TY - JOUR
T1 - Diabetes alters the association between high-density lipoprotein subfractions and carotid intima-media thickness
T2 - The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
AU - Generoso, Giuliano
AU - Bensenor, Isabela M.
AU - Santos, Itamar S.
AU - Santos, Raul D.
AU - Goulart, Alessandra C.
AU - Jones, Steven R.
AU - Kulkarni, Krishnaji R.
AU - Blaha, Michael J.
AU - Toth, Peter P.
AU - Lotufo, Paulo A.
AU - Bittencourt, Marcio Sommer
N1 - Funding Information:
The ELSA-Brasil baseline study was supported by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Financiadora de Estudos e Projetos and CNPq National Research Council; Grant Nos 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP and 01 06 0071.00 RJ).
Publisher Copyright:
© The Author(s) 2018.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - 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.
AB - 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.
KW - Cholesterol/metabolism
KW - HDL -C
KW - HDL -C
KW - HDL -C/HDL -C ratio
KW - atherosclerosis
KW - diabetes
KW - high-density lipoprotein
KW - high-density lipoprotein/metabolism
KW - vertical auto profile
KW - zonal ultracentrifugation
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U2 - 10.1177/1479164118788080
DO - 10.1177/1479164118788080
M3 - Article
C2 - 30024274
AN - SCOPUS:85050311542
SN - 1479-1641
VL - 15
SP - 541
EP - 547
JO - Diabetes and Vascular Disease Research
JF - Diabetes and Vascular Disease Research
IS - 6
ER -