Combination Of High-density Lipoprotein Cholesterol Research Articles

Combination of High-Density Lipoprotein Cholesterol and Lipoprotein(a) as a Predictor of Collateral Circulation in Patients With Severe Unilateral Internal Carotid Artery Stenosis or Occlusion.

Background and PurposeCollateral circulation is considered an important factor affecting the risk of stroke, but the factors that affect collateral circulation remain unclear. This study was performed to identify the factors associated with collateral circulation, especially blood lipids.MethodsThe study involved patients who had undergone digital subtraction angiography and were confirmed as having severe unilateral stenosis or occlusion of the internal carotid artery (ICA). We classified the collateral circulation status of each patient as good (Grade 3 or 4) or poor (Grade 0, 1, or 2) according to the grading system of the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology. We collected data on patients’ characteristics and identified the factors that affect collateral circulation.ResultsThis study included 212 patients. The multivariate logistic regression analysis showed that the high-density lipoprotein cholesterol (HDL-C) concentration and a complete anterior half of the circle of Willis were independent protective factors for good collateral circulation, whereas elevated lipoprotein(a) [Lp(a)] and serum creatinine concentrations were independent risk factors for good collateral circulation. The area under the receiver operating characteristics curve (AUC) was 0.68 (95% confidence interval [CI], 0.61–0.76) for HDL-C and 0.69 (95% CI, 0.62–0.76) for Lp(a). A binary logistic regression model analysis of the joint factor of HDL-C and Lp(a) yielded an AUC of 0.77 (95% CI, 0.71–0.84).ConclusionsIn patients with severe unilateral ICA stenosis or occlusion, the combination of HDL-C and Lp(a) is a useful predictor of collateral circulation.

Clinical Value of Serum Amyloid-A Protein, High-density Lipoprotein Cholesterol and Apolipoprotein-A1 in the Diagnosis and Follow-up of Neonatal Sepsis.

To evaluate the performance of serum amyloid-A (SAA), high-density lipoprotein cholesterol (HDL-C) and apolipoprotein-A1 (Apo-A1) levels in the identification and monitoring of neonatal sepsis. This prospective study included 113 full-term septic neonates (postnatal age 4-28 days) admitted to the Special Care Neonatal Unit of a University Hospital from January 1, 2016, to April 30, 2019, and 68 healthy neonates (controls). Blood samples were drawn serially in septic neonates at enrollment and on days 1, 3 and 7, and once in controls, for SAA, HDL-C and Apo-A1 determination. At enrollment, SAA levels were significantly higher in septic neonates in comparison with controls (median 50.7 vs. 3.5 mg/L; P < 0.0001); HDL-C and Apo-A1 levels were significantly lower in patients than in controls (P < 0.001 and P < 0.006, respectively). SAA levels were higher in culture-positive compared with culture-negative sepsis (median 202.0 vs. 14.2 mg/L; P < 0.0001). HDL-C and Apo-A1 levels did not differ significantly between culture-positive and culture-negative sepsis. Receiver operating characteristic curve analysis of SAA levels at enrollment resulted in significant areas under the curve (AUC) for detecting sepsis {AUC = 0.929 [95% confidence interval: 0.885-0.973]; P < 0.0001} and also for discriminating between culture-positive and culture-negative sepsis [AUC = 0.933 (95% confidence interval: 0.882-0.984); P < 0.0001]. The combination of HDL-C and Apo-A1 with SAA increased its diagnostic performance. Furthermore, serial SAA levels following enrollment could indicate clinical response in septic neonates. SAA seems to be a useful biomarker for identification and monitoring of neonatal sepsis, and also for discriminating between culture-positive and culture-negative sepsis. HDL-C and Apo-A1 could be used as complementary markers.

Serum high-density lipoprotein-cholesterol levels modify the association between plasma levels of oxidatively modified low-density lipoprotein and coronary artery disease in men

We investigated the association among plasma levels of oxidatively modified low-density lipoprotein (Ox-LDL), high-density lipoprotein-cholesterol (HDL-C), and the prevalence of coronary artery disease (CAD) in a case-control study. Cases (n = 183, male [M]/female [F]:138/45, age: 64.9 +/- 10.6 years) were defined as patients with angiographically proven coronary atherosclerosis (>/=50% stenosis) and controls were subjects with normal coronary arteries (n = 74, M/F:36/38, age: 57.6 +/- 14.4 years). Plasma Ox-LDL levels were measured by a sensitive detection method using the monoclonal antibody DLH3. In women, both Ox-LDL and lipid variables were similar between cases and controls. In men, cases had significantly lower (P <.05) levels of HDL-C (39.1 +/- 10.3 v 42.8 +/- 10.9 mg/dL) and apolipoprotein (apo) A-I than controls, while the difference in Ox-LDL between cases and controls was not significant (1.05 +/- 0.79 and 0.83 +/- 0.65 ng/10 microg LDL protein, respectively). However, HDL-C levels interacted with the association between Ox-LDL levels and CAD in males: increased Ox-LDL levels were significantly associated with CAD after controlling for age when HDL-C levels were high, but were not associated with CAD when HDL-C levels were low, as assessed by a multiple logistic regression analysis. In addition, the combination of HDL-C and Ox-LDL levels was a better indicator for CAD in males than HDL-C levels alone (-2 log likelihood, 24.1 v 19.4) after controlling for age and conventional risk factors of CAD, while Ox-LDL levels were not significantly associated with CAD. HDL-C levels interact with the association between plasma Ox-LDL levels and CAD in men, and increased Ox-LDL levels are an indicator of CAD in male subjects with high HDL-C levels.