[A meta-analysis on the association between high-density lipoprotein particle subfractions and cardiovascular disease...

High-density lipoprotein cholesterol (HDL-C) has cardio-protective effects. However, results from clinical trials showed that improving HDL-C levels alone did not reduce the cardiovascular disease (CVD) events and different HDL particles (HDL-P) subfractions may relate to different CVD risk. In this meta-analysis, we reviewed prospective studies reported relationships of HDL-P subfractions with CVD risk.

MEDLINE, Cochrane Library and China National Knowledge Infrastructure (CNKI) were searched up to July 1st, 2013.

Prospective studies that reported an association of HDL-P subfractions with the incidence of CVD were included and studies did not assess the hazard ratio, relative risk, or odds ratio of HDL-P and studies did not adjust for any other risk factors were excluded.

All studies were extracted by 1 researcher and verified by another researcher. Full data were extracted from the studies meanwhile the quality was evaluated. Heterogeneity was analyzed. Pooled relative risk (RR) and 95% confidence interval were calculated.

Six studies were enrolled in this meta-analysis. HDL-P can be grouped into three subfractions: large HDL-P, medium HDL-P and small HDL-P. Only higher large HDL-P concentration was associated with decreased risk for CVD and pooled RR was 0.65 (95%CI:0.55-0.76). Medium HDL-P and small HDL-P were not associated with the incidence of CVD events.

Higher large HDL-P concentration is associated with lower CVD risk. Assessment of HDL-P subfractions may thus be of great clinical importance for evaluating the CVD risk.