Differential impact of plasma triglycerides on HDL-cholesterol and HDL-apo A-I in a large cohort
Introduction
By 2020, cardiovascular disease will become the leading cause of death worldwide [1]. The atherogenic lipoproteins- principally LDL- and the antiatherogenic lipoproteins- HDL- account for just over 50% of the population-attributable risk [2]. Currently, HDL-C is used to quantitate HDL. However, apolipoproteins are important components of lipoprotein particles, and there is accumulating evidence that measurement of apo B and apo A-I may improve the prediction of the risk of cardiovascular disease [3], [4], [5], [6], [7].
In humans, there is a strong association between hypertriglyceridemia and lower levels of HDL-C and apo A-I [8], [9], [10], [11]. Little attention has been paid to the relative effects of hypertriglyceridemia on HDL-C versus apo A-I although there was initial evidence, some time ago, that hypertriglyceridemia may be associated with a greater reduction of HDL-C than apo A-I as well as with decreased HDL particle size [12], [13]. There were also data from population studies showing that the correlation between plasma triglycerides was higher to HDL-C than to apoA-I [14]. However, the issue has not been investigated systematically in a dyslipidemic cohort. The objective of the present study, therefore, was to examine HDL composition in a large group of subjects with a wide range of plasma triglyceride levels attending a lipid clinic.
Section snippets
Participants
Data from 1886 consecutive patients seen in consultation between 1995 and 2005 at the Lipid Clinic of the Laval University Medical Center in Québec City were included in this report. Patients ranged in age from 2 years to 86 years. All individuals were instructed to fast at least 12 h before blood samples were drawn and none of these were taken lipid-lowering medications.
Characterization of plasma lipids and lipoproteins
Venous blood samples were obtained from an antecubital vein into Vacutainer tubes containing K3EDTA (1 mg/ml, final
Participants
Data from 1886 participants are presented in this study; 61.5% of these were men with a mean age of 38.9 ± 17.7 years and body mass index (BMI) of 26.5 ± 5.3, and 38.5% were women with a mean age of 39.8 ± 20.1 years and BMI of 25.4 ± 6.1 kg/m2. Table 1 shows the distribution of lipid-lipoprotein profile of the participants. Their mean plasma cholesterol (C) was 6.06 ± 1.52 and the mean plasma triglycerides (TG) were 1.94 ± 1.09 mmol/L. The mean plasma HDL-C, LDL-C, apo B, and HDL-apo AI concentrations
Discussion
In humans, the association between high TG and low HDL-C levels is well known [4], [17], [18]. Moreover, hypertriglyceridemic patients with low HDL-C levels are at greater risk for coronary heart disease (CHD) than those with normal levels [19], although there is considerable evidence this is driven in large part by plasma apo B. Nevertheless, risk is determined as much by HDL as the atherogenic lipoproteins and therefore it is critical to determine how best to measure their concentration. Two
Acknowledgments
This work was supported in part by an operating grant from Heart and Stroke Foundation (Québec). André J. Tremblay is recipient of a HSFC grant. Patrick Couture is recipient of a scholarship from the FRSQ. The authors are grateful to the dedicated staff of the Lipid Research Center. The dedicated work of Mr. G. Cousineau is also acknowledged.
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