Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland; Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.
J Clin Lipidol. 2019 Nov-Dec;13(6):910-919.e2. doi: 10.1016/j.jacl.2019.09.011. Epub 2019 Sep 30.
South Asians are more prone to develop atherosclerotic cardiovascular disease (ASCVD) compared with white Caucasians, which is not fully explained by classical risk factors. We recently reported that the presence of aggregation-prone low-density lipoprotein (LDL) in the circulation is associated with increased ASCVD mortality.
We hypothesized that LDL of South Asians is more prone to aggregate, which may be explained by differences in their LDL lipid composition.
In this cross-sectional hypothesis-generating study, LDL was isolated from plasma of healthy South Asians (n = 12) and age- and BMI-matched white Caucasians (n = 12), and its aggregation susceptibility and lipid composition were analyzed.
LDL from South Asians was markedly more prone to aggregate compared with white Caucasians. Among all measured lipids, sphingomyelin 24:0 and triacylglycerol 56:8 showed the highest positive correlation with LDL aggregation. In addition, LDL from South Asians was enriched in arachidonic acid containing phosphatidylcholine 38:4 and had less phosphatidylcholines and cholesteryl esters containing monounsaturated fatty acids. Interestingly, body fat percentage, which was higher in South Asians (+26%), positively correlated with LDL aggregation and highly positively correlated with triacylglycerol 56:8, sphingomyelin 24:0, and total sphingomyelin.
LDL aggregation susceptibility is higher in healthy young South Asians compared with white Caucasians. This may be partly explained by the higher body fat percentage of South Asians, leading to sphingomyelin enrichment of LDL. We anticipate that the presence of sphingomyelin-rich, aggregation-prone LDL particles in young South Asians may increase LDL accumulation in the arterial wall and thereby contribute to their increased risk of developing ASCVD later in life.
南亚人比白种高加索人更容易患动脉粥样硬化性心血管疾病（ASCVD），这不能完全用传统的危险因素来解释。我们最近报道，循环中存在易于聚集的低密度脂蛋白（LDL）与 ASCVD 死亡率增加有关。
我们假设南亚人的 LDL 更容易聚集，这可能与其 LDL 脂质组成的差异有关。
在这项横断面假设生成研究中，从健康的南亚人（n=12）和年龄及 BMI 匹配的白种高加索人（n=12）的血浆中分离出 LDL，并分析其聚集易感性和脂质组成。
与白种高加索人相比，南亚人的 LDL 明显更容易聚集。在所有测量的脂质中，神经鞘磷脂 24:0 和三酰甘油 56:8 与 LDL 聚集呈最强正相关。此外，南亚人的 LDL 富含含有花生四烯酸的磷脂酰胆碱 38:4，并且含有较少的单不饱和脂肪酸的磷脂酰胆碱和胆固醇酯。有趣的是，体脂百分比在南亚人中更高（+26%），与 LDL 聚集呈正相关，与三酰甘油 56:8、神经鞘磷脂 24:0 和总神经鞘磷脂呈高度正相关。
与白种高加索人相比，健康的年轻南亚人 LDL 聚集易感性更高。这可能部分归因于南亚人体脂百分比较高，导致 LDL 中神经鞘磷脂含量增加。我们预计，年轻南亚人存在富含神经鞘磷脂、易于聚集的 LDL 颗粒，可能会增加 LDL 在动脉壁中的蓄积，从而增加他们以后患 ASCVD 的风险。
