Subfractions of High-Density Lipoprotein-Cholesterol and Carotid Intima-Media Thickness: The Northern Manhattan Study

Eduard Tiozzo, Hannah Gardener, Barry Hudson, Chuanhui Dong, David Della Morte, Milita Crisby, Ronald B Goldberg, Mitchell S V Elkind, Ying Kuen Cheung, Clinton B Wright, Ralph L Sacco, Moise Desvarieux, Tatjana Rundek

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Purpose - Recent drug trials have challenged the high-density lipoprotein-cholesterol (HDL-C) antiatherosclerotic hypothesis, suggesting that total level of HDL-C may not be the best target for intervention. HDL-C subfractions may be better markers of vascular risk than total levels of HDL-C. The objective of this cross-sectional study was to investigate the relationship between HDL2-C and HDL3-C fractions and carotid intima-media thickness (cIMT) in the population-based Northern Manhattan Study. Methods - We evaluated 988 stroke-free participants (mean age, 66±8 years; 60% women; 66% Hispanic, and 34% non-Hispanic) with available data on HDL-C subfractions using precipitation method and cIMT assessed by a high-resolution carotid ultrasound. The associations between HDL-C subfractions and cIMT were analyzed by multiple linear regression models. Results - The mean HDL2-C was 14±8 mg/dL, HDL3-C 32±8 mg/dL, and the mean total HDL-C was 46±14 mg/dL. The mean cIMT was 0.90±0.08 mm. After controlling for demographics and vascular risk factors, HDL2-C and total HDL-C were inversely associated with cIMT (per 2 SDs, β=-0.017, P=0.001 and β=-0.012, P=0.03, respectively). The same inverse association was more pronounced among those with diabetes mellitus (per 2SDs, HDL2-C: β=-0.043, P=0.003 and HDL-C: β=-0.029, P=0.02). HDL3-C was not associated with cIMT. Conclusions - HDL2-C had greater effect on cIMT than HDL3-C in this large urban population. The effect of HDL2-C was especially pronounced among individuals with diabetes mellitus. More research is needed to determine antiatherosclerotic effects of HDL-C subfractions and their clinical relevance.

Original languageEnglish (US)
Pages (from-to)1508-1513
Number of pages6
JournalStroke
Volume47
Issue number6
DOIs
StatePublished - Jun 1 2016

Fingerprint

Carotid Intima-Media Thickness
HDL Cholesterol
Linear Models
Diabetes Mellitus
Urban Population
Hispanic Americans
Blood Vessels
Cross-Sectional Studies
Stroke
Demography

Keywords

  • atherosclerosis
  • carotid intima-media thickness
  • cholesterol, HDL
  • diabetes mellitus
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Subfractions of High-Density Lipoprotein-Cholesterol and Carotid Intima-Media Thickness : The Northern Manhattan Study. / Tiozzo, Eduard; Gardener, Hannah; Hudson, Barry; Dong, Chuanhui; Della Morte, David; Crisby, Milita; Goldberg, Ronald B; Elkind, Mitchell S V; Cheung, Ying Kuen; Wright, Clinton B; Sacco, Ralph L; Desvarieux, Moise; Rundek, Tatjana.

In: Stroke, Vol. 47, No. 6, 01.06.2016, p. 1508-1513.

Research output: Contribution to journalArticle

Tiozzo, Eduard ; Gardener, Hannah ; Hudson, Barry ; Dong, Chuanhui ; Della Morte, David ; Crisby, Milita ; Goldberg, Ronald B ; Elkind, Mitchell S V ; Cheung, Ying Kuen ; Wright, Clinton B ; Sacco, Ralph L ; Desvarieux, Moise ; Rundek, Tatjana. / Subfractions of High-Density Lipoprotein-Cholesterol and Carotid Intima-Media Thickness : The Northern Manhattan Study. In: Stroke. 2016 ; Vol. 47, No. 6. pp. 1508-1513.
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AU - Tiozzo, Eduard

AU - Gardener, Hannah

AU - Hudson, Barry

AU - Dong, Chuanhui

AU - Della Morte, David

AU - Crisby, Milita

AU - Goldberg, Ronald B

AU - Elkind, Mitchell S V

AU - Cheung, Ying Kuen

AU - Wright, Clinton B

AU - Sacco, Ralph L

AU - Desvarieux, Moise

AU - Rundek, Tatjana

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N2 - Background and Purpose - Recent drug trials have challenged the high-density lipoprotein-cholesterol (HDL-C) antiatherosclerotic hypothesis, suggesting that total level of HDL-C may not be the best target for intervention. HDL-C subfractions may be better markers of vascular risk than total levels of HDL-C. The objective of this cross-sectional study was to investigate the relationship between HDL2-C and HDL3-C fractions and carotid intima-media thickness (cIMT) in the population-based Northern Manhattan Study. Methods - We evaluated 988 stroke-free participants (mean age, 66±8 years; 60% women; 66% Hispanic, and 34% non-Hispanic) with available data on HDL-C subfractions using precipitation method and cIMT assessed by a high-resolution carotid ultrasound. The associations between HDL-C subfractions and cIMT were analyzed by multiple linear regression models. Results - The mean HDL2-C was 14±8 mg/dL, HDL3-C 32±8 mg/dL, and the mean total HDL-C was 46±14 mg/dL. The mean cIMT was 0.90±0.08 mm. After controlling for demographics and vascular risk factors, HDL2-C and total HDL-C were inversely associated with cIMT (per 2 SDs, β=-0.017, P=0.001 and β=-0.012, P=0.03, respectively). The same inverse association was more pronounced among those with diabetes mellitus (per 2SDs, HDL2-C: β=-0.043, P=0.003 and HDL-C: β=-0.029, P=0.02). HDL3-C was not associated with cIMT. Conclusions - HDL2-C had greater effect on cIMT than HDL3-C in this large urban population. The effect of HDL2-C was especially pronounced among individuals with diabetes mellitus. More research is needed to determine antiatherosclerotic effects of HDL-C subfractions and their clinical relevance.

AB - Background and Purpose - Recent drug trials have challenged the high-density lipoprotein-cholesterol (HDL-C) antiatherosclerotic hypothesis, suggesting that total level of HDL-C may not be the best target for intervention. HDL-C subfractions may be better markers of vascular risk than total levels of HDL-C. The objective of this cross-sectional study was to investigate the relationship between HDL2-C and HDL3-C fractions and carotid intima-media thickness (cIMT) in the population-based Northern Manhattan Study. Methods - We evaluated 988 stroke-free participants (mean age, 66±8 years; 60% women; 66% Hispanic, and 34% non-Hispanic) with available data on HDL-C subfractions using precipitation method and cIMT assessed by a high-resolution carotid ultrasound. The associations between HDL-C subfractions and cIMT were analyzed by multiple linear regression models. Results - The mean HDL2-C was 14±8 mg/dL, HDL3-C 32±8 mg/dL, and the mean total HDL-C was 46±14 mg/dL. The mean cIMT was 0.90±0.08 mm. After controlling for demographics and vascular risk factors, HDL2-C and total HDL-C were inversely associated with cIMT (per 2 SDs, β=-0.017, P=0.001 and β=-0.012, P=0.03, respectively). The same inverse association was more pronounced among those with diabetes mellitus (per 2SDs, HDL2-C: β=-0.043, P=0.003 and HDL-C: β=-0.029, P=0.02). HDL3-C was not associated with cIMT. Conclusions - HDL2-C had greater effect on cIMT than HDL3-C in this large urban population. The effect of HDL2-C was especially pronounced among individuals with diabetes mellitus. More research is needed to determine antiatherosclerotic effects of HDL-C subfractions and their clinical relevance.

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KW - carotid intima-media thickness

KW - cholesterol, HDL

KW - diabetes mellitus

KW - stroke

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