Abstract

High density lipoprotein (HDL) cholesterol levels and cholesterol efflux capacity (CEC) are inversely correlated with coronary artery disease (CAD) risk. Myeloperoxidase (MPO) derived oxidants and HDL proteome changes are implicated in HDL dysfunction in subjects with CAD in the United States; however, the effect of MPO on HDL function and HDL proteome in ethnic Chinese population is unknown. We recruited four matched ethnic Chinese groups (20 patients each): subjects with 1) low HDL levels (HDL levels in men <40mg/dL and women <50mg/dL) and non-CAD (identified by coronary angiography or cardiac CT angiography); 2) low HDL and CAD; 3) high HDL (men >50mg/dL; women >60mg/dL) with no CAD; and 4) high HDL with CAD. Serum cytokines, serum MPO levels, serum CEC, MPO-oxidized HDL tyrosine moieties, and HDL proteome were assessed by mass spectrometry individually in the four groups.The cytokines, MPO levels, and HDL proteome profiles were not significantly different between the four groups. As expected, CEC was depressed in the entire CAD group but more specifically in the CAD low-HDL group. HDL of CAD subjects had significantly higher 3-nitrotyrosine than non-CAD subjects, but the MPO-specific 3-chlorotyrosine was unchanged; CEC in the CAD low-HDL group did not correlate with either HDL 3-chlorotyrosine or 3-nitrotyrosine levels. Neither 3-chlorotyrosine, which is MPO-specific, nor 3-nitrotyrosine generated from MPO or other reactive nitrogen species was associated with CEC. MPO mediated oxidative stress and HDL proteome composition changes are not the primary cause HDL dysfunction in Chinese subjects with CAD. These studies highlight ethnic differences in HDL dysfunction between United States and Chinese cohorts raising possibility of unique pathways of HDL dysfunction in this cohort.

Highlights

  • Cardiovascular disease (CVD) mortality from stroke and coronary artery disease (CAD) continues to be the primary public health issue in China [1, 2]

  • Because chlorination is the specific change attributed to MPO, whereas nitration can be derived from MPO or other reactive nitrogen species (RNS), these findings suggest that MPO may not cause high density lipoprotein (HDL) oxidation in CAD subjects; rather, RNS may be the potent oxidant in Chinese subjects

  • HDL 3-nitrotyrosine was identified as the best predictive marker associated with CAD in the Chinese cohort irrespective of HDL levels, whereas HDL 3-chlorotyrosine appeared to be associated with CAD only in the low-HDL cohort

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Summary

Introduction

Cardiovascular disease (CVD) mortality from stroke and coronary artery disease (CAD) continues to be the primary public health issue in China [1, 2]. Geographic location, urbanization, and family history of CVD significantly improved the CVD risk prediction model built for the Chinese population compared to traditional prediction models [5] Applying this risk model to Caucasian subjects in United States (US), or applying the Framingham risk score to Chinese, yielded very different predictive results, underscoring the presence of unique risk factors in both populations that are not transposable. Environmental factors (e.g., geographic region and urbanization) and familial aggregation (either because of shared environmental factors or genetic determinants of risk factors) play an essential role in Chinese CVD risk This unique risk factor burden in the Chinese population underscores the need to explore the mechanism behind these differences

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