Association between plasma lipids, and apolipoproteins and coronary artery disease: a cross-sectional study in a low-risk Korean population
Introduction
Coronary artery disease (CAD) is one of the most common causes of death in the world [1]. Recently, the change of food intake and lifestyle like the western population has made the prevalence of CAD in Koreans increase progressively [2].
Many studies have proven links between lipid risk factors, low- [3], [4] and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively) [5], [6], [7] in particular, and CAD. However, because a number of patients with CAD have LDL-C and HDL-C levels within normal range, the ability to identify subjects at high risk for the development of CAD based on the traditional lipid profiles such as LDL-C and HDL-C has been in doubt [8]. Especially, due to the lower level of the traditional lipid profiles in Koreans than in the series of patients from the western countries [9], the need to investigate another lipid parameters, if any, to help identify the individuals at high risk of CAD has been emphasized.
Apolipoprotein B (apo B) and apolipoprotein A-I (apo A-I) have been proposed as nontraditional lipid risk factors, but mixed results have been yielded between apolipoproteins and CAD [10], [11], [12], [13], [14], [15], [16].
Although there are numerous data in an American or European population with high lipid levels, the published data on apo B and apo A-I for CAD in an Asian population with low lipid level are rare.
Thus, the purpose of this study is to elucidate, in a relatively large number of a low-risk Korean population whether apo B, apo A-I and their ratio give additional information to the traditional lipid risk factors for identifying the individuals at high-risk for CAD.
Section snippets
Study population
A total of 956 consecutive patients, who were referred to or visited at Seoul National University Hospital for evaluation of chest pain, were recruited. Coronary angiography (CAG) was performed in all of the patients. Patients with rheumatic valvular disease, prosthetic valves, congenital heart disease, bacterial endocarditis, hypertrophic cardiomyopathy and chronic renal failure were excluded. Patients with plasma lipid levels of TC≥230 mg/dl, LDL-C≥120 mg/dl, HDL-C≤40 mg/dl and TG≥400 mg/dl
Results
There were 192 patients in CAD(−) and 352 patients in CAD(+). The clinical characteristics of 544 patients were presented in Table 1, and the levels of lipids and apolipoproteins were shown in Table 2.
Discussion
We revealed in a low-risk Korean population that plasma apo B/apo A-I ratio was associated with the presence of CAD. As well, apo B/apo A-I ratio gave additional information to that acquired by traditional lipid risk factors in this low-risk population.
Acknowledgements
This study was supported by a research grant to Dr. Hyo-Soo Kim from Korea Science and Engineering Foundation (KOSEF) through the Aging and Apoptosis Research Center at Seoul National University, Seoul, Korea.
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