Extremely elevated HDL-cholesterol levels are not associated with increased carotid intima-media thickness: data from ELSA Brasil

Author(s)

Laurinavicius, Antonio G. ; Santos, Itamar S. ; Santos, Raul D. ; Bensenor, Isabela M. ; Conceicao, Raquel D. ; Lotufo, Paulo A.

• Document type: Journal article
• Source: JOURNAL OF CLINICAL LIPIDOLOGY; v. 10, n. 4, p. 898-904, AUG 2016.
• Web of Science Citations: 2

Abstract

BACKGROUND: There is evidence that extremely elevated high-density lipoprotein cholesterol (EDL-c), that is, hyperalphalipoproteinemia (HALP) may indicate dysfunctional HDL, conferring increased cardiovascular risk. OBJECTIVE: We studied carotid intima-media thickness (cIMT) a marker of subclinical vascular disease according to HDL-c distribution. METHODS: cIMT was studied in subjects with ``normal{''} HDL-c levels (HDL-c 40-50 mg/dL for men; 50-60 mg/dL for women, mean 49.6 +/- 5.7 mg/dL, n = 3226); in those with HALP (HDL-c mg/dL for both sexes, mean 101.2 +/- 10 mg/dL, n = 264) and according to HDL-c quintile distribution (n = 9779). Multiple linear regression was used to test the association of HDL-c and cIMT. RESULTS: Subjects with HALP were older (54.5 +/- 9.6 vs 51.1 +/- 8.8 years, P < .001); more frequently females (86.4% vs 49%, P < .001); and presented a lower burden of risk factors: hypertension (24.6% vs 32.7%, P = .009), diabetes (10.2% vs 20.4%, P < .001), and obesity (18.6% vs 37.6%, P < .001). A similar profile was seen with higher HDL-c quintiles in the whole study population. When compared to normal HDL-c values, HALP was associated with lower maximal cIMT (0.779 +/- 0.189 mm vs 0.818 +/- 0.200 mm, P = .002), and there was a lower prevalence of individuals with cIMT >= 75th percentile for age and gender or high cIMT (17.5% vs 26.2%, P = .003). After multivariate analysis, no association was seen between HALP and increasing cIMT values, indeed the 5th HDL-c quintile was associated with lower risk of high cIMT (OR = 0.80; 95% CI = 0.68-0.95). CONCLUSION: HALP is associated with lower cIMT and does not indicate a pro-atherogenic phenotype. (C) 2016 National Lipid Association. All rights reserved. (AU)

• FAPESP's process: 10/20212-4 - Evaluation of subclinical atherosclerosis in individuals with markedly elevated HDL-cholesterol levels
• Grantee: Raul Dias dos Santos Filho
• Support Opportunities: Regular Research Grants