ABSTRACT. The high-density lipoprotein (HDL) subclass distribution was examined by gradient gel electrophoresis (gge) in 154 human cord blood samples, and determinations of triglyceride, total cholesterol, and HDL-cholesterol levels were performed. Three distinct gge patterns were recognizable. The first pattern, termed the normal (gge) pattern, was distinguished by a prominent double peak in the (HDL2,),, region and a pronounced peak in the (HDL3b)gge region. Minor peaks, or shoulders, were also seen in the (HDLZb)gge and (HDL3Jae regions, and a valley was present in the (HDL3,),,, region. This pattern was associated with normal lipid levels for cord blood plasma (mean triglycerides: 30-42 mg/dl; mean total cholesterol 62-85 mg/dl; mean HDL-cholesterol: 34-41 mg/ dl).The second pattern, termed the 2b(gge) pattern, contained a major peak in the ( H D L z~)~~, region rather than the shoulder seen in the normal (gge) pattern, while the (HDL2.)gge, (HDL3b),e, and (HDL3,),, regions were less pronounced. This pattern was associated with elevated total cholesterol and HDL-C levels (means 85-102 and 49-56 mg/dl, respectively). The third pattern, termed the 3b(gge) pattern, was characterized by a paucity of material in the (HDL2,,),, region, a single peak in the (HDLza),, region, and either a relative increase in the (HDL3b),e region, or a simultaneous increase in both (HDLs~),~ and (HDL3e),e. This pattern was associated with elevated triglyceride levels (means 78-88 mg/dl) and decreased HDL-C levels (means 20-30 mg/dl). Only two infants had a simultaneous elevation of triglycerides and total cholesterol and both cases exhibited the 3b(gge) pattern. Our study demonstrates that although the triglyceride and cholesterol levels in the newborn are much lower than those in adults, they are the important factors associated with the HDL subclass distribution. Elevated cholesterol was related to increased particles in the (HDL2b), region while elevated triglyceride levels were associated with a decrease in (HDL2b+2a)gge particles and a concomitant increase in (HDLsb),, particles. (Pediatr Res 20: 487-491, 1986) Abbreviations HDL, high-density lipoproteins TG, triglyceride TC, total cholesterol HDL-C, HDL-cholesterol gge, gradient gel electrophoresis CB, cord blood Received October 7, 1985: accepted January 23, 1986. Address correspondence and requests for reprints to Orsolya Genzel-Boroviczeny, M.D., Donner Laboratory, 1-213, University of California, Berkeley, CA 94720.This work was supported by NIH Program Project Grant HL 18574 from the National Heart, Lung, and Blood Institute of the National Institutes of Health and NIH National Research Service Award Training Grant HL 07279.There is growing evidence that HDL, and in particular the HDL2 subclass, have a protective role in the process of atherogenesis (1-3). In contrast to adults, in whom low density lipoproteins predominate, HDL is the predominant lipoprotein species in human CB (4-10). Davis et al. (4) found that in healthy term infants with lipoprotein levels below 10...