Arsenault Benoit J, Lemieux Isabelle, Després Jean-Pierre, Gagnon Pascale, Wareham Nicholas J, Stroes Erik S G, Kastelein John J P, Khaw Kay-Tee, Boekholdt S Matthijs
Hôpital Laval Research Centre, Pavilion Marguerite-D'Youville, 2725 chemin Sainte-Foy, Québec, Canada.
Atherosclerosis. 2009 Sep;206(1):276-81. doi: 10.1016/j.atherosclerosis.2009.01.044. Epub 2009 Feb 12.
To evaluate the association between HDL particle size measured by gradient gel electrophoresis and risk of incident coronary heart disease (CHD) in apparently healthy men and women.
We performed a prospective case-control study nested in the EPIC-Norfolk cohort. Cases were apparently healthy men and women aged 45-79 years who developed fatal or nonfatal CHD (n=1035). They were matched to 1920 controls who remained free of CHD over the follow-up period of 6 years.
Participants with the smallest HDL particles had the most unfavourable cardiometabolic risk profile whereas those with the largest HDL particles had the most favourable risk profile. Plasma HDL cholesterol levels were found to be the best correlate of HDL particle size (r=0.58 and r=0.62, respectively, for men and women, p<0.001). Men in the highest quartile of HDL particle size had an unadjusted odds ratio (OR) for future CHD of 0.75 (95% CI, 0.57-0.97) compared to those in the bottom quartile. For women, the equivalent OR was 0.50 (0.35-0.71). After additional adjustment for diabetes, body mass index, systolic blood pressure, LDL and HDL cholesterol levels, the ORs were 1.43 (1.01-2.03) in men and 0.84 (0.52-1.35) in women.
A decreased HDL particle size is associated with an adverse cardiometabolic risk profile. Small HDL particle size was also associated with an increased CHD risk, but this association was largely explained by traditional risk factors.
评估通过梯度凝胶电泳测量的高密度脂蛋白（HDL）颗粒大小与明显健康的男性和女性发生冠心病（CHD）风险之间的关联。
我们在EPIC-诺福克队列中进行了一项前瞻性病例对照研究。病例为年龄在45 - 79岁之间发生致命或非致命性冠心病的明显健康男性和女性（n = 1035）。他们与1920名在6年随访期内未患冠心病的对照者进行匹配。
HDL颗粒最小的参与者具有最不利的心脏代谢风险特征，而HDL颗粒最大的参与者具有最有利的风险特征。发现血浆HDL胆固醇水平是HDL颗粒大小的最佳关联指标（男性和女性的r分别为0.58和0.62，p < 0.001）。与HDL颗粒大小处于最低四分位数的男性相比，处于最高四分位数的男性未来患冠心病的未调整优势比（OR）为0.75（95%可信区间，0.57 - 0.97）。对于女性，相应的OR为0.50（0.35 - 0.71）。在进一步调整糖尿病、体重指数、收缩压、低密度脂蛋白和高密度脂蛋白胆固醇水平后，男性的OR为1.43（1.01 - 2.03），女性的OR为0.84（0.52 - 1.35）。
HDL颗粒大小减小与不良的心脏代谢风险特征相关。HDL颗粒小也与冠心病风险增加相关，但这种关联在很大程度上由传统风险因素解释。
