Hyperalphalipoproteinemia: Characterization of a cardioprotective profile associating increased high-density lipoprotein2 levels and decreased hepatic lipase activity☆

Abstract The aim of the present study was to investigate the high-density lipoprotein (HDL) strucutral characteristics and metabolism in hyperalphalipoproteinemic (HALP) patients (HDL-cholesterol) [HDL-C], 92 ± 14 mg/dL) with combined elevated low-density lipoprotein-cholesterol (LDL-C) levels (LDL-C, 181 ± 33 mg/dL). Patients were subjected to a complete cardiovascular examination, including ultrasonographic investigation of carotid arteries. Two HALP profiles were identified according to the HDL 2 HDL 3 ratio. HALP profile A was characterized in 28 patients by increased HDL 2 HDL 3 ratio, HDL 2b , and lipoprotein (Lp)A-I levels compared with normolipidemic subjects, and HALP profile B, including the 12 remaining patients, was characterized by a HDL 2 HDL 3 ratio within the normal range and by the increase of all HDL subclasses (HDL 2b,2a,3a,3b,3c ). LPA-I, and LpA-I:A-II levels. With regard to the exploration of carotid arteries, in HALP profile A, 20 patients were free from lesions and eight had only intimal wall thickening. In HALP profile B, only one patient was free from lesions, four had intimal wall thickening, and seven displayed plaques, but none had stenosis. Taking into account the number of patients with plaques within each group, HALP profile A was associated with a low prevalence of atherosclerotic lesions, whereas HALP profile B was less cardioprotective (odds ratio, 77.7 [95% confidence interval, 3.7 to 1,569.7]; P HDL 2 HDL 3 , HDL 2b , and LpA-I levels associated with decreased HL activity.