title: Low-density lipoprotein electronegativity is a novel cardiometabolic risk factor.
abstract: BACKGROUND
  Low-density lipoprotein (LDL) plays a central role in cardiovascular disease (CVD) development. In LDL chromatographically resolved according to charge, the most electronegative subfraction-L5-is the only subfraction that induces atherogenic responses in cultured vascular cells. Furthermore, increasing evidence has shown that plasma L5 levels are elevated in individuals with high cardiovascular risk. We hypothesized that LDL electronegativity is a novel index for predicting CVD.
  
  
  METHODS
  In 30 asymptomatic individuals with metabolic syndrome (MetS) and 27 healthy control subjects, we examined correlations between plasma L5 levels and the number of MetS criteria fulfilled, CVD risk factors, and CVD risk according to the Framingham risk score.
  
  
  RESULTS
  L5 levels were significantly higher in MetS subjects than in control subjects (21.9±18.7 mg/dL vs. 11.2±10.7 mg/dL, P:0.01). The Jonckheere trend test revealed that the percent L5 of total LDL (L5%) and L5 concentration increased with the number of MetS criteria (P<0.001). L5% correlated with classic CVD risk factors, including waist circumference, body mass index, waist-to-height ratio, smoking status, blood pressure, and levels of fasting plasma glucose, triglyceride, and high-density lipoprotein. Stepwise regression analysis revealed that fasting plasma glucose level and body mass index contributed to 28% of L5% variance. The L5 concentration was associated with CVD risk and contributed to 11% of 30-year general CVD risk variance when controlling the variance of waist circumference.
  
  
  CONCLUSIONS
  Our findings show that LDL electronegativity was associated with multiple CVD risk factors and CVD risk, suggesting that the LDL electronegativity index may have the potential to be a novel index for predicting CVD. Large-scale clinical trials are warranted to test the reliability of this hypothesis and the clinical importance of the LDL electronegativity index.
authors.affiliation: L5 Research Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Jing-Fang
authors.initials: JF
authors.lastname: Hsu
authors.affiliation: Department of Public Health, China Medical University, Taichung, Taiwan; Department of Health Risk Management, China Medical University, Taichung, Taiwan.
authors.forename: Tzu-Chieh
authors.initials: TC
authors.lastname: Chou
authors.affiliation: Vascular and Medicinal Research, Texas Heart Institute, Houston, Texas, United States of America.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lu
authors.affiliation: Vascular and Medicinal Research, Texas Heart Institute, Houston, Texas, United States of America.
authors.forename: Shu-Hua
authors.initials: SH
authors.lastname: Chen
authors.affiliation: L5 Research Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Fang-Yu
authors.initials: FY
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Physical Medicine & Rehabilitation, Department of Orthopedic Surgery, University of California San Diego, San Diego, California, United States of America.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Chen
authors.affiliation: Biostatistics and Epidemiology, Texas Heart Institute, Houston, Texas, United States of America.
authors.forename: MacArthur
authors.initials: M
authors.lastname: Elayda
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Mount Sinai Medical Center, New York, New York, United States of America; New York Heart Research Foundation, New York, New York, United States of America.
authors.forename: Steven
authors.initials: S
authors.lastname: Shayani
authors.affiliation: L5 Research Center, China Medical University Hospital, Taichung, Taiwan; Vascular and Medicinal Research, Texas Heart Institute, Houston, Texas, United States of America; Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America; Department of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chu-Huang
authors.initials: CH
authors.lastname: Chen
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology
chemical_list: D001786:Blood Glucose; D008075:Lipoproteins, HDL; D014280:Triglycerides