Total Cholesterol/HDL-cholesterol Ratio Best Lipid Predictor of Coronary Disease in Turkish Adults: Mean Triglyceride Levels Rise by 1 mg/dl Per Year

In a I O-year follow-up of the original co h ort of the Turkish Adult Risk Factor Study, plasma lipids were determined by the e n zyınat ic method with a Reflotron apparatus in 1862 subjects (mean age 50.6 ±14), and trends were studied after stratifying for sex and age groups. In addition, serum Iipoproteins and apolipoproteins AI and B were determined in 2416 participants comprising the original and new cohorts, the latter by (Behring) turbidimetry. Randam plasma samples were validated in a reference Jaboratory. Af ter age-standardization, mean concentrations of total cholesterol (TC) were not significantly changed in the ı 990s whereas those of triglyceride rose by 4 and 12.8 mg/dJ in men and women, respectively. The presence of high ratios of apo B/apo AI (0.92 and 0.82) in men and women represented an adverse setting of coronary risk. Data of the survey allawed to estimate the presence of 800.000 Turks in whom lipid-towering drugs were being adınİnistered - mostly not in secondary but primary prevention. Strong correlations were noted in univariare analysis between triglycerides and apo B and (inversely) HDL-cholesterol levels in both genders. Among the apparently healthy population at baseline, TC/HDLC ratio proved to be the only significant independent predictor of future fatal and nonfatal coronary heart disease, in a logistic regression model comprising ll risk parameters. Relative risk of 1.295 signified an associated 68% excess coronary risk between a ratio of - for example - 4 and 6. In conclusion, over the past 10 years, an annual increase by 1 mg/dl in plasma triglyceride levels constituted the principal change in plasma lipids among Turks. A prospective evaluation for the prediction of fatal and nonfatal CHD, showed the TC/HDL-C ratio to be the best independent lipid marker which thus should draw special consideration in the risk assessment of Turkish adults.