Cholesterol and Triglyceride Concentrations in Lipoproteins as Related to Carotid Intima-Media Thickness

Abstract

SummarySince distinct cholesterol and triglyceride concentrations in major lipoproteins and their subclasses may be related to atherosclerosis, we investigated the relationship of cholesterol and triglyceride concentrations in lipoprotein subclasses and the severity of carotid intima-media thickness (IMT), a surrogate marker of subclinical atherosclerosis. We studied 116 apparently healthy Japanese men (53 ± 9 years) without a history of cardiovascular diseases who were not taking any medication. Carotid IMT was measured by means of high-resolution vascular ultrasound. Plasma cholesterol and triglyceride concentrations in major lipoproteins and their subclasses were determined by HPLC with gel permeation columns. By univariate analyses, carotid IMT was the most closely related to age (r = 0.528, P < 0.001), followed by smoking habit expressed as pack-year cigarette consumption (r = 0.409, P < 0.001). In addition to total cholesterol and LDL cholesterol, carotid IMT was significantly associated with cholesterol and triglyceride concentrations in several LDL and VLDL subclasses. Stepwise multiple linear regression analysis revealed that age (β = 0.436, P < 0.001), smoking (pack-years) (β = 0.225, P = 0.007), and large LDL cholesterol (β = 0.175, P = 0.023) were independent predictors of determining carotid IMT (adjusted R 2 = 0.347, P < 0.001). These results indicate that large LDL cholesterol is an important, independent determinant of carotid IMT in healthy men. (Int Heart J 2012; 53: 29-34) Key words: Intima-media thickness, Lipoprotein, Large low-density lipoprotein cholesterol, High-performance liquid chromatography, Carotid artery T he plasma lipid profile is the most important indicator of risk for cardiovascular disease and stroke. Several components have been proposed as atherogenic lipids and lipoproteins, including low-density lipoprotein (LDL) cholesterol, apolipoprotein B, non-high-density lipoprotein (HDL) cholesterol, triglycerides, and small dense LDL.1,2) Low HDL cholesterol concentrations have gained notice for potentially increasing risk and promoting the development of atherosclerosis. Among plasma lipids, LDL still accounts for the bulk of clinical attention for the prevention of cardiovascular diseases. 3)However, lipoproteins are a heterogeneous group of particles that differ in terms of their physicochemical properties and biological behaviors. Increasingly, attempts have been made to improve evaluation by considering particular subfractions of plasma lipids, in particular LDL and HDL subclasses of atherogenic lipids and lipoproteins. 4) Recently, high-performance liquid chromatography (HPLC) with a gel permeation column has been established as an alternative method for classifying and quantifying lipoproteins on the basis of differences in particle size. 5,6) Intima-media thickness (IMT) in the carotid arteries, measured with high-resolution ultrasonography, is currently the standard clinical marker and a quantitative measure of atherosclerosis; a graded, predictive relationship to over...

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