Abstract 13657: Cholesterol Content of VLDL Particles and Incident Coronary Artery Calcification Among ELSA-Brasil Participants - A Metabolomic Approach

Abstract

Background: Very-low density lipoproteins (VLDL) are the smallest and most atherogenic particles. Research question: The association of cholesterol content in VLDL particles with incident coronary artery calcification (CAC) is unclear. Aim: To analyze the association of VLDL cholesterol content with 5-year CAC status among ELSA-Brasil participants. Methods: Data from 832 participants (50.3±7.2 years, 50.4% women) free of cardiovascular disease and statin use were analyzed. The cholesterol content of VLDL lipoproteins were assessed by high-throughput proton Nuclear Magnetic Resonance metabolomics platform. CAC score was assessed by computed tomography at baseline and after 5-year follow-up, being classified as absent CAC (baseline and follow-up CAC=0), prevalent CAC (baseline CAC>0) and incident CAC (baseline CAC=0 and follow-up CAC>0). Distribution of cholesterol content were compared by U-Mann Whitney test according to CAC status. Generalized linear models compared cholesterol concentrations according to CAC status, adjusted by sociodemographic (age, sex, race, education, health insurance), lifestyle (physical activity, alcohol and smoking) and comorbidities (hypertension, diabetes, obesity and total cholesterol ≥200mg/dL). Results: CAC incident was 6.6% of sample (n=55), whereas 26.2% was CAC prevalent (n=218) and 67.2% was CAC absent (n=559). VLDL cholesterol concentrations in CAC incident participants were higher than those with CAC absent, but similar to those with CAC prevalent - Figure 1. Regression models showed higher concentrations of all lipids in CAC incident than CAC absent, but there was no difference between CAC incident and CAC prevalent. The associations remained beyond adjustment for sociodemographic and lifestyle factors, but lost significance after adjustment for comorbidities. Conclusions: This finding suggests a predictive role of VLDL cholesterol content for CAC incidence among ELSA-Brasil participants.