Decreased HDL particle size and coronary heart disease risk

Part of the relationship between HDL size and coronary heart disease (CHD) risk is ascribed to markers associated with the metabolic syndrome. A prospective case-control study nested in the EPIC-Norfolk cohort was conducted in order to evaluate the association between HDL particle size and risk of incident CHD in apparently healthy subjects. To this end, 1035 seemingly healthy men and women who subsequently developed fatal or nonfatal CHD were matched to 1920 CHD-free controls over the 6-year follow-up period. Subjects with the smallest HDL particle size had the most unfavourable risk profile whereas those with the largest HDL particle size exhibited the most favourable risk profile, plasma HDL cholesterol level being otherwise the best correlate of HDL particle size. For men in the highest quartile of HDL particle size as compared to those in the bottom quartile, the unadjusted odds ratio (OR) for future CHD events was 0.75; for women, the equivalent OR was 0.50. However, after further adjustment for traditional CHD risk factors (diabetes, body mass index, systolic blood pressure, LDL and HDL cholesterol levels), the ORs were 1.43 in men and 0.84 in women. In conclusion, a decreased HDL particle size appears to be associated with an adverse metabolic risk profile and an increased CHD risk although this latter association was largely accounted for by traditional risk factors.

Abstract

Keywords:
Cardiovascular risk – Cardiovascular diseases – CHD – HDL – HDL cholesterol