Abstract
BackgroundTrails aimed at raising high density lipoprotein(HDL) cholesterol concentration failed to make better cardiovascular outcomes. HDL particles may be better biomarkers reflecting properties of HDL. This meta-analysis was conducted to evaluate the relation between blood HDL particles level and cardiovascular events.MethodsPubMed and other databases were searched for eligible studies and NewCastle-Ottawa Quality Assessment Scale(NOS) was used to assess the quality of included studies. A random or fixed-effect model was applied to calculate the pooled hazard ratio(HR).ResultsTwelve studies were finally included. The pooled HR(95%confidence interval) for per standard deviation(SD) increment and top quartile versus bottom quartile were 0.79(0.72,0.86) and 0.65(0.57,0.75), respectively. Subgroup analysis suggested that HR was significantly lower in subjects with a cardiovascular disease(CVD) history than that of people without established CVD. Subclass analysis indicated that HRs for per SD increment of small(0.85) and medium(0.84) HDL particles were significantly lower than that of large HDL particles(0.96).ConclusionsHDL particle level in blood was inversely related to CVD events, indicating that HDL particles maybe a protective factor in patients with CVD, thus making HDL particles a potential biomarker and therapy target.
Highlights
Trails aimed at raising high density lipoprotein(HDL) cholesterol concentration failed to make better cardiovascular outcomes
It is well acknowledged that high density lipoproteins (HDL) play a role in anti-atherosclerosis and protect against the development of cardiovascular diseases (CVD)
Trails aimed at increasing HDL cholesterol (HDL-C) failed to improve CVD outcomes [1, 2], raising the question whether HDL-C is the best biomarker for assessing the relationship between HDL and CVD risk
Summary
Both indicated that a higher HDL-P level was reversely related with CVD events. Subgroup meta-analysis was conducted to explore the source of heterogeneity in studies about HR for per SD increment. Seven articles analyzed the relation between levels of large HDL-P and CVD events. Four studied the relation between levels of medium HDL-P and CVD events. A shows the Begg's funnel plots of studies about HR calculated for per SD increment. B shows the Begg's funnel plots of studies about HR calculated for Q4 vs Q1 about HR calculated for per SD increment(Fig. 4a) and Q4 vs Q1(Fig. 4b) were almost symmetric(P = 0.108, 1.00, respectively),suggesting a low likelihood of publication bias
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