Cardiometabolic and Renal Risk, Biomedical Research Institute INCLIVA, Valencia, Spain; Department of Internal Medicine, Hospital Clinic of Valencia, University of Valencia, Spain.
Biosfer Teslab, Reus, Spain; Metabolomics platform, Rovira i Virgili University, Tarragona, Spain; Intitut d'Investigació Sanitària Pere i Virgili (IISPV), Reus, Spain.
Int J Cardiol. 2018 Aug 1;264:172-178. doi: 10.1016/j.ijcard.2018.03.128. Epub 2018 Mar 29.
The association of low-density lipoprotein (LDL) particle composition with cardiovascular risk has not been explored before. The aim was to evaluate the relationship between baseline LDL particle size and composition (proportions of large, medium and small LDL particles over their sum expressed as small-LDL %, medium-LDL % and large-LDL %) and incident cardiovascular disease in a population-based study.
Direct measurement of LDL particles was performed using a two-dimensional NMR-technique (Liposcale®). LDL cholesterol was assessed using both standard photometrical methods and the Liposcale® technique in a representative sample of 1162 adult men and women from Spain.
The geometric mean of total LDL particle concentration in the study sample was 827.2 mg/dL (95% CI 814.7, 839.8). During a mean follow-up of 12.4 ± 3.3 years, a total of 159 events occurred. Medium LDL particles were positively associated with all cardiovascular disease, coronary heart disease (CHD) and stroke after adjustment for traditional risk factors and treatment. Regarding LDL particle composition, the multivariable adjusted hazard ratios for CHD for a 5% increase in medium and small LDL % by a corresponding decrease of large LDL % were 1.93 (1.55, 2.39) and 1.41 (1.14, 1.74), respectively.
Medium LDL particles were associated with incident cardiovascular disease. LDL particles showed the strongest association with cardiovascular events when the particle composition, rather than the total concentration, was investigated. A change in baseline composition of LDL particles from large to medium and small LDL particles was associated with an increased cardiovascular risk, especially for CHD.
低密度脂蛋白（LDL）颗粒组成与心血管风险的关联尚未被探索。本研究旨在评估基线 LDL 颗粒大小和组成（大、中、小 LDL 颗粒的比例及其总和表示的小 LDL%、中 LDL%和大 LDL%）与人群中发生心血管疾病的关系。
采用二维 NMR 技术（Liposcale®）直接测量 LDL 颗粒。在西班牙的一个代表性成年人样本（1162 人）中，同时使用标准光度法和 Liposcale®技术评估 LDL 胆固醇。
研究样本中总 LDL 颗粒浓度的几何平均值为 827.2mg/dL（95%CI 814.7，839.8）。在平均 12.4±3.3 年的随访期间，共发生 159 例事件。在调整传统危险因素和治疗因素后，中 LDL 颗粒与所有心血管疾病、冠心病（CHD）和中风呈正相关。关于 LDL 颗粒组成，对于大 LDL%相应减少 5%时中 LDL%和小 LDL%每增加 5%，CHD 的多变量调整后的危险比分别为 1.93（1.55，2.39）和 1.41（1.14，1.74）。
中 LDL 颗粒与心血管疾病的发生有关。当研究 LDL 颗粒的组成而不是总浓度时，LDL 颗粒与心血管事件的相关性最强。基线 LDL 颗粒组成从大到中、小 LDL 颗粒的变化与心血管风险增加相关，尤其是 CHD。
