(Circulation. 2001;104:2295.)
© 2001 American Heart Association, Inc.
Clinical Investigations and Reports |
From the Department of Food Sciences and Nutrition, Laval University, and the Lipid Research Center (A.C.S.-P., I.L.R., J.-P.D., B.L.), CHUL Research Center; the Quebec Heart Institute (B.C., G.R.D., J.-P.D.), Laval Hospital; and the Department of Social and Preventive Medicine (P.-M.B.), Laval University, Québec, Canada.
Reprint requests to Benoît Lamarche, PhD, CHUL Research Center, 2705 Laurier Blvd, Ste-Foy, Québec, G1V 4G2, Canada. E-mail benoit.lamarche{at}crchul.ulaval.ca
Background Several cross-sectional studies and 3 prospective, nested, case-control studies have indicated that individuals with small, dense low density lipoprotein (LDL) particles are at increased risk for ischemic heart disease (IHD). However, whether LDL particle size is an independent risk factor for future IHD events remains controversial. The objective of the present study was to further analyze the cardiovascular risk associated with various electrophoretic characteristics of LDL particles in men.
Methods and Results LDL particles were characterized by polyacrylamide gradient gel electrophoresis (PAGGE) in a cohort of 2034 men of the Quebec Cardiovascular Study. All men were initially free of IHD and were followed up for a period of 5 years, during which 108 first IHD events were recorded. Among all LDL characteristics investigated by PAGGE, including LDL peak particle size, the cholesterol concentration in LDL particles with a diameter smaller than 255 Å showed the strongest association with the risk of IHD (relative risk=4.6 in men in the third vs first tertile of the distribution, P<0.001). Multivariate logistic and survival models indicated that the relationship between LDL cholesterol levels in particles with a diameter <255 Å and IHD risk was independent of all nonlipid risk factors and of LDL cholesterol, high density lipoprotein cholesterol, triglyceride, and lipoprotein(a) levels.
Conclusions Results from this large, population-based, prospective study suggest that further characterization of LDL particles by PAGGE, in addition to the traditional lipid profile, may improve our ability to predict IHD events in men.
Key Words: lipids epidemiology lipoproteins ischemia heart diseases nutrition
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