Year: 2009
Type: other
Abstract: Objectives -We assessed relations of low-density lipoprotein (LDL) particle number and LDL particle size as measured by nuclear magnetic resonance (NMR) spectroscopy with LDL cholesterol and the risk of future coronary artery disease (CAD) in a cohort of healthy subjects.Background -Whereas LDL cholesterol is an established risk factor for CAD, its discriminative power is limited.Measuring the number of LDL particles and their size may have stronger associations with CAD than LDL cholesterol.Methods -We conducted a case-control study nested in the prospective EPIC-Norfolk study which comprises 25,663 apparently healthy subjects aged 45 to 79 years with moderately elevated LDL cholesterol (mean 4.1 mmol/L).Cases (n= 1,003) were individuals who developed fatal or nonfatal CAD during 6 year follow-up.Controls (n=1,885) were matched for age, sex and enrolment time.Odds ratios for future CAD were calculated by quartile of each LDL variable.We also evaluated whether LDL particle number could improve the Framingham Risk Score to predict CAD.Results -In univariate analyses LDL particle number (odds ratio 2.00; 95% CI 1.58-2.59 in highest versus lowest quartile) and non-high-density lipoprotein (HDL) cholesterol (odds ratio 2.14; 95% CI 1.69-2.69 in highest versus lowest quartile) were more closely associated with CAD than LDL cholesterol (odds ratio 1.73; 95% CI 1.37-2.18 in highest versus lowest quartile).The additional value of LDL particle number was lost after adjustment for high-density lipoprotein (HDL) cholesterol and triglyceride levels.Whereas LDL size was inversely related to CAD (odds ratio 0.60; 95% CI 0.47-0.76 in highest versus lowest quartile) in univariate analysis, this relation was abolished upon adjustment for LDL particle number.In a model adjusted for the Framingham Risk Score, LDL particle number retained its association with CAD. Conclusion -In this large study of individuals with moderately elevated LDL cholesterol, LDL particle number was related to CAD on top of the Framingham Risk Score as well as after adjusting for LDL cholesterol.The additional value of LDL particle number was comparable to non-HDL cholesterol and it was abolished after adjusting for triglycerides and HDL cholesterol.
Author: Wim A. van der Steeg
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1899697911