Does simultaneous determination of LDL and HDL particle size improve prediction of coronary artery disease risk?

• Published in: Clinical and experimental medicine Vol. 8; no. 2; pp. 109 - 116
• Main Authors: Zeljkovic, Aleksandra, Spasojevic-Kalimanovska, Vesna, Vekic, Jelena, Jelic-Ivanovic, Zorana, Topic, Aleksandra, Bogavac-Stanojevic, Natasa, Spasic, Slavica, Vujovic, Ana, Kalimanovska-Ostric, Dimitra
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.06.2008; Springer Nature B.V
• Subjects: Area Under Curve; Blood tests; Cardiovascular disease; Coronary Artery Disease - blood; Coronary Artery Disease - etiology; Genotype & phenotype; Hematology; Humans; Internal Medicine; Lipids - blood; Lipoproteins, HDL - classification; Lipoproteins, LDL - classification; Logistic Models; Low density lipoprotein; Medicine; Medicine & Public Health; Oncology; Original; Particle Size; Phenotype; Predictions; Regression analysis; Risk Assessment; Lipoprotein subclasses; CAD risk prediction
• ISSN: 1591-8890; 1591-9528
• DOI: 10.1007/s10238-008-0165-z

Background Alterations in plasma lipoprotein subclass distribution affect the risk for coronary artery disease (CAD). However, it is unclear whether the determination of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) phenotypes may or may not improve the ability to predict CAD development. Methods Polyacrylamide gradient (3–31%) gel electrophoresis was used to simultaneously determine size and distribution of lipoprotein subclasses in 181 CAD patients and 178 controls. Results Mean LDL and HDL subclass sizes were significantly smaller in patients than in controls ( p < 0.001). Multivariate logistic regression analysis showed that small dense LDL particles were independent CAD risk predictors (OR = 2.867, p < 0.01), even when adjusted for other traditional risk factors, while small HDL particles lost their significance after adjustment (OR = 2.071, p = 0.054). The area under the ROC curve for LDL (0.671) and HDL (0.643) particle size measurement demonstrated low clinical accuracy when compared to the combination of traditional lipid risk factor measurements. Conclusions CAD is associated with the predominance of smaller LDL and HDL particles. However, simultaneous determination of these two lipoprotein phenotypes provides no additional power in discriminating CAD and non-CAD subjects, beyond that obtained by the traditional risk factors.