Diabetes alters the association between high-density lipoprotein subfractions and carotid intima-media thickness: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Giuliano Generoso, Isabela M. Bensenor, Itamar S. Santos, Raul D. Santos, Alessandra C. Goulart, Steven R. Jones, Krishnaji R. Kulkarni, Michael J. Blaha, Peter P. Toth, Paulo A. Lotufo, Marcio Sommer Bittencourt

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: High-density lipoprotein cholesterol comprises a group of heterogeneous subfractions that might have differential effects on atherosclerosis. Moreover, prior investigations suggest that the presence of diabetes (T2D) modifies the impact of some subfractions on atherosclerosis. In this study, we aimed to evaluate the association between high-density lipoprotein cholesterol subfractions and carotid intima-media thickness in the baseline assessment of the Brazilian Longitudinal Study of Adult Health participants from the São Paulo investigation centre. Methods: We evaluated 3930 individuals between 35 and 74 years without previous cardiovascular disease not using lipid-lowering drugs. High-density lipoprotein cholesterol subfractions (HDL 2 -C and HDL 3 -C) were measured by vertical ultracentrifugation (vertical auto profile). The relationship between each high-density lipoprotein cholesterol subfraction and carotid intima-media thickness was analysed by multiple linear regression models. Results: Total high-density lipoprotein cholesterol, as well as HDL 2 -C and HDL 3 -C, was negatively associated with carotid intima-media thickness after adjustment for demographic data (all p < 0.001) and traditional risk factors (all p < 0.05). When stratified by T2D status, the HDL 2 -C/HDL 3 -C ratio showed a negative association with carotid intima-media thickness in participants with T2D (p = 0.032), even after fully controlling for confounding variables, including total high-density lipoprotein cholesterol. Conclusion: HDL 2 -C, HDL 3 -C and HDL 2 /HDL 3 -C ratio are inversely associated with carotid intima-media thickness after adjustment for traditional risk factors. Association of the HDL 2 -C/HDL 3 -C ratio is modified by the presence of diabetes, being more pronounced in diabetic individuals.

Original languageEnglish (US)
Pages (from-to)541-547
Number of pages7
JournalDiabetes and Vascular Disease Research
Volume15
Issue number6
DOIs
StatePublished - Nov 1 2018

Keywords

  • Cholesterol/metabolism
  • HDL -C
  • HDL -C
  • HDL -C/HDL -C ratio
  • atherosclerosis
  • diabetes
  • high-density lipoprotein
  • high-density lipoprotein/metabolism
  • vertical auto profile
  • zonal ultracentrifugation

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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