Background: Dyslipidemia is recognized as a contributing factor to peripheral artery disease (PAD). However, the influence of lipoprotein subfractions as compared to traditional serum lipid levels is not well-understood.
Objective: This study explores the association between lipoprotein subfractions and the occurrence of PAD in patients with coronary heart disease (CHD).
Methods: In the CORDIOPREV study, 981 patients were categorized based on PAD diagnosis, determined by an ankle-brachial index (ABI) ≤0.9. Those with ABI >0.9 and <1.4 were considered PAD-free, while patients with ABI ≥1.4 were excluded. We employed high-throughput nuclear magnetic resonance (NMR) spectroscopy to analyze the concentration and lipid content of lipoprotein subfractions.
Results: PAD patients exhibited significantly lower levels of medium high-density lipoprotein (HDL) particles and reduced concentrations of associated lipids within these subfractions except for triglycerides. A higher concentration of large or medium HDL particles correlated with a lower PAD prevalence (odds ratio [OR]: 0.61, 95% CI, 0.44-0.84; OR: 0.59, 95% CI, 0.43-0.81, respectively). In multivariate logistic regression, medium HDL particle levels inversely associated with PAD presence (OR: 0.69, 95% CI, 0.48-0.99, P = .044) after adjustment for confounding factors.
Conclusions: The presence of PAD among CHD patients inversely correlates with medium HDL particle concentrations as determined by NMR. These insights could advance our understanding of PAD pathophysiology and HDL metabolism.
Keywords: Cardiovascular risk factors; Coronary heart disease; High-density lipoprotein particles; Lipoprotein subfractions; Peripheral artery disease.
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