title: Can dysfunctional HDL explain high coronary artery disease risk in South Asians?
abstract: BACKGROUND
  Coronary artery disease (CAD) is the leading cause of mortality and morbidity in United States, and South Asian immigrants (SAIs) have a higher risk for CAD compare to Caucasians. Traditional risk factors do not completely explain high risk, and some of the unknown risk factors need to be explored. We assessed dysfunctional pro-inflammatory high density lipoprotein (HDL) in SAIs and assessed its association with sub-clinical CAD using carotid intima-media thickness (IMT) as a surrogate marker for atherosclerosis.
  
  
  METHODS
  Cross-sectional study on SAIs aged 40-65 years. Sub-clinical CAD was measured using carotid intima media thickness (IMT) as a surrogate marker of atherosclerosis. Dysfunctional or pro-inflammatory HDL was determined by novel cell free assay and HDL inflammatory Index.
  
  
  RESULTS
  Dysfunctional HDL was found in the 50% participants, with HDL-inflammatory index of >or=1.00, suggesting pro-inflammatory HDL (95% CI, 0.8772-1.4333). The prevalence of sub-clinical CAD using carotid IMT (>or=0.80 mm) was seen in 41.4% (95% CI, 0.2347-0.5933). On logistic regression analysis, positive carotid IMT was found to be associated with dysfunctional HDL after adjusting for age, family history of cardiovascular disease, and hypertension (p=0.030).
  
  
  CONCLUSIONS
  The measurement of HDL level as well as functionality plays an important role in CAD risk assessment. Those SAIs with dysfunctional HDL and without known CAD can be a high risk group requiring treatment with lipid lowering drugs to reduce future risk of CAD. Further large studies are required to explore association of dysfunctional HDL with CAD and identify additional CAD risk caused by dysfunctional HDL.
authors.affiliation: Medical College of Georgia, Augusta, Georgia 30912, USA. sdodani@mcg.edu
authors.forename: Sunita
authors.initials: S
authors.lastname: Dodani
authors.forename: Rajwinderjit
authors.initials: R
authors.lastname: Kaur
authors.forename: Srinavasa
authors.initials: S
authors.lastname: Reddy
authors.forename: Guy L
authors.initials: GL
authors.lastname: Reed
authors.forename: Mohammad
authors.initials: M
authors.lastname: Navab
authors.forename: Varghese
authors.initials: V
authors.lastname: George
mesh_terms: D000328:Adult; D000368:Aged; D001210:Asia, Southeastern / Q000208:ethnology; D001213:Asian / Q000208:ethnology* / Q000235:genetics*; D008076:Cholesterol, HDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000235:genetics*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL