Associations between Lipoprotein Subclasses and Cardiovascular Function in Ageing

Abnormal lipoprotein profiles have been frequently described in association with atherogenic cardiovascular diseases. However, the relevance of lipoproteins in human cardiovascular health in ageing, a process that commonly manifests as heart failure in older adults, is less often investigated. Capitalizing on ¹H NMR spectroscopy, which identifies lipoprotein subclasses in great detail, we explored in-depth associations between 112 lipoproteins and cardiac function in N = 474 unique older adults, hypothesizing that specific lipoproteins may be associated with cardiac ageing. Decreases in moderate-density low-density lipoproteins (1.034-1.037 g/mL) and increases in moderate very low density lipoproteins (VLDL) (0.961-0.995 g/mL) were observed among older adults with poorer cardiac function. There was heterogeneous distribution of lower-density (0.950-0.961 g/mL) very low density lipoproteins' subfractions, which became more prominent in patients with poor cardiac function. Prominent apolipoprotein-A increases that are specific to those with poorer cardiac function were observed among those taking lipid-lowering medications, localized to specific lower density high density lipoprotein subfractions (1.063-1.112 g/mL). Based on a gradient boosting binary classification model, lipoprotein subclasses could partially predicted the cardiac function status of the participants. Overall, these results suggest that lipoprotein subclasses may be used to understand lipid pathways involved in cardiac ageing.

The online version contains supplementary material available at https://doi.org/10.1007/s43657-026-00315-3.