Clinical biomarkers of high-density lipoprotein dysfunction among middle-aged Turks

Abstract

Objective: Impaired function of high-density lipoprotein (HDL) particles generates cardiometabolic disorders in people prone to impaired glucose tolerance for which clinical biomarkers need delineation. Study design: Prospective population-based study. Methods: Totally, data of 2725 adults followed-up over 7.3±3.0 years were analyzed by Cox regression analysis. C-reactive protein (CRP), complement C3 (C3), triglycerides (Trg) and HDL-cholesterol were tested to predict risk for incident diabetes or coronary heart disease (CHD). Results: Beyond atherogenic dyslipidemia, high-Trg/normal HDL-cholesterol category was associated with elevated CRP and diabetes risk in women. Normotriglyceridemic men with normal HDL-cholesterol showed higher apolipoprotein A-I levels and higher diabetes risk than men having low HDL-cholesterol. Diabetes risk doubled in hypertriglyceridemic women regardless of HDL-cholesterol. Trg/HDL-C>2 in men and Trg>1.7 mmol/L in women were best predictors of diabetes. C3>1.3 g/L served additively in women alone. Regarding CHD risk, not CRP, but C3 contributed independently to Trg/HDL>2 in men [RR 2.46 (95% CI 1.33; 4.53)]; a high ratio was merely additive to elevated CRP in women. Among five cut-off values, predictive values for diabetes were highest for CRP >2.5 mg/L in men, Trg>1.7 mmol/L and C3>1.3 g/dL in women. Conclusion: Trg/HDL-C ratio >2 and/or CRP >2.5 mg/L in men and Trg>1.7 mmol/L+C3>1.3 g/dL in women are most appropriate markers regarding impaired antiinflammatory or atheroprotective HDL function. In normotriglyceridemic men with normal HDL-cholesterol levels, diabetes risk may be elevated due to presumably dysfunctional apolipoprotein A-I. (Anadolu Kardiyol Derg 2012; 12: 628-36) Key words: Coronary heart disease, Cox proportional regression analysis, C-reactive protein, diabetes type-2, HDL dysfunction, triglycerides, sensitivity, specificity Original Investigation Özgün Araşt›rma 628ÖZET Amaç: Yüksek yoğunluklu lipoprotein (HDL) parçacıklarının fonksiyon bozukluğu, glikoz tolerans bozukluğuna yatkın kişilerde kardiyometabolik hastalık üretebildiğinden, klinik belirteçlerinin belirlenmesi gerekir. Çalışma dizaynı: Öne dönük popülasyona dayalı. Yöntem: Toplam 2725 yetişkin 7.3±3.0 yıllık takipte Cox regresyon analiziyle değerlendirildi. Başlangıçta ilgili olguların dışlanmasından sonra, ileride diyabet ve koroner kalp hastalığının gelişmesi bakımından, C-reaktif protein (CRP), kompleman C3 (C3), trigliseridler (Trg) ve HDL-kolesterolün öngörü değerleri incelendi. Bulgular: Diyabet riski açısından kadınlarda, aterojen dislipidemi dışında, artmış CRP ile bağıntılı yüksek-Trg/normal HDL-kolesterol kategorisi ilişki gösterdi. Normal trigliserid ve HDL-kolesterol seviyesine sahip erkekler, düşük HDL-kolesterollü erkeklere kıyasla, daha yüksek apolipoprotein A-I düzeyiyle birlikte yüksek diyabet riski sergiledi. Hipertrigliseridemili kadınlarda diyabet riski, HDL-kolesterol düzeylerine bakılmaksızın, ikiye katlandı. CRP >2.5 mg/L ölçütü her iki cinsiyette diyabeti anlamlı öngördü; am...

Study of Lipid Profile and it’s Risk Factor AIP with BMI Division for CVD Patients Compared to Healthy Control

“…A high TG/HDL ratio alone was predictive of CHD risk only in men, whereas combined presence of high TG/HDL ratio and elevated CRP conferred CHD risk in women. The interplay across gender, hypertriglyceridemia, elevated CRP and HDL dysfunction in the development of cardio metabolic risk sex the joint role of the proinflammatory state, represented by elevated circulating TG, CRP and HDL dysfunction (67) .…”

Anthropometric indexes for predicting high blood pressure in Turkish adults

“…[ 6 ] Although numerous prospective and cross-sectional trials have been carried out, there is no agreement about which indicator has a stronger relationship with blood pressure (BP) and which is a stand-alone risk factor. [ 6 , 7 , 8 , 9 , 10 , 11 ] The Prospective Population-Based Turkish Adult Risk Factor Study determined BMI in women and WHR in men as predictors of systolic BP (SBP) and diastolic BP (DBP)[ 12 ] while another study reported that WC was an independent indicator in hypertensive patients. [ 13 ] However, up to date, the efficacy of anthropometric indices as a direct predictor of hypertension and the relationship between BP has not been comprehensively investigated in Turkish adults.…”

“…[ 13 ] However, up to date, the efficacy of anthropometric indices as a direct predictor of hypertension and the relationship between BP has not been comprehensively investigated in Turkish adults. [ 12 , 13 , 14 ]…”

Genetic Variants Associated with Severe Hypertriglyceridemia: LPL, APOC2, APOA5, GPIHBP1, LMF1, and APOE

“…10 A limited number of studies exist quantifying the prevalence of HTG in Turkey. [11][12][13] Kayıkçıoğlu et al 13 reported a prevalence of HTG (>150 mg/dL) in Turkey 36.5% in general. Onat A.…”

“…Onat A. 12 reported a prevalence of mild-to-moderate HTG in Turkey of 39.6% and 29.2% in men and women, respectively, and Bayram et al 11 reported the population prevalence of HTG as 35.7% (33.5% for women and 38.3% for men). Analysis of rare LOF variants in Turkish patients with HTG has not been previously performed.…”