The differential associations between HDL, non-HDL and total cholesterols and atherosclerotic calcium deposits in multiple vascular beds

Background The purpose of this study was to determine the magnitude of associations between four different cholesterol measures and systemic atherosclerotic calcification. Methods One thousand and seventy-eight consecutive patients were evaluated by electron beam computed tomography for the extent of calcified atherosclerosis in the carotids, coronaries, thoracic aorta, abdominal aorta, renals and iliacs, as well as the mitral and aortic annuli. HDL, non-HDL and total cholesterol were measured using the Cholestec LDX system. Results Overall, the prevalence of calcium in the carotids, coronaries, thoracic aorta, abdominal aorta, iliacs, renals, mitral annulus and aortic annulus was 31.6, 58.7, 40.5, 55.0, 16.8, 57.0, 8.3 and 23.6%, respectively. After multivariable adjustment, a 1-S.D. interval in the total to HDL cholesterol ratio in men was significantly associated with 36 and 29% higher odds for any calcium in the abdominal aorta and iliac arteries, respectively. In women, this same interval was significantly associated with odds ratios of 1.66 and 1.41 for the presence of any calcium in the thoracic and abdominal aorta, respectively. Conclusion Measurement of HDL and non-HDL cholesterols, as well as calculation of the total cholesterol to HDL ratio, may provide a practical means for stratifying the risk for extra-coronary calcified atherosclerosis.