137 - Atherogenic Lipoproteins and Carotid Intimal Medial Thickness Progression over 5 years (ID 93)
Abstract
Background and Aims
Carotid intimal medical thickness (cIMT) is associated with cardiovascular disease (CVD). The association between atherogenic lipoproteins including small dense low-density lipoprotein cholesterol (sdLDL-C) and carotid intimal medial thickness progression has not been fully evaluated in a prospective cohort study. We assessed the hypothesis that sdLDL-C is the most atherogenic lipoproteins with regard to cIMT progression.
Methods
Plasma total cholesterol, low-density lipoprotein cholesterol (LDL-C), sdLDL-C, LDL-triglycerides (LDL-TG), high density lipoprotein cholesterol (HDL-C), HDL2-C, HDL3-C, triglycerides, lipoprotein(a) [Lp(a)], and adiponectin were measured in 2,030 men and women (median age 59 years, free of CVD and off cholesterol lowering medication). At both baseline and after 5 years of follow-up, cIMT was assessed. Univariate, multivariate regression, and least square analyses were performed to examine the relationships between direct LDL-C, sdLDL-C, Lp(a), and other lipoproteins with cIMT progression.
Results
Median cIMT at baseline was 0.63 mm and median 5 year progression was 0.18 mm. After adjustment for standard CVD risk factor including age, gender, systolic blood pressure, total cholesterol, HDL-C, smoking, diabetes, and hypertension treatment, only LDL-C, sdLDL-C, and the sdLDL-C/LDL-C ratio were associated with cIMT progression. Even in subjects with direct LDL-C < 100 mg/dL, considered to be at low CVD risk, elevated sdLDL-C were associated with cIMT progression (P for trend = 0.009) in a model with established CVD risk factors, although the sdLDL-C/LDL-C ratio did not.
Conclusions
Both sdLDL-C and direct LDL-C are significantly associated with cIMT progression; therefore, measurement of sdLDL-C may allow for the formulation of optimal therapy to cIMT progression.
