Prospective study of coronary heart disease vs. HDL2, HDL3, and other lipoproteins in Gofman's Livermore Cohort.
OBJECTIVE
To assess the relationship of lipoprotein subfractions to coronary heart disease (CHD).


METHODS
Prospective 29.1-year follow-up of 1905 men measured for lipoprotein mass concentrations by analytic ultracentrifugation between 1954 and 1957. Vital status was determined for 97.2% of the cohort. Blinded physician medical record and death certificate review confirmed 179 CHD deaths. Follow-up questionnaires identified 182 nonfatal myocardial infarctions and 93 revascularization procedures from 1346 (98.3%) of the surviving cohort and from the next-of-kin of 153 men who died.


RESULTS
When adjusted for age, total incident CHD was inversely related to HDL2-mass (P=0.0001) and HDL3-mass (P=0.02), and concordantly related to LDL-mass (P<10(-11)), IDL-mass (P<10(-7)), and small (P<10(-7)) and large VLDL-mass concentrations (P=0.003). The hazard reduction per mg/dl of HDL was greater for HDL2-mass than HDL3-mass (P=0.04). The lowest quartiles of both HDL2-mass (P=0.007) and HDL3-mass (P=0.001) independently predicted total incident CHD when adjusted for traditional risk factors. Risk for premature CHD (≤65 years old) was significantly greater in men within the lowest HDL2 (P=0.03) and HDL3 quartiles (P=0.04) and having higher LDL-mass concentrations (P=0.001). Serum cholesterol's relationship to incident CHD (P<10(-8)) was accounted for by adjustment for LDL-mass concentrations (adjusted P=0.90).


CONCLUSIONS
Lipoprotein subfractions differ in their relationship to CHD.
Lawrence Berkeley Laboratory, Berkeley, CA 94720, USA. ptwilliams@lbl.gov
Paul T
PT
Williams
Daniel E
DE
Feldman
D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008075:Lipoproteins, HDL / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D008076:Cholesterol, HDL; D008074:Lipoproteins; D008075:Lipoproteins, HDL