脉粥样硬化的潜在有用和实用的生物标志物。总的来说,这些研究结果表明,HDL-C/ApoA-I指数可用于评估无CAD的成人中更高的心脏代谢危险因素和亚临床动脉粥样硬化的可能性.
