Does simultaneous determination of LDL and HDL particle size improve prediction of coronary artery disease risk?
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.
Zeljkovic
Aleksandra
A
Institute of Medical Biochemistry, POB 146, 11000, Belgrade, Serbia. aleksandra.zeljkovic@pharmacy.bg.ac.yu
Spasojevic-Kalimanovska
Vesna
V
Vekic
Jelena
J
Jelic-Ivanovic
Zorana
Z
Topic
Aleksandra
A
Bogavac-Stanojevic
Natasa
N
Spasic
Slavica
S
Vujovic
Ana
A
Kalimanovska-Ostric
Dimitra
D
D019540:Area Under Curve; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology*; D006801:Humans; D008055:Lipids / Q000097:blood; D008075:Lipoproteins, HDL / Q000145:classification*; D008077:Lipoproteins, LDL / Q000145:classification*; D016015:Logistic Models; D010316:Particle Size; D010641:Phenotype; D018570:Risk Assessment
D008055:Lipids; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL