© 1998 American Heart Association, Inc.
Original Contributions |
LDL Oxidation and Extent of Coronary Atherosclerosis
From the Department of Consumer Research and Epidemiology, Dutch Organization for Applied Scientific Research Nutrition and Food Research Institute, Zeist (L.P.L.v.d.V., A.F.M.K., G.v.P.); Department of Epidemiology and Biostatistics, Erasmus University, Rotterdam (L.P.L.v.d.V., D.E.G.); Gaubius Laboratory, Dutch Organization for Applied Scientific Research Prevention and Health, Leiden (W.v.D., H.M.P.G.); Thorax Centre, Academic Hospital Dijkzigt, Rotterdam (D.A.C.M.K.); and Julius Centre for Patient Oriented Research, Utrecht University, Utrecht (D.E.G.), the Netherlands.
Correspondence to Dr Hans M.G. Princen, Gaubius Laboratory, TNO-PG, Zernikedreef 9, PO Box 2215, 2301 CE Leiden, the Netherlands. E-mail jmg.princen{at}pg.tno.nl
Abstract—Accumulated evidence
indicates that oxidative modification of LDL plays an important role in
the atherogenic process. Therefore, we investigated the relation
between coronary atherosclerosis and
susceptibility of LDL to oxidation in a case-control study in men
between 45 and 80 years of age. Case subjects and hospital control
subjects were selected from subjects undergoing a first
coronary angiography. Subjects with severe coronary
stenosis (
85% stenosis in one and 50%
stenosis in a second major coronary vessel) were
classified as case subjects (n=91). Hospital control subjects with no
or minor stenosis (
50% stenosis in no more than two
of the three major coronary vessels, n=94) and population
control subjects free of plaques in the carotid artery (n=85) were
pooled for the statistical analysis into one control category.
Enrollment procedures allowed for similar distributions in age and
smoking habits. Case subjects had higher levels of total and LDL
cholesterol and triglycerides and lower levels
of HDL cholesterol. Resistance time, maximum rate of
oxidation, and maximum diene production were measured ex vivo
using copper-induced LDL oxidation. A borderline significant inverse
trend was observed for coronary atherosclerosis
risk at increasing resistance time. Odds ratios (95% confidence
interval) for the successive quartiles were 1.0 (reference), 0.77 (0.39
to 1.53), 0.67 (0.33 to 1.34), and 0.55 (0.27 to 1.15)
(ptrend=0.07). No relation with maximum rate of oxidation
was found, and higher maximum diene levels were found in control
subjects (P<.01). The main determinant of oxidation was
the fatty acid composition of LDL. No effect of smoking or use of
medication was observed. We conclude that although LDL resistance to
oxidation may be a factor in atherogenesis, the ex vivo measure is not
a strong predictor of severity of coronary atherosclerosis.
Key Words: LDL oxidation • atherosclerosis • resistance time • propagation rate • LDL composition
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