title: Accumulation of apoE-enriched triglyceride-rich lipoproteins in patients with coronary artery disease.
abstract: Triglycerides (TGs) are vehicled by multiple particles with different abilities to promote atherosclerosis. Among plasma TG-rich lipoproteins (TRLs), subspecies may or may not contain apolipoprotein E (apoE) molecules: in this study, we evaluated the relative contribution of apoE-rich and apoE-poor TRLs to coronary atherosclerosis. We selected a group of males with premature coronary artery disease (CAD) without any of the classical nonlipid risk factors and/or high plasma lipid levels and evaluated the plasma concentration of TRL subspecies in comparison with healthy controls. Patients with CAD and controls had total cholesterol and TG levels within the normal range (despite slightly, even if significantly, higher TG levels in patients with CAD) and low-density lipoprotein cholesterol levels near optimal values. Nevertheless, patients with CAD had significantly lower high-density lipoprotein cholesterol, smaller low-density lipoprotein peak particle size, and a reduced HDL2b subfraction than controls. In addition, we observed higher concentrations of total TRL in patients with CAD together with a selective increase in apoE-rich particles. All these data were confirmed after correction for TG levels. We also investigated which parameters were associated with the spread of coronary atherosclerosis. Subjects with a single-vessel disease had selectively lower levels of apoE-rich fractions than patients with a multivessel disease. This was confirmed by multivariate analysis. Patients with a premature CAD free of nonlipid conventional risk factors, despite not having elevated lipid levels, show several lipoprotein abnormalities. Besides known atherogenic alterations, the accumulation of apoE-rich TRL subfractions may represent an additive factor that can potentially promote and initiate the atherosclerotic process.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Palermo, and Intensive Care Unit, Villa Maria Eleonora Hospital, Palermo, Italy. carlob@unipa.it
authors.forename: Carlo M
authors.initials: CM
authors.lastname: Barbagallo
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.forename: Davide
authors.initials: D
authors.lastname: Noto
authors.forename: Arian
authors.initials: A
authors.lastname: Frasheri
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pernice
authors.forename: Antonio
authors.initials: A
authors.lastname: Rubino
authors.forename: Daniele
authors.initials: D
authors.lastname: Pieri
authors.forename: Vito
authors.initials: V
authors.lastname: Pinto
authors.forename: Angelo B
authors.initials: AB
authors.lastname: Cefalù
authors.forename: Carla
authors.initials: C
authors.lastname: Giordano
authors.forename: Alberto
authors.initials: A
authors.lastname: Notarbartolo
authors.forename: Maurizio R
authors.initials: MR
authors.lastname: Averna
mesh_terms: D000328:Adult; D001057:Apolipoproteins E / Q000097:blood* / Q000235:genetics; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D002846:Chromatography, Affinity; D003324:Coronary Artery Disease / Q000097:blood*; D004591:Electrophoresis, Polyacrylamide Gel; D006801:Humans; D007328:Insulin / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014280:Triglycerides / Q000097:blood / Q000378:metabolism*
chemical_list: D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D017270:Lipoprotein(a); D014280:Triglycerides