title: Subfractions of High-Density Lipoprotein-Cholesterol and Carotid Intima-Media Thickness: The Northern Manhattan Study.
abstract: Recent drug trials have challenged the high-density lipoprotein-cholesterol (HDL-C) antiatherosclerotic hypothesis, suggesting that total level of HDL-C may not be the best target for intervention. HDL-C subfractions may be better markers of vascular risk than total levels of HDL-C. The objective of this cross-sectional study was to investigate the relationship between HDL2-C and HDL3-C fractions and carotid intima-media thickness (cIMT) in the population-based Northern Manhattan Study.
  
  
  
  We evaluated 988 stroke-free participants (mean age, 66±8 years; 60% women; 66% Hispanic, and 34% non-Hispanic) with available data on HDL-C subfractions using precipitation method and cIMT assessed by a high-resolution carotid ultrasound. The associations between HDL-C subfractions and cIMT were analyzed by multiple linear regression models.
  
  
  
  The mean HDL2-C was 14±8 mg/dL, HDL3-C 32±8 mg/dL, and the mean total HDL-C was 46±14 mg/dL. The mean cIMT was 0.90±0.08 mm. After controlling for demographics and vascular risk factors, HDL2-C and total HDL-C were inversely associated with cIMT (per 2 SDs, β=-0.017, P=0.001 and β=-0.012, P=0.03, respectively). The same inverse association was more pronounced among those with diabetes mellitus (per 2SDs, HDL2-C: β=-0.043, P=0.003 and HDL-C: β=-0.029, P=0.02). HDL3-C was not associated with cIMT.
  
  
  
  HDL2-C had greater effect on cIMT than HDL3-C in this large urban population. The effect of HDL2-C was especially pronounced among individuals with diabetes mellitus. More research is needed to determine antiatherosclerotic effects of HDL-C subfractions and their clinical relevance.
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.). etiozzo@miami.edu.
authors.forename: Eduard
authors.initials: E
authors.lastname: Tiozzo
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Hannah
authors.initials: H
authors.lastname: Gardener
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Barry I
authors.initials: BI
authors.lastname: Hudson
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Dong
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Milita
authors.initials: M
authors.lastname: Crisby
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Goldberg
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Ying Kuen
authors.initials: YK
authors.lastname: Cheung
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Moise
authors.initials: M
authors.lastname: Desvarieux
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, Miller School of Medicine (E.T.), Department of Neurology, Miller School of Medicine (E.T., H.G., C.D., D.D.-M., C.B.W., R.L.S., T.R.), Division of Endocrinology, Diabetes and Metabolism (B.I.H.), Diabetes Research Institute and Lipid Disorder Clinic (R.B.G.), and Department of Public Health Sciences (R.L.S.), University of Miami, FL; Department of System Medicine, University of Rome Tor Vergata, Rome, Italy (D.D.-M.); Biomarker Discovery and Advanced Technologies (BioDAT), IRCCS San Raffaele Pisana, Rome, Italy (D.D.-M.); Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden (M.C.); Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY (M.S.V.E.); Department of Biostatistics (Y.K.C.) and Department of Epidemiology (M.D.), Mailman School of Public Health, Columbia University, New York, NY; and Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Paris, France (M.D.).
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D014463:Ultrasonography; D014505:Urban Population
chemical_list: D008076:Cholesterol, HDL; D008075:Lipoproteins, HDL
keywords: atherosclerosis; carotid intima-media thickness; cholesterol, HDL; diabetes mellitus; stroke