Elsevier

Clinical Biochemistry

Volume 32, Issue 2, March 1999, Pages 149-152
Clinical Biochemistry

Capsule
Clinical significance of plasma HDL subfractions (HDL2, HDL3) in patients with peripheral arterial disease (PAD) in the Greek population

https://doi.org/10.1016/S0009-9120(98)00099-XGet rights and content

Abstract

Objective: In this study the major high density lipoprotein (HDL) subfractions (HDL2, HDL3) were examined, in angiographically selected patients with peripheral arterial disease (PAD).

Results: Patients with PAD have significantly high triglyceride levels. HDL2 and HDL3 levels were found significantly reduced in patients with PAD. Also, the ratio HDL2-C/HDL3-C was significantly reduced in patients with PAD.

Conclusions: The aim of the present study is to provide additional support to the hypothesis that the determination of HDL subfractions could be useful to elucidate possible mechanism(s) for a better assessment of the risk profile for PAD.

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

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