High-density lipoprotein subfractions and carotid plaque: The Northern Manhattan Study

Abstract

Objective The objective of this cross-sectional analysis was to investigate the relation between two major high-density lipoprotein cholesterol (HDL-C) subfractions (HDL2-C and HDL3-C) and carotid plaque in a population based cohort. Methods We evaluated 988 stroke-free participants (mean age 66±8 years; 40% men; 66% Hispanic and 34% Non-Hispanic) with available data on HDL subfractions using precipitation method and carotid plaque area and thickness assessed by a high-resolution 2D ultrasound. The associations between HDL-C subfractions and plaque measurements were analyzed by quantile regression. Results Plaque was present in 56% of the study population. Among those with plaque, the mean±SD plaque area was 19.40±20.46 mm2 and thickness 2.30±4.45 mm. The mean±SD total HDL-C was 46±14 mg/dl, HDL2-C 14±8 mg/dl, and HDL3-C 32±8 mg/dl. After adjusting for demographics and vascular risk factors, there was an inverse association between HDL3-C and plaque area (per mg/dl: beta= −0.26 at the 75th percentile, p=0.001 and beta= −0.32 at the 90th percentile, p=0.02). A positive association was observed between HDL2-C and plaque thickness (per mg/dl; beta= 0.02 at the 90% percentile, p=0.003). HDL-C was associated with plaque area (per mg/dl: beta= −0.18 at the 90th percentile, p=0.01), but only among Hispanics. Conclusion In our cohort we observed an inverse association between HDL3-C and plaque area and a positive association between HDL2-C and plaque thickness. HDL-C subfractions may have different contributions to the risk of vascular disease. More studies are needed to fully elucidate HDL-C anti-atherosclerotic functions in order to improve HDL-based treatments in prevention of vascular disease and stroke.

High-density lipoprotein subclass measurements improve mortality risk prediction, discrimination and reclassification in a cardiac catheterization cohort

“…16,28 Likewise, in two recent population-based studies, HDL 3 -C levels are negatively associated with prevalent carotid atherosclerosis. 29,30 These results contradict earlier studies wherein decreased risk is associated with greater concentrations of the larger HDL 2 -C subfractions and increased risk is associated with greater concentrations of HDL 3 -C. 12–14 Such discordances may be explained, in part, by the various methods used to characterize HDL subclasses (ultracentrifugation, gel electrophoresis, ion mobility, NMR). For instance, in JUPITER, NMR-measured HDL-P is strongly related to residual cardiovascular risk while ion mobility-measured HDL-P has no association.…”

Risk factors of carotid plaque and carotid common artery intima‐media thickening in a high‐stroke‐risk population

“…These studies have explored the association between traditional cardiovascular or cerebrovascular risk factors, such as serum lipid parameter, age, gender, hypertension, diabetes, smoking and CPs or CIMT. It was agreed consistently that these risk factors increased the presence of CPs and CIMT (Calmarza, Trejo, Lapresta, & Lopez, 2015; Panayiotou et al., 2013; Tiozzo et al., 2014; Touboul et al., 2011; Yang et al., 2014; Zhan et al., 2016). In this study, the independent risk factors of CP were male gender, age, high FBG and LDL‐C levels, stroke, diabetes, hypertension and smoking; the risk factors of CCAIMT were male gender, age, stroke, hypertension, diabetes, AF or valvulopathy and smoking, whereas alcohol use was associated with a lower risk.…”

Subclinical Atherosclerosis Among Young and Middle-Aged Adults Using Carotid Intima-Media Thickness Measurements

“…37 IMT has been found to be superior in detecting subclinical atherosclerosis in comparison to traditional measures of CVD risk, however. 38 Finally, the use of a dichotomous variable to define carotid plaque, rather than plaque size 39 and density, 29 also may limit results.…”