Cholesterol-Overloaded HDL Particles Are Independently Associated With Progression of Carotid Atherosclerosis in a Cardiovascular Disease-Free Population A Community-Based Cohort Study
Cholesterol-Overloaded HDL Particles Are Independently Associated With Progression of Carotid Atherosclerosis in a Cardiovascular Disease-Free Population A Community-Based Cohort Study
复制标题
DOI：
10.1016/j.jacc.2014.11.019
复制
发表时间：
2015-02-03
影响因子：
24
通讯作者：
Zhao, Dong
中科院分区：
文献类型：
--
作者：
Qi, Yue;Fan, Jie;Zhao, Dong
背景在实验研究中，胆固醇负荷过高的高密度脂蛋白颗粒对高密度脂蛋白的抗动脉粥样硬化作用产生负面影响。然而，目前尚不清楚胆固醇超载的高密度脂蛋白颗粒是否参与了人类动脉粥样硬化的发展。目的本研究的目的是探讨在无心血管疾病的人群中，高密度脂蛋白颗粒是否与颈动脉粥样硬化的进展有关。方法采用核磁共振波谱技术对930名年龄在45岁至74岁之间的社区人群进行基线高密度脂蛋白颗粒数量的测定。每个高密度脂蛋白颗粒的胆固醇分子的估计值(高密度脂蛋白-C/磷比率)被计算为高密度脂蛋白胆固醇与高密度脂蛋白颗粒的比率。使用固定增量法，高密度脂蛋白-C/磷比率被归类为-lt；41.0(最低)、41.0至46.9、47.0至52.9和53.0美元(最高)。以颈动脉斑块进展和斑块总面积(TPA)的变化为指标，采用改良Poisson回归方法评价HDLC/P比值与颈动脉粥样硬化5年进展的关系。结果基线高密度脂蛋白胆固醇/磷脂比值平均为46.4±9.3(范围23.8~86.9)。基线高密度脂蛋白胆固醇/磷脂比值与颈动脉粥样硬化的5年进展显著相关。与水平最低的参与者相比，高密度脂蛋白-C/磷比率最高的参与者有1.5 6倍的进展(95%可信区间：1.14至2.13；p 0.006)。在没有基线斑块的参与者中，与最低水平相比，最高水平亚组的复查TPA增加了9.4mm2。结论我们的研究结果表明，胆固醇超载的高密度脂蛋白颗粒与颈动脉粥样硬化的进展独立相关。这可能解释了为什么在最近的试验中，提高高密度脂蛋白胆固醇是无益的。这项研究强烈表明，胆固醇含量和颗粒数量的组合决定了高密度脂蛋白的抗动脉粥样硬化功能，而不是任何一个单独的参数。(J am Coll心脏ol 2015；65：355-63)c 2015年，由美国心脏病学会基金会主办。
BACKGROUND Cholesterol- overloaded high- density lipoprotein ( HDL) particles exert a negative impact on the antiatherogenic function of HDL in experimental studies. However, it remains unclear whether cholesterol- overloaded HDL particle is involved in the development of atherosclerosis in humans. OBJECTIVES The objective of this study was to explore whether cholesterol- overloaded HDL particles are associated with the progression of carotid atherosclerosis in a cardiovascular disease- free population. METHODS Baseline HDL particle number was measured using nuclear magnetic resonance spectroscopy in 930 participants ages 45 to 74 years in a community- based cohort study. An estimate of cholesterol molecules per HDL particle ( HDL- C/ P ratio) was calculated as the ratio of HDL cholesterol to HDL particles. HDL- C/ P ratio was categorized as < 41.0 ( lowest), 41.0 to 46.9, 47.0 to 52.9, and $ 53.0 ( highest) using a fixed increment method. Modified Poisson regression was used to assess the association between HDL- C/ P ratio and 5- year progression of carotid atherosclerosis as indicated by progression of carotid plaques and change in total plaque area ( TPA). RESULTS Mean baseline HDL- C/ P ratio was 46.4 9.3 ( range 23.8 to 86.9). Baseline HDL- C/ P ratio was significantly associated with 5- year progression of carotid atherosclerosis. Participants with the highest HDL- C/ P ratio had 1.56- fold ( 95% confidence interval: 1.14 to 2.13; p 0.006) increased progression compared with those with the lowest level. Among participants without baseline plaque, TPA in re- examination was larger by 9.4 mm2 in the subgroup with the highest level when compared with the lowest level. CONCLUSIONS Our findings suggest that cholesterol- overloaded HDL particles are independently associated with the progression of carotid atherosclerosis. This may explain why in recent trials raising HDL cholesterol was not beneficial. This study strongly suggests that the combination of cholesterol content and particle number determines the antiatherogenic function of HDLs, rather than either parameter alone. ( J Am Coll Cardiol 2015; 65: 355- 63) c 2015 by the American College of Cardiology Foundation.