Compositional Features of HDL Particles Interact with Albuminuria to Modulate Cardiovascular Disease Risk.

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Lipidology

Background:

• Elevated urinary albumin excretion (UAE) is linked to cardiovascular disease (CVD).
• Apolipoprotein B-containing lipoproteins modify UAE-CVD associations.
• High-density lipoprotein (HDL) functionality is altered by elevated UAE.

Purpose of the Study:

• To investigate if specific HDL features modify the association between elevated UAE and CVD risk.
• To analyze the impact of HDL particle characteristics on UAE-associated CVD.

Main Methods:

• Utilized data from the PREVEND study, including baseline and follow-up screenings.
• Employed multivariable Cox proportional-hazards modeling.
• Performed standard lipid/lipoprotein analyses and nuclear magnetic resonance (NMR) lipoprotein analyses focusing on HDL parameters (HDL particle concentration, apolipoprotein A-I).
• Derived measures of HDL apoA-I content (apoA-I/HDL-C, apoA-I/HDL-P) and analyzed interactions with UAE.

Main Results:

• Baseline screening showed inverse associations for HDL-C and apoA-I, and a direct association for apoA-I/HDL-C with UAE-CVD risk.
• Second screening revealed inverse associations for HDL-P, large HDL-P, medium HDL-P, HDL size, and apoA-I/HDL-P.
• Significant interactions between UAE and HDL features were observed, including apoA-I/HDL-C (baseline) and apoA-I/HDL-P and medium HDL-P (second screening).

Conclusions:

• Features of HDL particles, particularly HDL apoA-I content (indicated by apoA-I/HDL-P) and medium HDL-P, significantly modify the association between elevated UAE and CVD risk.
• These findings highlight the complex interplay between kidney function markers and lipoprotein metabolism in cardiovascular health.