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Clinical, biochemical profile and atherosclerotic cardiovascular risk score (ASCVD) in patients with high HDL
Raksha Udupi Mallya1, Sudha Vidyasagar1, Varashree Bs2
1Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
Insights
Individuals with high HDL cholesterol exhibit increased physical activity, lower BMI, and reduced ASCVD risk. This suggests a link between lifestyle factors and elevated HDL cholesterol levels.
Area of Science:
- Cardiovascular Health
- Metabolic Disorders
- Lipid Metabolism
Background:
- High-density lipoprotein (HDL) cholesterol levels are elevated in some western coastal populations, with unknown causative factors.
- Understanding these factors is crucial for assessing atherosclerotic cardiovascular disease (ASCVD) risk.
Purpose of the Study:
- To investigate factors associated with high HDL cholesterol.
- To determine the impact of high HDL cholesterol on ASCVD risk.
Main Methods:
- A case-control study involving 150 participants (63 cases with high HDL, 87 controls with normal HDL).
- Data collected included diet, seafood consumption, habits, comorbidities, physical activity (GPAQ), and blood reports.
- Cholesterol esterase transfer protein (CETP) levels were measured using ELISA in a subset of patients.
Main Results:
- High HDL cholesterol was associated with greater physical activity (higher METs), lower BMI, and lower triglyceride levels.
- Patients with high HDL had a significantly lower 10-year ASCVD risk score.
- Lower CETP levels were observed in the high HDL group, though not statistically significant. Alcohol and seafood consumption did not influence HDL levels.
Conclusions:
- Physically active individuals with high HDL cholesterol have a lower ASCVD risk.
- Lower BMI, triglyceride levels, and CETP levels are associated with high HDL cholesterol.
- Further research is needed to establish normal CETP levels in the Indian population and its role in cardiovascular protection.
Background:
It was observed that many people in the western coastal belt were found to have a high HDL cholesterol, the cause of which was not known. This study was done to learn about the factors contributing to the high HDL cholesterol in these patients and its effect on ASCVD risk.
Methods:
In this prospective, case control study, 150 patients were recruited, of which 63 were cases (patients with high HDL cholesterol), and 87 were controls (patients with normal HDL cholesterol). Details regarding their diet, sea-food consumption, habits, comorbidities, daily activity (using GPAQ questionnaire), and blood reports were collected. ASCVD risk score was calculated using an online ASCVD risk estimator. Blood samples of 96 patients (cases 40, controls 56) was tested for cholesterol esterase transfer protein (CETP) levels using ELISA, and the results were compared.
Results:
Patients with high HDL cholesterol were found to be physically more active and had median metabolic equivalent (METs) of 4680 (1200, 8580) compared with controls with median METs of 1680 (720, 5580), P-0.013. Cases had a lower mean BMI 23.09(SD-3.69), than in patients with normal HDL cholesterol with a mean of 24.41(SD-4.01), P-0.04. Cases also had a lower triglyceride level (91(69,118) in cases vs 121 (80,151) in controls, P-0.002. Alcohol and sea food consumption had no role on HDL levels in this study. The median CETP level was lower in patients with high HDL levels, 0.336(0.08, 0.336) versus 1.435(0.061, 2.893) in the control group although not statistically significant. Patients with high HDL cholesterol were found to have a significantly lower median 10-year ASCVD risk score 3.05 (0.6, 8.95), compared with patients with normal HDL 6.45 (2.7,14.2).
Conclusion:
Patients with high HDL cholesterol were found to be physically more active, had a lower BMI, a lower triglyceride level, and a lower ASCVD risk compared with controls. They also had a lower CETP level. Further research will be required to determine the normal CETP level in Indian population, their genetic makeup, and whether it has a role in cardiovascular protection.
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