Discordance between Circulating Atherogenic Cholesterol Mass and Lipoprotein Particle Concentration in Relation to Future Coronary Events in Women

It is uncertain whether measurement of circulating total atherogenic lipoprotein particle cholesterol mass [non-HDL cholesterol (nonHDLc)] or particle concentration [apolipoprotein B (apo B) and LDL particle concentration (LDLp)] more accurately reflects risk of incident coronary heart disease (CHD)...

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Veröffentlicht in:Clinical chemistry (Baltimore, Md.) Jg. 63; H. 4; S. 870 - 879
Hauptverfasser: Lawler, Patrick R, Akinkuolie, Akintunde O, Ridker, Paul M, Sniderman, Allan D, Buring, Julie E, Glynn, Robert J, Chasman, Daniel I, Mora, Samia
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Oxford University Press 01.04.2017
Schlagworte:
Apolipoprotein B
Apolipoproteins
Apolipoproteins B - blood
Atherosclerosis - blood
Biomarkers
Biomarkers - blood
Cardiovascular disease
Cardiovascular diseases
Cholesterol
Cholesterol - blood
Controlled Clinical Trials as Topic
Coronary artery disease
Coronary Disease - blood
Diabetes mellitus
Discordance
Female
Hazards
Health risk assessment
Healthy Volunteers
Heart
Heart diseases
High density lipoprotein
Humans
Lipids
Low density lipoprotein
Metabolic disorders
Metabolic syndrome
Middle Aged
NMR
Nuclear magnetic resonance
Quartiles
Regression analysis
Risk assessment
Risk Factors
Women's Health
Womens health
ISSN:0009-9147, 1530-8561
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Zusammenfassung:It is uncertain whether measurement of circulating total atherogenic lipoprotein particle cholesterol mass [non-HDL cholesterol (nonHDLc)] or particle concentration [apolipoprotein B (apo B) and LDL particle concentration (LDLp)] more accurately reflects risk of incident coronary heart disease (CHD). We evaluated CHD risk among women in whom these markers where discordant. Among 27533 initially healthy women in the Women's Health Study (NCT00000479), using residuals from linear regression models, we compared risk among women with higher or lower observed particle concentration relative to nonHDLc (highest and lowest residual quartiles, respectively) to individuals with agreement between markers (middle quartiles) using Cox proportional hazards models. Although all 3 biomarkers were correlated ( ≥ 0.77), discordance occurred in up to 20.2% of women. Women with discordant high particle concentration were more likely to have metabolic syndrome (MetS) and diabetes (both < 0.001). Over a median follow-up of 20.4 years, 1246 CHD events occurred (514725 person-years). Women with high particle concentration relative to nonHDLc had increased CHD risk: age-adjusted hazard ratio (95% CI) = 1.77 (1.56-2.00) for apo B and 1.70 (1.50-1.92) for LDLp. After adjustment for clinical risk factors including MetS, these risks attenuated to 1.22 (1.07-1.39) for apo B and 1.13 (0.99-1.29) for LDLp. Discordant low apo B or LDLp relative to nonHDLc was not associated with lower risk. Discordance between atherogenic particle cholesterol mass and particle concentration occurs in a sizeable proportion of apparently healthy women and should be suspected clinically among women with cardiometabolic traits. In such women, direct measurement of lipoprotein particle concentration might better inform CHD risk assessment.
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ISSN:0009-9147
1530-8561
DOI:10.1373/clinchem.2016.264515