HDL subfractions and very early CAD: novel findings from untreated patients in a Chinese cohort.

Yan Zhang,Na-Qiong Wu,Yuan-Lin Guo,Cheng-Gang Zhu,Chuan-Jue Cui,Xiao-Lin Li,Jian-Jun Li,Ying Gao,Sha Li,Ping Qing,Rui-Xia Xu,Jing Sun

doi:10.1038/srep30741

Abstract

Coronary artery disease (CAD) in very young individuals is a rare disease associated with poor prognosis. However, the role of specific lipoprotein subfractions in very young CAD patients (≤45 years) is not established yet. A total of 734 consecutive CAD subjects were enrolled and were classified as very early (n = 81, ≤45), early (n = 304, male: 45–55; female: 45–65), and late (n = 349, male: >55; female: >65) groups. Meanwhile, a group of non-CAD subjects were also enrolled as controls (n = 56, ≤45). The lipoprotein separation was performed using Lipoprint System. As a result, the very early CAD patients have lower large high-density lipoprotein (HDL) subfraction and higher small low-density lipoprotein (LDL) subfraction (p < 0.05). Although body mass index was inversely related to large HDL subfraction, overweight did not influence its association with very early CAD. In the logistic regression analysis, large HDL was inversely [OR 95% CI: 0.872 (0.825–0.922)] while small LDL was positively [1.038 (1.008–1.069)] related to very early CAD. However, after adjusting potential confounders, the association was only significant for large HDL [0.899 (0.848–0.954)]. This study firstly demonstrated that large HDL subfraction was negatively related to very early CAD suggestive of its important role in very early CAD incidence.

Highlights

The prevalence of coronary artery disease (CAD) has increased sharply and manifested a younger trend, which has becoming an important public health issue[1]
The current study is the first to document the relationship between lipoprotein subfractions and very early Coronary artery disease (CAD) occurrence involving 734 consecutive CAD patients and 56 non-CAD controls who were not treated with lipid-lowering drugs
We found that CAD patients in younger ages have significantly lower large high-density lipoprotein (HDL) subfractions, higher small HDL and low-density lipoprotein (LDL) subfractions, and relatively smaller mean LDL particle size

Summary

Introduction

The prevalence of coronary artery disease (CAD) has increased sharply and manifested a younger trend, which has becoming an important public health issue[1]. Previous epidemiological studies indicated that the relatively more important risk factors in young patients are their elevated body mass index (BMI), smoking habits, hypertension, and dyslipidemia[4]. Our group demonstrated that patients with CAD have relatively lower large HDL subfraction and higher small HDL and LDL subfraction, providing new perspectives with regard to the role of different lipoprotein subfractions in the CAD prevalence[14]. In light of the specialization of patients with CAD in young ages, we hypothesized that the distribution and impact of lipoprotein subfractions in younger CAD patients may be varied with those in older ones.

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Conclusion