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Indicators of the atherogenic lipoprotein phenotype measured with density gradient ultracentrifugation predict changes in carotid intima-media thickness in men and women

Authors Maki KC, Dicklin MR, Davidson MH, Mize PD, Kulkarni KR

Received 5 November 2011

Accepted for publication 2 December 2011

Published 16 January 2012 Volume 2012:8 Pages 31—38

DOI https://doi.org/10.2147/VHRM.S27963

Review by Single-blind

Peer reviewer comments 3

Kevin C Maki1, Mary R Dicklin1, Michael H Davidson2, Patrick D Mize3, Krishnaji R Kulkarni3
1Provident Clinical Research/Biofortis North America, Glen Ellyn, IL, 2The University of Chicago Pritzker School of Medicine, Chicago, IL, 3Atherotech, Birmingham, AL, USA

Objective: Progression of carotid intima-media thickness (CIMT) is a surrogate indicator for the early stages of atherosclerosis.
Methods: The study investigated relationships between baseline lipoprotein cholesterol, triglyceride (TG), and apolipoprotein (Apo) B levels assessed with density gradient ultracentrifugation (DGU) and progression of posterior wall common CIMT in men (45–75 years of age) and women (55–74 years of age) in the control arm of a clinical trial. Participants had baseline posterior wall CIMT 0.7–2.0 mm, without significant stenosis. CIMT was assessed using B-mode ultrasound at baseline, and 12 and ~18 months. A DGU cholesterol panel that assessed the major lipoprotein classes and subclasses, plus triglycerides, lipoprotein (a) cholesterol, low-density lipoprotein (LDL) peak time (inversely related to LDL particle density), and Apo B were performed on fasting baseline samples. Apo B was also measured using an enzyme linked immunosorbent assay.
Results: Baseline CIMT was inversely associated (P < 0.001) with CIMT progression. After adjustment for baseline CIMT, significant predictors of posterior wall CIMT progression in linear regression analyses included LDL peak time (inverse, P = 0.045), total high-density lipoprotein cholesterol (HDL-C) (inverse, P = 0.001), HDL2-C (inverse, P = 0.005), HDL3-C (inverse, P = 0.003), very low-density lipoprotein (VLDL)-C (P = 0.037), and VLDL1+2-C (P = 0.016).
Conclusion: These data indicate that DGU-derived indicators of the “atherogenic lipoprotein phenotype,” including increased TG-rich lipoprotein cholesterol, lower HDL-C and HDL-C subfractions, and a greater proportion of LDL-C carried by more dense LDL particles, are associated with CIMT progression in men and women at moderate risk for coronary heart disease.

Keywords: carotid intima media thickness, density gradient ultracentrifugation, coronary heart disease risk, lipids, atherosclerosis, lipoprotein subfractions

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