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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28:575.)
© 2008 American Heart Association, Inc.

Clinical and Population Studies

Plasma Levels of HDL Subpopulations and Remnant Lipoproteins Predict the Extent of Angiographically-Defined Coronary Artery Disease in Postmenopausal Women

Stefania Lamon-Fava; David M. Herrington; David M. Reboussin; Michelle Sherman; Katalin V. Horvath; L. Adrienne Cupples; Charles White; Serkalem Demissie; Ernst J. Schaefer; Bela F. Asztalos

From the Lipid Metabolism Laboratory (S.L.-F., M.S., K.V.H., E.J.S., B.F.A.), Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Mass; the Department of Internal Medicine–Cardiology (D.M.H.) and the Department of Public Health Sciences (D.M.R.), Wake Forest University School of Medicine, Winston-Salem, NC; and the Department of Biostatistics (L.A.C., C.W., S.D.), Boston University, Boston, Mass.

Correspondence to Stefania Lamon-Fava, MD, PhD, Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research, Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111. E-mail stefania.lamon-fava{at}tufts.edu

Abstract

Objective— The association of coronary heart disease (CHD) with subpopulations of triglyceride (TG)-rich lipoproteins and high-density lipoproteins (HDL) is established in men, but has not been well characterized in women.

Methods and Results— Plasma HDL subpopulation concentrations, quantified by 2-dimensional gel electrophoresis, and plasma remnant-like particle cholesterol (RLP-C) concentrations were measured in 256 postmenopausal women with established CHD and in 126 CHD-free postmenopausal women. Coronary artery disease was assessed in women with CHD by quantitative coronary angiography. Plasma RLP-C and preβ1 HDL concentrations were higher and 1 and 2 HDL concentrations were lower in CHD than in CHD-free women. After adjustment for conventional CHD-risk factors, plasma levels of RLP-C were positively associated with the degree of coronary artery disease. In similar analyses, plasma preβ1 HDL particle concentrations were positively associated and 2 HDL particle concentrations were inversely associated with the extent of coronary atherosclerosis. Plasma TG, low density lipoprotein cholesterol, and HDL cholesterol levels were not associated with the degree of coronary atherosclerosis.

Conclusions— The degree of coronary atherosclerosis in postmenopausal women is linked to a dysregulation of the TG/HDL metabolism. Subpopulations of TG-rich and HDL lipoproteins are better predictors of disease than TG and HDL cholesterol concentrations.

We measured plasma levels of remnant lipoproteins and HDL subpopulations in 256 postmenopausal women with angiographic evidence of coronary heart disease. The degree of coronary atherosclerosis was positively associated with both remnant lipoprotein levels and preβ1 HDL levels and inversely associated with 2 HDL levels, but not with TG or HDL cholesterol. Subpopulations of TG-rich and HDL lipoproteins are better predictors of CHD severity than TG and HDL-cholesterol levels.

Key Words: women • angiography • lipoproteins • coronary heart disease