Abstract
Beyond LDL, HDL is the urgent target for atherosclerosis; few data exist regarding how compositional changes in HDL can affect coronary artery disease in which the anti-atherogenic quality of HDL is not simply defined by the plasma HDL-C level. Therefore, we determine the roles of HDL composition, closely related with VLDL metabolism, in angiographically evaluated coronary artery disease. Methods: A total of 365 patients (202 males, mean age of 58±13) suspected coronary artery disease were enrolled, and coronary stenosis index (CSI) was estimated with angiography in 210 patients (134 males, mean age of 61 ± 11). Fasting lipid profiles without lipid drugs at least 4 weeks were analyzed by ultracentrifugation, and free cholesterol, cholesterol ester, triglycerides (TG) and phospholipids (PL) levels in each fraction were determined. Pre-diabetes was defined as fasting glucose 110-125 mg/dL or impaired glucose tolerance with 75gOGTT. Results: Mean CSI was 10.8 and median was 8.0. CSI showed weak positive association with plasma TG ( p <0.05, R 2 2%), and negative association with HDL-C ( p <0.01, R 2 5%). In HDL composition, HDL-TG/PL ratio showed strong positive association with CSI ( p <0.0001, R 2 8%) and number of coronary vessel with significant (>75%) stenosis (p<0.0005, R 2 6%). HDL-TG itself was weakly associated with CSI ( p <0.05, R 2 2%). HDL-TG/PL was positively associated with CETP mass ( p <0.01, R 2 5%). HDL-TG/PL showed no gender difference. CSI did not show significant association with LDL-C in this study; presumably most of patients with high LDL-C levels had been treated with statins already. CSI showed strong negative associattion with eGFR ( p <0.0005, R 2 9%). eGFR showed weak negative association with HDL-C, but positive association with HDL-TG/PL (both p <0.05). Pre-diabetes patients showed higher CSI than normal group (14.7±13 vs. 8.9±9, p <0.005), and also higher HDL-TG/PL ( p <0.05). Conclusion: We propose HDL-TG/PL as residual risk biomarker also reflecting chronic kidney disease and pre-diabetes beyond LDL-C.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call