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Quantity and function of high density lipoprotein as an indicator of coronary atherosclerosis
1Department of Internal Medicine and Pathology, Fukuoka University School of Medicine, Japan. hh035399@msat.fukuoka-u.ac.jp
Insights
High fractional esterification rate of cholesterol in HDL (FER(HDL)) is an independent risk factor for coronary artery disease (CAD). Combining FER(HDL) with HDL-C levels offers a potent indicator for CAD risk.
Area of Science:
- Cardiovascular Research
- Lipid Metabolism
- Biomarker Discovery
Background:
- High-density lipoprotein (HDL) plays a crucial role in reverse cholesterol transport, contributing to HDL's antiatherogenic properties.
- Fractional esterification rate of cholesterol in HDL-depleted plasma (FER(HDL)) is a novel in vivo measure of HDL function.
Purpose of the Study:
- To investigate the association between FER(HDL) and coronary artery disease (CAD).
- To determine how serum HDL-C levels influence the relationship between FER(HDL) and CAD.
Main Methods:
- A case-control study involving 185 patients with angiographically proven CAD (cases) and 74 controls without CAD.
- Measurement of FER(HDL) and serum HDL-C levels in all participants.
Main Results:
- Cases exhibited significantly higher FER(HDL) and lower HDL-C levels compared to controls (p < 0.05).
- Both FER(HDL) and HDL-C showed significant linear associations with CAD.
- The association between FER(HDL) and CAD risk was dependent on HDL-C levels, being significant only in the lowest HDL-C tertile.
Conclusions:
- HDL function, as assessed by FER(HDL), is an independent risk factor for CAD.
- The combined assessment of FER(HDL) and HDL-C levels may serve as a powerful indicator for CAD risk.
- This combination could offer insights into the underlying mechanisms of atherosclerosis.
Objectives:
To examine the association between the fractional esterification rate of cholesterol (C) in low density lipoprotein- and very low density lipoprotein-depleted plasma (FER(HDL)) and coronary artery disease (CAD) and the influence of serum HDL-C levels.
Background:
The function of HDL in reverse cholesterol transport is involved in the antiatherogenic action of HDL, and FER(HDL) is a newly established quantitative measure of HDL function in vivo.
Methods:
Cases (n = 185, F/M: 43/142) and controls (n = 74, F/M:27/47) were defined as subjects with/without angiographically proven CAD, respectively.
Results:
The cases had significantly (p < 0.05) higher FER(HDL) values (13.2+/-0.3 %/h vs. 12.1+/-0.5 %/h) and lower HDL-C levels (39.0+/-1.0 mg/dL vs. 46.8+/-1.4 mg/dL) than the controls. The associations of FER(HDL) and HDL-C with CAD were linear and significant (p < 0.05). Multiple logistic regression analysis indicated that the association of FER(HDL) with CAD varied with the HDL-C level: significant for the low HDL-C tertile (chi-square = 6.20, p < 0.05) but not significant for the middle and high HDL-C tertiles (chi-square = 0.08 and 0.03, n.s.). The risk of CAD, relative to that in patients with low FER(HDL) and high HDL-C, was higher in patients with low FER(HDL) and low HDL-C (odds ratio [95% confidence interval]: 2.37 [1.12-4.97], p < 0.05) and was highest in patients with high FER(HDL) and low HDL-C (3.85 [1.84-8.06], p < 0.01).
Conclusions:
The functional assay of HDL (FER(HDL)) is an independent risk factor for CAD. The combination of FER(HDL) and HDL-C could be a potent indicator for CAD, and may reflect a potential mechanism of atherosclerosis.