HDL-PHigh Density Lipoprotein Particle
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HDL-P and HDL size were assessed by nuclear magnetic resonance (NMR) spectroscopy, and high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-1 (apoA-1) were chemically assayed before and after patients were randomised to receive one-year therapy with either statin drug rosuvastatin (20 mg/day) or placebo.
Based on these findings, the research team concluded that HDL-P may be a better marker of residual risk than chemically measured HDL-C or apoA-1.
(20) The only lipid concentration that can serve as a surrogate of apoA-I or HDL-P is HDL-C, where the assumption is that higher HDL-C indicates higher apoA-I, and vice versa.
Neither HDLC, nor apoA-I, nor HDL-P, nor HDL size is consistently related to HDL particle functionality--i.e., the ability of HDL to lipidate or delipidate, appropriately traffic cholesterol, or perform numerous other nonlipid antiatherogenic functions.
[5] Nonstandard abbreviations: CVD, cardiovascular disease; NMR, nuclear magnetic resonance; CRP, C-reactive protein; hsCRP, high-sensitivity CRP; HDL-C, HDL-cholesterol; CATHGEN, CATHeterization GENetics: MI, myocardial infarction; CAD, coronary artery disease; PCI, percutaneous coronary intervention; CABG, coronary artery bypass grafting; HDL-P, HDL particle concentration; MS-HDL-P, medium plus small HDL-P subclasses; OR, odds ratio; HR, hazard ratio; BMI, body mass index; LDL-P, LDL particle concentration; AIC, Akaike Information Criterion; GRACE, Global Registry of Acute Coronary Events; FHS, Framingham Heart Study; NRI, net reclassification index; IDI, integrated discrimination improvement.
Mortality risk for a 62 year-old white male with hypertension, hyperlipidemia, CAD, and a BMI of 30 according to MS- HDL-P and GlycA concentrations.
Two methods have been described for quantifying HDL-P in human plasma, one on the basis of nuclear magnetic resonance (NMR) (15), and the other, ion mobility analysis (IMA) (16).
We next used reconstituted discoidal HDL (9.6 nm diameter) to determine whether calibrated IMA can accurately quantify HDL-P. These particles were selected because they resemble native HDL and contain 2 apoA-I molecules per particle (31, 33), allowing us to establish the concentration of stock solutions on the basis of protein content.
Up to now, there have been 2 primary methods for measuring HDL-P. The most widely used relies on proton nuclear magnetic resonance (NMR) (5).
Despite the success of these HDL-P measurement strategies, questions remain about their overall accuracy.
Shen's model was updated to investigate the theoretical relationship between HDL size and the HDL-C/ApoA-I ratio and to provide estimates of HDL-P. Details are provided in the online Supplemental Data.
The NMR method also provides a measure of the total HDL-P, CV <1.5% (12).