Quantity and function of high density lipoprotein as an indicator of coronary atherosclerosis
1999
Objectives
To examine the association between the fractional esterification rate of cholesterol (C) in low density lipoprotein- and very low density lipoprotein-depleted plasma (FERHDL) and coronary artery disease (CAD) and the influence of serum HDL-C levels.
Background
The function of HDL in reverse cholesterol transport is involved in the antiatherogenic action of HDL, and FERHDLis a newly established quantitative measure of HDL function in vivo.
Methods
Cases (n = 185, F/M: 43/142) and controls (n = 74, F/M:27/47) were defined as subjects with/without angiographically proven CAD, respectively.
Results
The cases had significantly (p < 0.05) higher FERHDLvalues (13.2 ± 0.3 %/h vs. 12.1 ± 0.5 %/h) and lower HDL-C levels (39.0 ± 1.0 mg/dL vs. 46.8 ± 1.4 mg/dL) than the controls. The associations of FERHDLand HDL-C with CAD were linear and significant (p < 0.05). Multiple logistic regression analysis indicated that the association of FERHDLwith CAD varied with the HDL-C level: significant for the low HDL-C tertile (chi-square = 6.20, p < 0.05) but not significant for the middle and high HDL-C tertiles (chi-square = 0.08 and 0.03, n.s.). The risk of CAD, relative to that in patients with low FERHDLand high HDL-C, was higher in patients with low FERHDLand low HDL-C (odds ratio [95% confidence interval]: 2.37 [1.12–4.97], p < 0.05) and was highest in patients with high FERHDLand low HDL-C (3.85 [1.84–8.06], p < 0.01).
Conclusions
The functional assay of HDL (FERHDL) is an independent risk factor for CAD. The combination of FERHDLand HDL-C could be a potent indicator for CAD, and may reflect a potential mechanism of atherosclerosis.
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