Cholesterol levels in small LDL particles predict the risk of coronary heart disease in the EPIC-Norfolk prospective population study.
OBJECTIVE
To evaluate the association of low-density lipoprotein cholesterol (LDL-C) levels in small and large LDL particles with risk of incident coronary heart disease (CHD).


RESULTS
We performed a prospective case-control study nested in the EPIC-Norfolk cohort. Cases were apparently healthy men and women aged 45-79 years who developed fatal or non-fatal CHD (n = 1035), and who were matched by age, gender, and enrollment time to 1920 controls who remained free of CHD. Electrophoretic characteristics of LDL particles were measured using 2-16% polyacrylamide gradient gel electrophoresis. Concentrations of LDL-C(<255 A) were higher in cases than controls in men (1.34 +/- 0.88 vs. 1.15 +/- 0.80 mmol/L, P < 0.001) as well as in women (1.12 +/- 0.84 vs. 0.94 +/- 0.74 mmol/L, P < 0.001). The unadjusted odds ratio (OR) for future CHD in men of the top tertile of LDL-C(<255 A) was 1.68 (95% CI, 1.33-2.13; P < 0.001) whereas in women the unadjusted OR was 1.53 (95% CI, 1.13-2.07; P < 0.001). However, after further adjustments for confounding variables, the association between LDL-C(<255 A) and CHD was no longer significant in men and in women.


CONCLUSIONS
Cholesterol concentrations in different LDL subclasses show different relationships with CHD risk in this European cohort.
Arsenault
Benoit J
BJ
Department of Cardiology, Québec Heart Institute, Hôpital Laval Research Centre, Pavilion Marguerite-D'Youville, 4th Floor, 2725, chemin Sainte-Foy, Québec, QC, Canada G1V 4G5.
Lemieux
Isabelle
I
Després
Jean-Pierre
JP
Wareham
Nicholas J
NJ
Luben
Robert
R
Kastelein
John J P
JJ
Khaw
Kay-Tee
KT
Boekholdt
S Matthijs
SM
D000368:Aged; D016022:Case-Control Studies; D002784:Cholesterol / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000737:chemistry*; D003327:Coronary Disease / Q000097:blood* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
D008078:Cholesterol, LDL; D002784:Cholesterol