Original Article
Fatty acid composition of HDL phospholipids and coronary artery disease

https://doi.org/10.1016/j.jacl.2008.11.010Get rights and content

Background

The phospholipid fatty acid content of high-density lipoprotein (HDL) partially reflects that of the diet and has been reported to be associated with several important biological functions that might serve as risk markers for coronary heart disease.

Objective

To investigate whether fatty acid composition of HDL phospholipids correlates with angiographically documented coronary artery disease (CAD).

Methods

The population included 212 patients who underwent clinically indicated coronary angiography. The patients were classified with significantly diseased arteries (SDA) if one or more coronary arteries had a stenosis >50% and with minimally diseased arteries (MDA) if there was no significant stenosis (<40%) in any artery. The severity of CAD was expressed by the number of affected vessels. The fatty acid composition of HDL phospholipids was determined by gas liquid chromatography. Multivariate analyses were used to test the independence of associations between the presence and severity of CAD as outcome variables and fatty acid composition of HDL phospholipids.

Results

Patients with SDA showed significantly lower levels of linoleic acid (P = .041), eicosapentaenoic acid (EPA) (P = .027), and docosahexaenoic acid (DHA) (P = .026) than patients with MDA in univariate analyses. The association of linoleic acid (odds ratio [OR] .90, P < .05), EPA (OR, 0.41, P < .02), and DHA (OR, 0.48, P < .02) remained statistically significant in the multivariate analyses. The content of EPA (β = −0.23, P < .01) and DHA (β = −0.17, P < .05) remained inversely significantly associated with the severity of CAD.

Conclusions

This study shows that polyunsaturated fatty acids, including EPA and DHA content of HDL particles, are independently associated with the presence and severity of angiographically documented CAD.

Section snippets

Subjects

Subjects were recruited from a patient population scheduled for diagnostic coronary angiography at Madani Hospital in Tabriz between February 1, 2007 and February 30, 2008. In the present study, 212 patients (151 men and 61 women) were enrolled. Exclusion criteria were age >60 years, a previous hospital admission related to cardiovascular disease, current lipid-lowering medication, and a previous diagnosis of angina, hypercholesterolemia, or diabetes. Hypercholesterolemia was defined as a total

Results

The clinical details and lipid profiles of both groups of patients are presented in Table 1. Patients with angiographically significant coronary atherosclerosis were 3.5 years older than patients without coronary atherosclerosis (P = .003). The mean values of total cholesterol was higher in the patients with SDA than in the patients with MDA (176 ± 41 vs 165 ± 35 mg/dL), reflecting the higher LDL cholesterol in patients with SDA (101 ± 35 vs 92 ± 29 mg/dL).

Palmitic acid was the major fatty acid

Discussion

In this cross-sectional study, we investigated the strength and independence of association between angiographically significant CAD and fatty acid composition of HDL phospholipids. The results showed that higher n-6 and n-3 PUFA percentages of HDL phospholipids are associated with reduced incidence of stenoses >50%. These associations were independent of risk factors found to be correlated with CAD in univariate analysis. These findings are consistent with results from the Nurses’ Health Study

Conclusion

This study shows that PUFA, including linoleic acid, EPA, and DHA content of HDL particles, are inversely associated with the severity of stenoses in coronary arteries. Moreover, EPA and DHA content of HDL particles are inversely associated with the number of lesions producing >50% stenosis in those with significant CAD. These correlations appear to be independent of serum lipoprotein concentrations. Further investigation, while controlling for other risk factors, namely inflammatory markers

References (28)

  • P.W. Baker et al.

    Phospholipid composition of reconstituted high density lipoproteins influences their ability to inhibit endothelial cell adhesion molecule expression

    J Lipid Res

    (2000)
  • P. Rise et al.

    Fatty acid composition of plasma, blood cells and whole blood: relevance for the assessment of the fatty acid status in humans

    Prostaglandins Leukot Essent Fatty Acids

    (2007)
  • W.S. Harris et al.

    Tissue n-3 and n-6 fatty acids and risk for coronary heart disease events

    Atherosclerosis

    (2007)
  • F. Ghahremanpour et al.

    Adipose tissue trans fatty acids and risk of coronary artery disease: a case control study

    Ann Nutr Metab

    (2008)
  • Cited by (22)

    • Can phosphatidylserine enhance atheroprotective activities of high-density lipoprotein?

      2016, Biochimie
      Citation Excerpt :

      This notion was further supported by the observation that the addition of PS increased acidity at the lipid bilayer surface and enabled formation of discoid rHDL even at endosomal pH and slightly lower pH of the Golgi complex [14]. The amount and fatty acid composition of PS in HDL particles can be important for their biological activities [5,15]. PS bears a potential to impact multiple functions of HDL, including antiinflammatory and antiapoptotic effects, cholesterol efflux capacity, antioxidative activity and antithrombotic properties.

    • Serum total and high-density lipoprotein phospholipids: Independent predictive value for cardiometabolic risk

      2014, Clinical Nutrition
      Citation Excerpt :

      Noteworthy in this context is that, in a systematic review, long-chain polyunsaturated fatty acids arachidonic acid and docosahexaenoic acid have been found to contribute to plasma PL more in women than men, and mainly in populations with low dietary n-3 fatty acid intake27 to which Turks belong. Previous reports on HDL-pl, though few and cross-sectionally designed, have pointed to a protective role against atherogenesis of some PL components, such as the HDL-associated lactonase paraoxonase-1,28 or polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid contents.29 Piperi et al.30 underlined, however, in a Greek cohort that lower HDL-pl/total cholesterol ratio was correlated with the degree of coronary artery disease narrowing.

    • Two common polymorphisms in the peroxisome proliferator-activated receptor γ gene may improve fertilization in IVF

      2011, Reproductive BioMedicine Online
      Citation Excerpt :

      The fertilization rate was defined as the proportion of oocytes with two pronuclei. Follicular fluid fatty acid methyl esters were prepared by transmethylation and analysed for fatty acid composition as previously described (Noori et al., 2009). Genetic analyses were performed on genomic DNA isolated from circulating leukocytes.

    • Oxidative stability of pork meat lipids as related to high-oleic sunflower oil and vitamin E diet supplementation and storage conditions

      2011, Meat Science
      Citation Excerpt :

      In fact, the low incidence of heart disease and low levels of plasma cholesterol of the Mediterranean population have been correlated to an increased intake of monounsaturated fat (Simopoulos, 2006) suggesting that, in general, people should increase their relative intakes of monounsaturated lipid. Diets rich in oleic acid have shown to reduce levels of low density lipoproteins (LDL), without decreasing high-density lipoproteins (HDL) in plasma and leading to a simultaneous decline of oxidized LDL (Noori, Darabi, Rahimipour, Rahbani, & Abadi, 2009; Stein, Dabach, Ben-Naim, Halperin, & Stein, 2008). Since a large proportion of the saturated fat intake in Western society arises from animal fat, a greater unsaturation of the pork meat lipid fraction is, therefore, expected to have a general positive impact on human health.

    • Alterations in lipid profile of autistic boys: A case control study

      2010, Nutrition Research
      Citation Excerpt :

      The clinical significance of autistic boys with low plasma HDL and high TG levels as compared to healthy controls and the presence of an interaction between autism and plasma TG in relation to plasma HDL level observed in this study is not clear. The differences in phospholipids contained in various plasma lipoproteins are small, but HDL phospholipids constitute the major part of plasma phospholipids [22]. It is therefore plausible that lower HDL levels in cases in our study may result in lower total ω-3 fatty acids and docosahexaenoic acid levels in cases as compared to controls.

    View all citing articles on Scopus
    View full text