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High-density lipoprotein subfractions and carotid plaque: the Northern Manhattan Study
Eduard Tiozzo1, Hannah Gardener2, Barry I Hudson3
1Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
Insights
High-density lipoprotein cholesterol (HDL-C) subfractions HDL3-C and HDL2-C show distinct associations with carotid plaque characteristics. Lower HDL3-C relates to reduced plaque area, while higher HDL2-C correlates with increased plaque thickness, impacting vascular disease risk.
Area of Science:
- Cardiovascular Medicine
- Lipid Metabolism
- Vascular Biology
Background:
- High-density lipoprotein cholesterol (HDL-C) plays a crucial role in reverse cholesterol transport.
- HDL-C exists in distinct subfractions, HDL2-C and HDL3-C, with potentially differential atherogenic roles.
- Understanding these subfractions' associations with subclinical atherosclerosis is vital for cardiovascular risk assessment.
Purpose of the Study:
- To investigate the relationship between HDL2-C and HDL3-C levels and carotid plaque characteristics.
- To analyze associations with carotid plaque area and thickness in a population-based cohort.
- To explore potential differential impacts of HDL subfractions on vascular disease risk.
Main Methods:
- Cross-sectional analysis of 988 stroke-free participants (mean age 66 ± 8 years).
- HDL subfractions (HDL2-C, HDL3-C) measured using a precipitation method.
- Carotid plaque area and thickness assessed via high-resolution 2D ultrasound; quantile regression used for analysis.
Main Results:
- Carotid plaque was present in 56% of participants.
- Inverse association found between HDL3-C and plaque area (p=0.001 at 75th percentile).
- Positive association observed between HDL2-C and plaque thickness (p=0.003 at 90th percentile).
- Total HDL-C associated with plaque area only in Hispanic participants (p=0.01).
Conclusions:
- HDL3-C is inversely associated with carotid plaque area.
- HDL2-C is positively associated with carotid plaque thickness.
- HDL subfractions may have distinct roles in atherogenesis, suggesting potential for targeted HDL-based therapies.
Objective:
The objective of this cross-sectional analysis was to investigate the relation between two major high-density lipoprotein cholesterol (HDL-C) subfractions (HDL2-C and HDL3-C) and carotid plaque in a population based cohort.
Methods:
We evaluated 988 stroke-free participants (mean age 66 ± 8 years; 40% men; 66% Hispanic and 34% Non-Hispanic) with available data on HDL subfractions using precipitation method and carotid plaque area and thickness assessed by a high-resolution 2D ultrasound. The associations between HDL-C subfractions and plaque measurements were analyzed by quantile regression.
Results:
Plaque was present in 56% of the study population. Among those with plaque, the mean ± SD plaque area was 19.40 ± 20.46 mm² and thickness 2.30 ± 4.45 mm. The mean ± SD total HDL-C was 46 ± 14 mg/dl, HDL2-C 14 ± 8 mg/dl, and HDL3-C 32 ± 8 mg/dl. After adjusting for demographics and vascular risk factors, there was an inverse association between HDL3-C and plaque area (per mg/dl: beta = -0.26 at the 75th percentile, p = 0.001 and beta = -0.32 at the 90th percentile, p = 0.02). A positive association was observed between HDL2-C and plaque thickness (per mg/dl; beta = 0.02 at the 90% percentile, p = 0.003). HDL-C was associated with plaque area (per mg/dl: beta = -0.18 at the 90th percentile, p = 0.01), but only among Hispanics.
Conclusion:
In our cohort we observed an inverse association between HDL3-C and plaque area and a positive association between HDL2-C and plaque thickness. HDL-C subfractions may have different contributions to the risk of vascular disease. More studies are needed to fully elucidate HDL-C anti-atherosclerotic functions in order to improve HDL-based treatments in prevention of vascular disease and stroke.