Academia Open
Vol 10 No 1 (2025): June (In Progress)
Medicine

Lipoprotein Ratios as Biomarkers for Assessing Chronic Atherosclerosis Progression
Rasio Lipoprotein sebagai Biomarker untuk Menilai Perkembangan Aterosklerosis Kronis


View Article
  • Abbas Mohsin Abbas,
  • Iman H Shewael,
  • Osama A. Mohsein*
Abbas Mohsin Abbas
Pathological Analysis Department, College of Science, University of Thi-Qar, Iraq
Iman H Shewael
College of Science, University of Thi-Qar, Iraq
Osama A. Mohsein
Thi-Qar Health Directorate, Al Habbobi Teaching Hospital, Thi-Qar, Iraq *

(*) Corresponding Author
Picture in here are illustration from public domain image or provided by the author, as part of their works
DOI: https://doi.org/10.21070/acopen.10.2025.10736
Published March 5, 2025
Keywords
  • Lipoprotein Ratios,
  • Chronic Atherosclerosis,
  • Inflammatory Markers,
  • LDL/HDL,
  • Immune Response,
  • Cardiovascular Risk
    • ...More
    Less
How to Cite
Abbas, A. M., Shewael, I. H., & Mohsein, O. A. (2025). Lipoprotein Ratios as Biomarkers for Assessing Chronic Atherosclerosis Progression. Academia Open, 10(1), 10.21070/acopen.10.2025.10736. https://doi.org/10.21070/acopen.10.2025.10736

Copyright (c) 2025 Abbas Mohsin Abbas, Iman H Shewael, Osama A. Mohsein

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

General Background: Lipoprotein ratios are critical biomarkers for assessing chronic atherosclerosis progression, providing insights into lipid metabolism imbalances and cardiovascular risk. Specific Background: While their role in cardiovascular disease is established, their correlation with inflammatory markers in chronic atherosclerosis remains underexplored. Knowledge Gap: Limited studies have comprehensively examined the interplay between lipid dysregulation and systemic inflammation in chronic atherosclerosis. Aims: This study evaluates the significance of lipoprotein ratios as biomarkers for chronic atherosclerosis progression and their association with inflammatory markers. Methods: A case-control study at Al-Habbobi Teaching Hospital (October 1, 2024 – February 1, 2025) included 60 chronic atherosclerosis patients and 30 healthy controls. Lipoprotein ratios (LDL/HDL, TC/HDL, non-HDL cholesterol) and inflammatory markers (CRP, IL-6, IFN-γ, adiponectin, MCP-1) were analyzed using ELISA, with atherosclerosis severity assessed via intima-media thickness (IMT). Results: Patients exhibited significantly elevated BMI, smoking prevalence, hypertension, lipoprotein ratios (p < 0.001), and inflammatory markers, indicating chronic inflammation. Lipid dysregulation strongly correlated with inflammation. Novelty: This study provides novel evidence linking lipoprotein ratios with inflammatory responses, reinforcing their role as integrated biomarkers. Implications: Understanding lipid-immune interactions may improve early diagnosis, risk stratification, and targeted therapy development for chronic atherosclerosis.

Highlights:

  1. Lipoprotein ratios and inflammation contribute to chronic atherosclerosis progression.
  2. Case-control study analyzing lipoprotein ratios, inflammatory markers, and IMT.
  3. Strong correlation between lipid dysregulation, inflammation, and atherosclerosis severity.

Keyword: Lipoprotein Ratios, Chronic Atherosclerosis, Inflammatory Markers, LDL/HDL, Immune Response, Cardiovascular Risk

View Article

Downloads

Download data is not yet available.

Metrics

No metrics found.

References

  1. P. Libby, "Inflammation in Atherosclerosis—No Longer a Theory," Clinical Chemistry, vol. 67, no. 1, pp. 131-142, 2021.
  2. R. J. Henning, "Obesity and Obesity-Induced Inflammatory Disease Contribute to Atherosclerosis: A Review of the Pathophysiology and Treatment of Obesity," American Journal of Cardiovascular Disease, vol. 11, no. 4, p. 504, 2021.
  3. K. R. Feingold, "Introduction to Lipids and Lipoproteins," Endotext [Internet], 2024.
  4. J. Boren et al., "Metabolism of Triglyceride-Rich Lipoproteins in Health and Dyslipidemia," Nature Reviews Cardiology, vol. 19, no. 9, pp. 577-592, 2022.
  5. D. Lateef, N. Nasser, and O. Mohsein, "The Relationships Between Aplein, Vaspin, and Thyroid Hormone Levels in Obese Diabetic and Non-Diabetic Women," Journal of Experimental and Clinical Medicine, vol. 41, no. 2, pp. 239-245, 2024.
  6. A. Adnan, Z. M. Farhan, and O. A. Mohsein, "Understanding the Link Between Diabetes Mellitus and Fatty Liver Disease: A Narrative Review," International Journal of Chemical Studies, vol. 12, no. 4, pp. 40-48, 2024.
  7. H. W. Jung, S. P. Hong, and K. S. Kim, "Comparison of Apolipoprotein B/A1 Ratio, TC/HDL-C, and Lipoprotein (a) for Predicting Outcomes After PCI," PLoS One, vol. 16, no. 7, p. e0254677, 2021.
  8. J. Mohammadshahi et al., "Role of Lipid Profile and Its Relative Ratios (Cholesterol/HDL‐C, Triglyceride/HDL‐C, LDL‐C/HDL‐C, WBC/HDL‐C, and FBG/HDL‐C) on Admission Predicts In‐Hospital Mortality in COVID‐19," Journal of Lipids, vol. 2023, no. 1, p. 6329873, 2023.
  9. V. Raja et al., "Non-HDL-Cholesterol in Dyslipidemia: Review of the State-of-the-Art Literature and Outlook," Atherosclerosis, vol. 374, p. 117312, 2023.
  10. J. H. Contois et al., "Standardization of Apolipoprotein B, LDL‐Cholesterol, and Non‐HDL‐Cholesterol," Journal of the American Heart Association, vol. 12, no. 15, p. e030405, 2023.
  11. H. S. Abd-Alwahab, Z. M. Farhan, and N. Ahmed, "Estimation of Thyroid Hormone and Adipocytokine Levels in Men With Obesity and Type 2 Diabetes in Thi-Qar Governorate," [unpublished manuscript].
  12. M. K. Akboga et al., "Systemic Immune-Inflammation Index and C-Reactive Protein/Albumin Ratio Could Predict Acute Stent Thrombosis and High SYNTAX Score in Acute Coronary Syndrome," Angiology, vol. 74, no. 7, pp. 693-701, 2023.
  13. R. Salemi et al., "Co-Occurrence of Interleukin-6 Receptor Asp358Ala Variant and High Plasma Levels of IL-6: An Evidence of IL-6 Trans-Signaling Activation in Deep Vein Thrombosis (DVT) Patients," Biomolecules, vol. 12, no. 5, p. 681, 2022.
  14. C. M. Yelnik et al., "Relevance of Inflammatory and Complement Activation Biomarkers Profiling in Antiphospholipid Syndrome Patients Outside Acute Thrombosis," Clinical and Experimental Rheumatology, 2023.
  15. J. L. Silveira Rossi et al., "Metabolic Syndrome and Cardiovascular Diseases: Going Beyond Traditional Risk Factors," Diabetes/Metabolism Research and Reviews, vol. 38, no. 3, p. e3502, 2022.
  16. J. H. Moon et al., "Metabolic Dysfunction-Associated Fatty Liver Disease Predicts Long-Term Mortality and Cardiovascular Disease," Gut and Liver, vol. 16, no. 3, pp. 433-440, 2021.
  17. A. Dehghan et al., "Framingham Risk Scores for Determination of the 10-Year Risk of Cardiovascular Disease in Participants With and Without the Metabolic Syndrome: Results of the Fasa Persian Cohort Study," BMC Endocrine Disorders, vol. 24, no. 1, p. 95, 2024.
  18. W. Li et al., "Association Between the Triglyceride Glucose-Body Mass Index and Future Cardiovascular Disease Risk in a Population With Cardiovascular-Kidney-Metabolic Syndrome Stage 0–3: A Nationwide Prospective Cohort Study," Cardiovascular Diabetology, vol. 23, no. 1, p. 292, 2024.
  19. D. Rotariu et al., "Oxidative Stress—Complex Pathological Issues Concerning the Hallmark of Cardiovascular and Metabolic Disorders," Biomedicine & Pharmacotherapy, vol. 152, p. 113238, 2022.
  20. T. Sun et al., "Predictive Value of LDL/HDL Ratio in Coronary Atherosclerotic Heart Disease," BMC Cardiovascular Disorders, vol. 22, no. 1, p. 273, 2022.
  21. P. Qin et al., "Low‐Density Lipoprotein Cholesterol/High‐Density Lipoprotein Cholesterol Ratio and Carotid Intima‐Media Thickness: A Cohort Study in China," Lipids, vol. 56, no. 1, pp. 59-68, 2021.
  22. C. E. Kosmas et al., "The Triglyceride/High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio as a Risk Marker for Metabolic Syndrome and Cardiovascular Disease," Diagnostics, vol. 13, no. 5, p. 929, 2023.
  23. T. Yang et al., "Correlation Between the Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio and Other Unconventional Lipid Parameters With the Risk of Prediabetes and Type 2 Diabetes in Patients With Coronary Heart Disease: A RCSCD-TCM Study in China," Cardiovascular Diabetology, vol. 21, no. 1, p. 93, 2022.
  24. M. K. Hansen et al., "Non-HDL Cholesterol and Residual Risk of Cardiovascular Events in Patients With Ischemic Heart Disease and Well-Controlled LDL Cholesterol: A Cohort Study," The Lancet Regional Health–Europe, vol. 36, 2024.
  25. A. Wang et al., "Non-HDL-C/HDL-C Ratio Is Associated With Carotid Plaque Stability in General Population: A Cross-Sectional Study," Frontiers in Neurology, vol. 13, p. 875134, 2022.
  26. M. Y. Henein et al., "The Role of Inflammation in Cardiovascular Disease," International Journal of Molecular Sciences, vol. 23, no. 21, p. 12906, 2022.
  27. I. Melnikov et al., "Higher Monomeric C-Reactive Protein Levels Are Associated With Premature Coronary Artery Disease," Frontiers in Immunology, vol. 15, p. 1501125, 2025.
  28. N. Katkenov et al., "Systematic Review on the Role of IL-6 and IL-1β in Cardiovascular Diseases," Journal of Cardiovascular Development and Disease, vol. 11, no. 7, p. 206, 2024.
  29. N. Katkenov et al., "Systematic Review on the Role of IL-6 and IL-1β in Cardiovascular Diseases," J. Cardiovasc. Dev. Dis., vol. 11, no. 7, p. 206, 2024.
  30. H. Greigert et al., "New Insights into the Pathogenesis of Giant Cell Arteritis: Mechanisms Involved in Maintaining Vascular Inflammation," J. Clin. Med., vol. 11, no. 10, p. 2905, 2022.
  31. E. Biros, J. E. Reznik, and C. S. Moran, "Role of Inflammatory Cytokines in Genesis and Treatment of Atherosclerosis," Trends Cardiovasc. Med., vol. 32, no. 3, pp. 138–142, 2022.
  32. N. Hong et al., "The Relationship Between Dyslipidemia and Inflammation Among Adults in East Coast China: A Cross-Sectional Study," Front. Immunol., vol. 13, p. 937201, 2022.
  33. V. Popadic et al., "Correlation of Dyslipidemia and Inflammation With Obstructive Sleep Apnea Severity," Front. Pharmacol., vol. 13, p. 897279, 2022.
  34. C. Blanco et al., "Peri-Implantitis, Systemic Inflammation, and Dyslipidemia: A Cross-Sectional Biochemical Study," J. Periodontal Implant Sci., vol. 51, no. 5, p. 342, 2021.