title: High-density lipoprotein subfractions and carotid plaque: the Northern Manhattan Study.
abstract: OBJECTIVE
  The objective of this cross-sectional analysis was to investigate the relation between two major high-density lipoprotein cholesterol (HDL-C) subfractions (HDL2-C and HDL3-C) and carotid plaque in a population based cohort.
  
  
  METHODS
  We evaluated 988 stroke-free participants (mean age 66 ± 8 years; 40% men; 66% Hispanic and 34% Non-Hispanic) with available data on HDL subfractions using precipitation method and carotid plaque area and thickness assessed by a high-resolution 2D ultrasound. The associations between HDL-C subfractions and plaque measurements were analyzed by quantile regression.
  
  
  RESULTS
  Plaque was present in 56% of the study population. Among those with plaque, the mean ± SD plaque area was 19.40 ± 20.46 mm² and thickness 2.30 ± 4.45 mm. The mean ± SD total HDL-C was 46 ± 14 mg/dl, HDL2-C 14 ± 8 mg/dl, and HDL3-C 32 ± 8 mg/dl. After adjusting for demographics and vascular risk factors, there was an inverse association between HDL3-C and plaque area (per mg/dl: beta = -0.26 at the 75th percentile, p = 0.001 and beta = -0.32 at the 90th percentile, p = 0.02). A positive association was observed between HDL2-C and plaque thickness (per mg/dl; beta = 0.02 at the 90% percentile, p = 0.003). HDL-C was associated with plaque area (per mg/dl: beta = -0.18 at the 90th percentile, p = 0.01), but only among Hispanics.
  
  
  CONCLUSIONS
  In our cohort we observed an inverse association between HDL3-C and plaque area and a positive association between HDL2-C and plaque thickness. HDL-C subfractions may have different contributions to the risk of vascular disease. More studies are needed to fully elucidate HDL-C anti-atherosclerotic functions in order to improve HDL-based treatments in prevention of vascular disease and stroke.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: etiozzo@med.miami.edu.
authors.forename: Eduard
authors.initials: E
authors.lastname: Tiozzo
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: hgardener@med.miami.edu.
authors.forename: Hannah
authors.initials: H
authors.lastname: Gardener
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, University of Miami, Miami, FL, USA. Electronic address: bhudson@med.miami.edu.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Hudson
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: cdong@med.miami.edu.
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Dong
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy; IRCCS San Raffaele Pisana, Rome, Italy. Electronic address: ddellamorte@stroke.med.miami.edu.
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.affiliation: Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden. Electronic address: milita.crisby@ki.se.
authors.forename: Milita
authors.initials: M
authors.lastname: Crisby
authors.affiliation: Diabetes Research Institute and Lipid Disorder Clinic, University of Miami, Miami, FL, USA.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Goldberg
authors.affiliation: Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA. Electronic address: mse13@cumc.columbia.edu.
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA. Electronic address: yc632@columbia.edu.
authors.forename: Ying Kuen
authors.initials: YK
authors.lastname: Cheung
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: cwright@med.miami.edu.
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: rsacco@med.miami.edu.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: trundek@med.miami.edu.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000208:ethnology; D002339:Carotid Arteries / Q000473:pathology*; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D053439:Lipoproteins, HDL2 / Q000097:blood*; D053440:Lipoproteins, HDL3 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009518:New York; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000208:ethnology; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D053439:Lipoproteins, HDL2; D053440:Lipoproteins, HDL3
keywords: Carotid plaque; High-density lipoprotein; High-density lipoprotein subfractions