CapsuleClinical significance of plasma HDL subfractions (HDL2, HDL3) in patients with peripheral arterial disease (PAD) in the Greek population
Introduction
Epidemiological studies have demonstrated that low levels of high density lipoprotein cholesterol (HDL-C) are a major risk factor for cardiovascular disease 1, 2, 3. In addition, there is evidence that it is the HDL2 subfraction (d = 1.063–1.125 g/mL), which is the principal determinant of risk 4, 5. However, most studies have not implicated HDL3 (d = 1.125–1.21 g/mL) as a risk factor, but its plasma levels have been shown to be sensitive to dietary and alcohol intake (6).
It is well known that the most oftening observed lipid abnormalities in patients with peripheral arterial disease (PAD) is hypertriglyceridemia, probably due to an increase in very low density lipoprotein concentration 7, 8. Moreover, low levels of HDL2 are associated with hypertriglyceridemia (9), obesity (10), carbohydrate-rich diet (11), and male gender (12). High levels instead are found in females and physically active subjects (13). As far as our knowledge is concerned, there haven’t been any studies dealing with the concentration of HDL2 and HDL3 subfractions in subjects with established PAD.
The purpose of the present study is to investigate the levels of these two subfractions in patients with PAD, coming from Greek population and to compare the result with data from a control population.
Section snippets
Materials and methods
The total number of healthy subjects and patients examined, was 178; 82 patients (52 males, average age 54 ± 7.6 and 30 females, average age 60 ± 1.4), with clinical and laboratory evidence of PAD. Diagnosis of PAD was based on clinical history and was confirmed by angiography and Doppler ultrasound. Information about nonlipid related factors, such as smoking alcohol, hypertension, diabetes, etc., was also collected. Three of the patients were suffering from diabetes mellitus, eight from
Results
As shown in Table 1, the levels of TC were significantly higher in both groups of patients (males and females). The levels of TG were also higher in both groups of patients and the increase was found as statistically significant (p < 0.05).
HDL-C values were significantly lower in patients (both males and females). HDL2-C and HDL3-C levels were significantly lower in patients (both males and females), but in the female group of patients the decrease was statistically more significant (p < 0.001).
Discussion
Total HDL is heterogeneous and consists of HDL1, a minor component, HDL2 and HDL3 (16). Most studies show that the factors that ultimately influence total HDL-C concentration primary act on HDL2-C (17) and that HDL2 is the most variable subfraction whereas HDL3-C appears to be less important although others indicate the importance of HDL3 (18).
The importance of low HDL-C as a cardiovascular risk factor, has been well established and there has been speculation concerning the possibility that the
References (33)
- et al.
Plasma high density lipoproteins concentrations and development of ischaemic heart disease
Lancet
(1975) - et al.
High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study
Am J Med
(1977) - et al.
Serum lipids and lipoproteins in peripheral vascular disease
Lancet
(1971) - et al.
High density lipoprotein subfractions in relation to lipoprotein lipase activity of tissues in man. Evidence for reciprocal regulation of HDL2 and HDL3 levels by lipoprotein lipase
Clin. Chim. Acta
(1981) - et al.
High density lipoprotein distribution
Atheroscerosis
(1978) - et al.
Changes in high density subfractions and other lipoproteins induced by exercise
Clin. Chim. Acta
(1981) - et al.
A micromethod for the rapid ultracentrifugal separation of human plasma high density lipoprotein subfractions HDL2 and HDL3
Clin. Chim. Acta
(1981) HDL-cholesterol—the variable components
Lancet
(1978)- et al.
Alteration in plasma lipids, lipoproteins and high density lipoproteins subfractions in peripheral arterial disease
Atherosclerosis
(1997) High density lipoprotein metabolism
J Lip Res
(1984)
Lipoprotein abnormalities in patients with extracoronary atherosclerosis
Atherosclerosis
Serum high density lipoproteins in peripheral vascular disease
Lancet
The in vitro formation of HDL2 during the action of LCAT. The role of triglyceride-rich lipoproteins
J Lipid Res
On the metabolic function of heparin releasable liver lipase
Biochem Biophys Res Comm
HDL and coronary heart disease
The relationship between the cholesterol content and subfraction distribution of plasma high lipoproteins
Clin. Chem. Acta
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High-density lipoprotein subclasses and their relationship to cardiovascular disease
2012, Journal of Clinical LipidologyCitation Excerpt :Table 1 presents cross-sectional association studies between quantitative estimates of coronary artery disease and HDL subclasses.7,25,37–55 Table 2 presents comparative studies between persons with and without cardiovascular disease, including subjects that have survived a myocardial infarction versus matched healthy controls, and angiographic studies that divide subjects by presence or absence of documented coronary artery disease.7,26,34,35,38,40,41,45,46,48,53,56–91 Their findings are presented as mean HDL subfraction differences between cases and controls, or as the odds for myocardial infarction or coronary artery disease with increasing subfraction concentrations.
HDL sub fractions and their clinical implications
2012, Biomedicine (India)