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[Changes in high density lipoproteins in peripheral vascular disease]
J Pedro-Botet1, M Sentí, X Nogués
1Departamento de Medicina, Hospital del Mar, Barcelona.
Insights
High-density lipoprotein cholesterol (HDL-C) is a key indicator for peripheral vascular disease (PVD). Lower HDL-C levels correlate with increased severity of lower limb ischemia in PVD patients.
Area of Science:
- Cardiovascular Medicine
- Lipidology
- Vascular Biology
Background:
- Lipid and lipoprotein disturbances are implicated in atherosclerosis development.
- Changes in high-density lipoprotein (HDL) composition in peripheral vascular disease (PVD) and their link to lower limb ischemia severity require clarification.
Purpose of the Study:
- To investigate HDL composition changes in PVD patients.
- To determine the relationship between HDL composition and the severity of lower limb ischemia.
Main Methods:
- Study included 102 men with PVD and 100 age-sex-matched controls.
- Collected data on smoking history and measured serum lipids, HDL-cholesterol, HDL-proteins, apoprotein A-I, and HDL-triglycerides.
- Assessed ischemia severity using the arm-ankle pressure index.
Main Results:
- PVD patients exhibited higher serum triglycerides and lower HDL-cholesterol and HDL-proteins compared to controls.
- Smoker patients with PVD had elevated triglycerides and reduced HDL-cholesterol.
- A significant decrease in HDL-cholesterol was observed with increasing severity of lower limb ischemia.
Conclusions:
- HDL-cholesterol is identified as the primary marker for PVD.
- The severity of ischemia in PVD is directly associated with reduced HDL-cholesterol levels.
- Apolipoprotein A-I was not found to be a risk marker for PVD in this study.
Background:
It is well known that lipid and lipoprotein disturbances play an important role in the development of atherosclerosis. However, the changes in the high density lipoprotein (HDL) composition in patients with peripheral vascular disease (PVD) and its relation to the severity of ischemia of the lower limbs need to be clarified.
Methods:
HDL abnormalities have been studied in 102 men with PVD and in 100 age-sex-matched controls. History of smoking was recorded in 88 patients, but only 58 were smokers at the time of the study; 35 of controls were smokers.
Results:
Serum triglycerides were 1.66 +/- 0.85 mmol/L (mean +/- SD) in patients and 1.29 +/- 0.61 mmol/L in controls (p less than 0.001). HDL-cholesterol was 0.97 +/- 0.27 mmol/L and 1.08 +/- 0.28 mmol/L (p less than 0.01) respectively; HDL-proteins were 1.16 +/- 0.21 g/L and 1.25 +/- 0.17 g/L (p less than 0.005) respectively. No significant differences were observed when serum apoprotein (apo) A-I and HDL-triglycerides levels were compared between patients and controls. Smoker patients showed a significant increase in serum triglycerides (p less than 0.005) and a lower HDL-cholesterol concentrations (p less than 0.005) compared with non smoker patients. Patients with more severe distal involvement according to the arm-ankle pressure index showed a significantly greater reduction in HDL-cholesterol (p less than 0.05).
Conclusions:
HDL-cholesterol is the best marker of PVD, and the degree of severity of ischemia was associated with greater decrease in HDL-cholesterol. Apo A-I has not been revealed as a risk marker for PVD.