Abstract 1689: HDL Size and HDL Particle Concentration Independently Predict Coronary Artery Disease Risk in Apparently Healthy Individuals. The EPIC-Norfolk Prospective Population Study
High-density lipoprotein (HDL) cholesterol levels are inversely related with risk of coronary heart disease (CHD). Since HDL particles are heterogeneous in size and composition, they may be differentially associated with other cardiovascular risk factors and cardiovascular risk per se. To study the independent relationships of HDL size and HDL particle concentration (HDL-P) with risk of future CHD. Prospective case-control study. Norfolk, United Kingdom. Cases were 822 apparently healthy men and women who developed CHD during follow-up. Controls were 1401 participants who remained free of CHD, and were matched to cases by sex, age and enrollment time. First CHD events leading to either hospitalization or death. NMR spectroscopy-measured HDL-P (p < 0.001), NMR-measured HDL size (p = 0.002) as well as gradient gel electrophoresis (GGE)-measured HDL size (p = 0.005) were lower in cases compared to controls. HDL size and HDL-P were only weakly correlated (for NMR-measured r = 0.09, for GGE-measured r = 0.11). HDL size was strongly associated with risk factors characteristic of the metabolic syndrome, including waist-hip ratio, triglycerides, and apolipoprotein B, whereas HDL-P was not. HDL size and HDL-P were independently associated with CHD risk. The association between HDL size and CHD risk was abolished upon adjustment for apolipoprotein B and triglycerides, whereas HDL-P remained independently associated with CHD risk. HDL size and HDL-P were independently associated with other cardiovascular risk factors and with the risk of developing CHD. The relationship between HDL size was completely explained by markers associated with the metabolic syndrome, indicating that part of the relationship between HDL cholesterol and CHD risk is merely a reflection of this constellation of metabolic risk.