Pulmonary surfactant protein B carried by HDL predicts incident CVD in patients with type 1 diabetes

HDL, heart disease, and the lung

“…Of note, the association was independent of smoking, which was previously shown to cause increases in SP-B plasma levels ( 12 ). Also of note, the association was independent of HDL-cholesterol although the authors detected SP-B almost exclusively in HDL ( 11 ).…”

“…In the current issue of Journal of Lipid Research , Shao et al. ( 11 ) provide further evidence for the potential of SP-B as an HDL-associated biomarker, namely for risk of ASCVD in patients with diabetes mellitus type 1. In a cohort of 145 type 1 diabetes patients randomly selected from all subjects within the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study, 47 subjects developed an ASCVD event within an average follow-up of 16 years.…”

“…However, Shao et al. ( 11 ) did not find any significant impact of SP-B on the capacity of HDL to promote cholesterol efflux from macrophages or to inhibit the expression of adhesion molecules in endothelial cells. Neither did our lab find any association of SP-B abundance with cholesterol efflux capacity nor anti-apoptotic effects of HDL toward endothelial cells ( 16 ).…”

“…It would hence have been interesting to see how measures of pulmonary and cardiac function such a VO 2 max and B-type natriuretic peptides affect the association of SP-B with ASCVD events in the study of Shao et al. ( 11 ).…”

“…The former scenario is assumed by Shao et al. ( 11 ). However, the latter scenario cannot be ruled out, since apoA-I is recovered in bronchoalveolar lavage fluids ( 21 ).…”