Published Online
on November 24, 2003

A more recent version of this article appeared on December 2, 2003

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Submitted on July 1, 2003
Revised on September 11, 2003
Accepted on September 12, 2003

Inflammatory/Antiinflammatory Properties of High-Density Lipoprotein Distinguish Patients From Control Subjects Better Than High-Density Lipoprotein Cholesterol Levels and Are Favorably Affected by Simvastatin Treatment

Benjamin J. Ansell MD, Mohamad Navab PhD^*, Susan Hama BSc, Naeimeh Kamranpour MSc, Gregg Fonarow MD, Greg Hough MSc, Shirin Rahmani MD, Rachel Mottahedeh BSc, Ravi Dave MD, Srinivasa T. Reddy PhD, and Alan M. Fogelman MD

From the Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, Calif.

^* To whom correspondence should be addressed. E-mail: mnavab{at}mednet.ucla.edu.

Background--The inflammatory/antiinflammatory properties of HDL were compared with HDL cholesterol in 2 groups of patients and in age- and sex-matched control subjects.

Methods and Results--Group 1 consisted of 26 patients not yet taking a statin who presented with coronary heart disease (CHD) or CHD equivalents by National Cholesterol Education Program Adult Treatment Panel III criteria studied before and 6 weeks after 40 mg/d of simvastatin. Group 2 consisted of 20 patients with documented CHD and HDL cholesterol 84 mg/dL. The inflammatory/antiinflammatory properties of HDL were determined by the ability of the subject’s HDL to alter LDL-induced monocyte chemotactic activity (MCA) in a human artery wall coculture. Induction of MCA by a control LDL was determined in the absence or presence of the subject’s HDL. Values in the absence of HDL were normalized to 1.0. Values >1.0 after the addition of HDL indicated proinflammatory HDL; values <1.0 indicated antiinflammatory HDL. Group 1 values before simvastatin were LDL cholesterol, 118±24 mg/dL; HDL cholesterol, 57±13 mg/dL; triglycerides, 125±64 mg/dL; and high-sensitivity C-reactive protein (hs-CRP), 1.7±1.9 mg/L; and MCA values were 1.38±0.91, compared with 0.38±0.14 for control subjects (P=1.5x10^-5). After simvastatin, values were LDL cholesterol, 73±24 mg/dL; HDL cholesterol, 61±14 mg/dL; triglycerides, 99±52 mg/dL; and hs-CRP, 1.3±1.3 mg/L; and MCA values were 1.08±0.71. In group 2, values were LDL cholesterol, 108±34 mg/dL; HDL cholesterol, 95±14 mg/dL; triglycerides, 89±44 mg/dL; and hs-CRP, 0.8±0.7 mg/L; and MCA values were 1.28±0.29, compared with 0.35±0.11 for control subjects (P=1.7x10^-14). Similar results were obtained with the cell-free assay.

Conclusions--The inflammatory/antiinflammatory properties of HDL distinguished patients from control subjects better than HDL cholesterol and were improved with simvastatin.

Key words: lipoproteins • cholesterol • inflammation • statins

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