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Plasma triglycerides related decrease in high-density lipoprotein cholesterol and its association with myocardial
Insights
Familial hypercholesterolemia (FH) patients show significantly lower high-density lipoprotein (HDL) cholesterol levels, strongly linked to elevated triglycerides and body weight, increasing ischemic heart disease risk.
Area of Science:
- Cardiovascular Medicine
- Lipid Metabolism
- Genetics
Background:
- Familial hypercholesterolemia (FH) is linked to premature atherosclerosis.
- Decreased high-density lipoprotein (HDL) cholesterol may be a risk factor in FH.
Purpose of the Study:
- To analyze HDL cholesterol concentration and distribution in FH subjects.
- To investigate the relationship between HDL, triglycerides, and ischemic heart disease in FH.
Main Methods:
- Study included 71 men with heterozygous FH and 46 controls.
- Measured HDL cholesterol, plasma triglycerides, VLDL, LDL, and total cholesterol.
- Assessed prevalence of tendon xanthomas and ischemic heart disease.
Main Results:
- FH heterozygotes had 21% lower HDL cholesterol than controls (33 vs 42 mg/dL).
- Reduced HDL cholesterol strongly correlated with higher plasma triglycerides and VLDL cholesterol.
- HDL decrease was not associated with LDL cholesterol but weakly with total cholesterol and body weight.
Conclusions:
- Decreased HDL cholesterol is a significant finding in FH heterozygotes.
- Elevated triglycerides and body weight contribute to reduced HDL levels in FH.
- Further research is needed to understand the atherogenic role of HDL in FH.
Abstract:
Recent studies suggest that decreased levels of high-density lipoprotein (HDL) may contribute to the risk of premature occlusive atherosclerosis in familial hypercholesterolemia (FH). To investigate further, we have analyzed the concentration as well as distribution of HDL cholesterol in relation to plasma triglycerides and their influence on ischaemic heart disease in FH subjects. The study was carried out in 71 men with heterozygous FH and 46 matched controls. FH subjects were relatively young with a mean age of 38 +/- 11 years. Tendon xanthomatas were observed in 57% of the subjects, whereas ischemic heart disease was identified in 33%. Compared to normals, the mean value of HDL cholesterol is significantly reduced by 21% in FH heterozygotes (42 +/- 12 v 33 +/- 9 mg/dL, P less than 0.001). The decrease in HDL cholesterol is highly correlated to the levels of plasma triglycerides (r = -0.50, P less than 0.001) and VLDL cholesterol (r = -0.53, P less than 0.001). Moreover, HDL cholesterol decrease is not associated with elevated levels of LDL cholesterol (r = -0.20, NS), which is the primary characteristic feature of FH subjects. However, HDL cholesterol decrease is weakly related to total plasma cholesterol concentration (r = -0.24, P less than 0.05). The body weight is also contributory to the reduction of HDL cholesterol (r = -0.42, P less than 0.01), probably due to its strong positive correlation to plasma triglycerides (r = +0.54, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)