title: Clinical biomarkers of high-density lipoprotein dysfunction among middle-aged Turks.
abstract: OBJECTIVE
  Impaired function of high-density lipoprotein (HDL) particles generates cardiometabolic disorders in people prone to impaired glucose tolerance for which clinical biomarkers need delineation.
  
  
  METHODS
  Prospective population-based study.
  
  
  METHODS
  Totally, data of 2725 adults followed-up over 7.3 ± 3.0 years were analyzed by Cox regression analysis. C-reactive protein (CRP), complement C3 (C3), triglycerides (Trg) and HDL-cholesterol were tested to predict risk for incident diabetes or coronary heart disease (CHD).
  
  
  RESULTS
  Beyond atherogenic dyslipidemia, high-Trg/normal HDL-cholesterol category was associated with elevated CRP and diabetes risk in women. Normotriglyceridemic men with normal HDL-cholesterol showed higher apolipoprotein A-I levels and higher diabetes risk than men having low HDL-cholesterol. Diabetes risk doubled in hypertriglyceridemic women regardless of HDL-cholesterol. Trg/HDL-C>2 in men and Trg>1.7 mmol/L in women were best predictors of diabetes. C3>1.3 g/L served additively in women alone. Regarding CHD risk, not CRP, but C3 contributed independently to Trg/HDL>2 in men [RR 2.46 (95% CI 1.33; 4.53)]; a high ratio was merely additive to elevated CRP in women. Among five cut-off values, predictive values for diabetes were highest for CRP >2.5 mg/L in men, Trg>1.7 mmol/L and C3>1.3 g/dL in women.
  
  
  CONCLUSIONS
  Trg/HDL-C ratio >2 and/or CRP >2.5 mg/L in men and Trg>1.7 mmol/L+C3>1.3 g/dL in women are most appropriate markers regarding impaired antiinflammatory or atheroprotective HDL function. In normotriglyceridemic men with normal HDL-cholesterol levels, diabetes risk may be elevated due to presumably dysfunctional apolipoprotein A-I.
authors.affiliation: Department of Cardiology, Cerrahpaşa Faculty of Medicine, Turkish Society of Cardiology, İstanbul-Turkey. alt_onat@yahoo.com.tr
authors.forename: Altan
authors.initials: A
authors.lastname: Onat
authors.forename: Günay
authors.initials: G
authors.lastname: Can
authors.forename: Sani
authors.initials: S
authors.lastname: Murat
authors.forename: Gökhan
authors.initials: G
authors.lastname: Ciçek
authors.forename: Ender
authors.initials: E
authors.lastname: Örnek
authors.forename: Hüsniye
authors.initials: H
authors.lastname: Yüksel
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood; D014421:Turkey
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein