Nuclear magnetic resonance lipoprotein subclasses and the APOE genotype influence carotid atherosclerosis in patients with systemic lupus erythematosus.
OBJECTIVE
Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis. Since the conventional lipid profile (total plasma cholesterol, triglycerides, low and high density lipoprotein cholesterol) is not consistently altered in SLE, we hypothesized that investigation of lipoprotein subclasses would improve prediction of risk of atherosclerosis in these patients.


METHODS
As a quantitative index of atherosclerosis, we measured the carotid intima-media thickness (IMT) in 68 patients with SLE and related the atherosclerosis to a detailed lipoprotein profile generated using nuclear magnetic resonance (NMR). We measured the cholesterol transported by the pool of remnant lipoproteins (RLPc) and evaluated the modulatory effect of the APOE genotype on the lipoprotein subclass profile and atherosclerosis associated with SLE.


RESULTS
Circulating lipoprotein remnant particles [RLPc and intermediate density lipoprotein (IDL)] were positively correlated with IMT, and among them, the indicator that explained 20.2% of the variability in carotid atherosclerosis measured in these patients was IDL, as assessed by NMR. Carriers of the APOE2 allele were at increased risk due to a significant accumulation of IDL particles.


CONCLUSIONS
Lipoprotein subclasses are more associated with subclinical atherosclerosis in patients with SLE than the lipid variables that are routinely measured. The IDL fraction, which is significantly modulated by the APOE genotype, is the most strongly, significantly, and positively correlated with IMT.
Gonzàlez
Marta
M
Unitat de Recerca en Lípids i Arteriosclerosi, Facultat de Medicina, Servei de Medicina Interna de l'Hospital Universitari de Sant Joan, Institut d'Investigacions Sanitàries Pere Virgili, Universitat Rovira i Virgili, CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Reus, Spain.
Ribalta
Josep
J
Vives
Glòria
G
Iftimie
Simona
S
Ferré
Raimón
R
Plana
Núria
N
Guardiola
Montse
M
Dallinga-Thie
Geesje
G
Masana
Lluís
L
Castro
Antoni
A
D000483:Alleles; D000704:Analysis of Variance; D001057:Apolipoproteins E / Q000235:genetics*; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics*; D005787:Gene Frequency; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
D001057:Apolipoproteins E; D008074:Lipoproteins