Quantity and function of high density lipoprotein as an indicator of coronary atherosclerosis

Objectives To examine the association between the fractional esterification rate of cholesterol (C) in low density lipoprotein- and very low density lipoprotein-depleted plasm (FERHDL) and coronary artery disease (CAD) and the influence of serum HDL-C levels. Background The function of HDL in reverse cholesterol transport is involved in the antiatherogenic action of HDL, and FERHDL is newly established quantitative measure of HDL function in vivo. Methods Cases (n = 185, F/M: 43/142) and controls (n = 74, F/M:27/47) were defined as subjects with/without angiographically proven CAD, respectively. Results The cases had significantly (p < 0.05) higher FERHDL values (13.2 ± 0.3 %/h vs. 12.1 ± 0.5 %/h) and lower HDL-C levels (39.0 ± 1.0 mg/dL vs. 46.8 ± 1.4 mg/dL) than the controls. The associations of FERHDL and HDL-C with CAD were linear and significant (p < 0.05). Multiple logistic regression analysis indicated that the association of FERHDL with CAD varied with the HDL-C level: significant for the low HDL-C tertile (chi-square = 6.20, p < 0.05) but not significant for the middle and high HDL-C tertiles (chi-square = 0.08 and 0.03, n.s.). The risk of CAD, relative to that in patients with low FERHDL and high HDL-C, was higher in patients with low FERHDL and low HDL-C (odds ratio [95% confidence interval]: 2.37 [1.12–4.97], p < 0.05) and was highest in patients with high FERHDL and low HDL-C (3.85 [1.84–8.06], p < 0.01). Conclusions The functional assay of HDL (FERHDL) is an independent risk factor for CAD. The combination of FERHDL and HDL-C could be potent indicator for CAD, and may reflect potential mechanism of atherosclerosis.