1
|
Cardoso-Saldaña GC, Antonio-Villa NE, Martínez-Alvarado MDR, González-Salazar MDC, Posadas-Sánchez R. Low HDL-C/ApoA-I index is associated with cardiometabolic risk factors and coronary artery calcium: a sub-analysis of the genetics of atherosclerotic disease (GEA) study. BMC Endocr Disord 2024; 24:110. [PMID: 38987727 PMCID: PMC11238479 DOI: 10.1186/s12902-024-01642-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/02/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND The high-density lipoprotein cholesterol to apolipoprotein A-I index (HDL-C/ApoA-I) may be practical and useful in clinical practice as a marker of atherosclerosis. This study aimed to investigate the association between the HDL-C/ApoA-I index with cardiometabolic risk factors and subclinical atherosclerosis. METHODS In this cross-sectional sub-analysis of the GEA study, 1,363 individuals, women (51.3%) and men (48.7%) between 20 and 75 years old, without coronary heart disease or diabetes mellitus were included. We defined an adverse cardiometabolic profile as excess adipose tissue metrics, non-alcoholic liver fat measured by non-contrasted tomography, metabolic syndrome, dyslipidemias, and insulin resistance. The population was stratified by quartiles of the HDL-C/Apo-AI index, and its dose-relationship associations were analysed using Tobit regression, binomial, and multinomial logistic regression analysis. RESULTS Body mass index, visceral and pericardial fat, metabolic syndrome, fatty liver, high blood pressure, and CAC were inversely associated with the HDL-C/ApoA-I index. The CAC > 0 prevalence was higher in quartile 1 (29.2%) than in the last quartile (22%) of HDL-C/ApoA-I index (p = 0.035). The probability of having CAC > 0 was higher when the HDL-C/ApoA-I index was less than 0.28 (p < 0.001). This association was independent of classical coronary risk factors, visceral and pericardial fat measurements. CONCLUSION The HDL-C/ApoA-I index is inversely associated with an adverse cardiometabolic profile and CAC score, making it a potentially useful and practical biomarker of coronary atherosclerosis. Overall, these findings suggest that the HDL-C/ApoA-I index could be useful for evaluating the probability of having higher cardiometabolic risk factors and subclinical atherosclerosis in adults without CAD.
Collapse
Affiliation(s)
- Guillermo Celestino Cardoso-Saldaña
- Department of Endocrinology, National Institute of Cardiology Ignacio Chávez, Juan Badiano No. 1, Col Sección XVI, CP 14080, Tlalpan, México City, Mexico.
| | - Neftali Eduardo Antonio-Villa
- Department of Endocrinology, National Institute of Cardiology Ignacio Chávez, Juan Badiano No. 1, Col Sección XVI, CP 14080, Tlalpan, México City, Mexico
| | - María Del Rocío Martínez-Alvarado
- Department of Endocrinology, National Institute of Cardiology Ignacio Chávez, Juan Badiano No. 1, Col Sección XVI, CP 14080, Tlalpan, México City, Mexico
| | - María Del Carmen González-Salazar
- Department of Endocrinology, National Institute of Cardiology Ignacio Chávez, Juan Badiano No. 1, Col Sección XVI, CP 14080, Tlalpan, México City, Mexico
| | - Rosalinda Posadas-Sánchez
- Department of Endocrinology, National Institute of Cardiology Ignacio Chávez, Juan Badiano No. 1, Col Sección XVI, CP 14080, Tlalpan, México City, Mexico
| |
Collapse
|
2
|
Li L, Cai G, Lu W, Li F, Yu L, Xiao J. The ratio of HDL-C to apoA-I interacts with free triiodothyronine to modulate coronary artery disease risk. BMC Cardiovasc Disord 2021; 21:504. [PMID: 34666674 PMCID: PMC8524928 DOI: 10.1186/s12872-021-02316-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE In the present work, research was carried out to explore the correlation between the high-density lipoprotein cholesterol (HDL-C)/apolipoprotein A-I (apoA-I) ratio and serum free triiodothyronine (FT3) and their interaction on the risk of coronary artery disease (CAD). METHODS A total of 1686 patients who underwent selective coronary angiography were enrolled in the present study, including 1279 patients with CAD and 407 controls. The subjects were divided into three groups according to tertiles of the HDL-C/apoA-I ratio. Binary logistic regression analysis was used to evaluate the interaction of the HDL-C/apoA-I ratio and FT3 level with the risk of CAD. RESULTS The group with the highest HDL-C/apoA-I ratio had the lowest levels of FT3. Multiple linear regression analysis showed that the HDL-C/apoA-I ratio was negatively associated with FT3 after adjusting for age, sex, body mass index (BMI), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), FT4 and TSH. A logistic regression model showed that a high HDL-C/apoA-I ratio (> 0.89 mmol/g) and high FT3 levels (> 4.5 pmol/l) were protective factors for CAD. Patients with a lower HDL-C/apoA-I ratio (≤ 0.89 mmol/g) and lower FT3 level (≤ 4.5 pmol/l) had an increased risk of CAD (OR = 2.441, P = 0.000, S = 1.13, AP = 0.068, AP* = 0.116, RERI = 0.168). CONCLUSIONS The HDL-C/apoA-I ratio was negatively associated with FT3, and there was a significant interaction between the HDL-C/apoA-I ratio and FT3 with the risk of CAD.
Collapse
Affiliation(s)
- Li Li
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China.
| | - Gaojun Cai
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China.
| | - Wei Lu
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Feng Li
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Lei Yu
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Jianqiang Xiao
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
| |
Collapse
|
3
|
Gebhard C, Rhainds D, He G, Rodés-Cabau J, Lavi S, Spence JD, Title L, Kouz S, L'Allier PL, Grégoire J, Ibrahim R, Cossette M, Guertin MC, Beanlands R, Rhéaume E, Tardif JC. Elevated level of lecithin:cholesterol acyltransferase (LCAT) is associated with reduced coronary atheroma burden. Atherosclerosis 2018; 276:131-139. [DOI: 10.1016/j.atherosclerosis.2018.07.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/10/2018] [Accepted: 07/18/2018] [Indexed: 01/08/2023]
|
4
|
Relation of high-density lipoprotein cholesterol:apolipoprotein a-I ratio to progression of coronary atherosclerosis in statin-treated patients. Am J Cardiol 2014; 114:681-5. [PMID: 25030535 DOI: 10.1016/j.amjcard.2014.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 06/08/2014] [Accepted: 06/08/2014] [Indexed: 12/29/2022]
Abstract
High-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apoA-I) levels are inversely associated with adverse cardiovascular outcomes. Associations between these HDL-C-related measurements and coronary plaque progression have not been studied. We performed a retrospective analysis of 2,566 statin-treated patients with angiographic coronary artery disease who underwent serial evaluation of atheroma burden with intravascular ultrasound. Relations between achieved levels of HDL-related measurements with clinical characteristics and changes in plaque burden were determined. A strong correlation between HDL-C and apoA-I (r = 0.80, p <0.001) was observed. HDL-C, apoA-I, and the HDL-C:apoA-I ratio demonstrated negative correlations with the change in percent atheroma volume and total atheroma volume (all p ≤0.001). Increasing levels of achieved HDL-C:apoA-I (p = 0.04), but not HDL-C (p = 0.18) or apoA-I (p = 0.67), were associated with less progression of percent atheroma volume. Similar results were seen for change in total atheroma volume, with less progression seen with increased HDL-C:apoA-I (p = 0.002) but not with increases in HDL-C (p = 0.09) or apoA-I (p = 0.19). In conclusion, increasing levels of HDL-C:apoA-I associated with less progression of coronary atherosclerosis. This suggests that interventions increasing the cholesterol content of HDL particles may be of cardiovascular benefit.
Collapse
|
5
|
Li XL, Li JJ, Guo YL, Zhu CG, Qing P, Wu NQ, Xu B, Gao RL. The ratio of high-density lipoprotein cholesterol to apolipoprotein A-I predicts myocardial injury following elective percutaneous coronary intervention. Clin Cardiol 2014; 37:558-65. [PMID: 25113039 DOI: 10.1002/clc.22308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/21/2014] [Accepted: 05/27/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND High-density lipoprotein (HDL) has cardioprotective properties. Each HDL particle has a few molecules of apolipoprotein A-I (apoA-I) and carries various amounts of cholesterol. The ratio of high-density lipoprotein cholesterol (HDL-C) to apoA-I may reflect mean HDL particle size. HYPOTHESIS HDL-C/apoA-I ratio may provide more information than HDL-C and apoA-I in predicting myocardial injury following elective percutaneous coronary intervention (PCI). METHODS We prospectively enrolled 2529 consecutive patients who underwent elective PCI and assessed the relationships of preprocedural HDL-C, apoA-I, and their ratio with peak cardiac troponin I (cTnI) within 24 hours after PCI. RESULTS Neither HDL-C nor apoA-I levels showed significant association with postprocedural cTnI elevation, whereas HDL-C/apoA-I ratio was associated with postprocedural cTnI elevation above 3 up to 30 × upper limit of normal (ULN), with the lowest risk in the middle quintile (all P values for quadratic term were <0.05). Adjusted odds ratios (95% confidence interval) of postprocedural cTnI >3 × ULN for quintile 1 to 5 of HDL-C/apoA-I ratio were: 1 (reference), 0.81 (0.62-1.07), 0.57 (0.43-0.75), 0.65 (0.49-0.85), and 0.76 (0.58-1.01), respectively, and the adjusted odds ratios of postprocedural cTnI >30 × ULN for quintile 1 to 5 of HDL-C/apoA-I ratio were: 1 (reference), 0.81 (0.49-1.361), 0.42 (0.23-0.77), 0.66 (0.38-1.14), and 0.82 (0.49-1.38), respectively. CONCLUSIONS There was a U-shaped association between HDL-C/apoA-I ratio and myocardial injury following PCI.
Collapse
Affiliation(s)
- Xiao-Lin Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Mazer NA, Giulianini F, Paynter NP, Jordan P, Mora S. A comparison of the theoretical relationship between HDL size and the ratio of HDL cholesterol to apolipoprotein A-I with experimental results from the Women's Health Study. Clin Chem 2013; 59:949-58. [PMID: 23426429 DOI: 10.1373/clinchem.2012.196949] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND HDL size and composition vary among individuals and may be associated with cardiovascular disease and diabetes. We investigated the theoretical relationship between HDL size and composition using an updated version of the spherical model of lipoprotein structure proposed by Shen et al. (Proc Natl Acad Sci U S A 1977;74:837-41.) and compared its predictions with experimental data from the Women's Health Study (WHS). METHODS The Shen model was updated to predict the relationship between HDL diameter and the ratio of HDL-cholesterol (HDL-C) to apolipoprotein A-I (ApoA-I) plasma concentrations (HDL-C/ApoA-I ratio). In the WHS (n = 26 772), nuclear magnetic resonance spectroscopy (NMR) was used to measure the mean HDL diameter (d(mean,NMR)) and particle concentration (HDL-P); HDL-C and ApoA-I (mg/dL) were measured by standardized assays. RESULTS The updated Shen model predicts a quasilinear increase of HDL diameter with the HDL-C/ApoA-I ratio, consistent with the d(mean,NMR) values from WHS, which ranged between 8.0 and 10.8 nm and correlated positively with the HDL-C/ApoA-I ratio (r = 0.608, P < 2.2 × 10(-16)). The WHS data were further described by a linear regression equation: d(WHS) = 4.66 nm + 12.31(HDL-C/Apo-I), where d(WHS) is expressed in nanometers. The validity of this equation for estimating HDL size was assessed with data from cholesteryl ester transfer protein deficiency and pharmacologic inhibition. We also illustrate how HDL-P can be estimated from the HDL size and ApoA-I concentration. CONCLUSIONS This study provides a large-scale experimental examination of the updated Shen model. The results offer new insights into HDL structure, composition and remodeling and suggest that the HDL-C/ApoA-I ratio might be a readily available biomarker for estimating HDL size and HDL-P.
Collapse
Affiliation(s)
- Norman A Mazer
- Clinical Pharmacology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | | | | | | |
Collapse
|
7
|
Effects of lecithin: Cholesterol acyltransferase genotypes, enzyme levels, and activity on high-density lipoprotein levels. J Clin Lipidol 2011; 5:152-158. [DOI: 10.1016/j.jacl.2011.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 02/15/2011] [Accepted: 02/22/2011] [Indexed: 11/21/2022]
|
8
|
Holleboom A, Kuivenhoven J, Vergeer M, Hovingh G, van Miert J, Wareham N, Kastelein J, Khaw KT, Boekholdt S. Plasma levels of lecithin:cholesterol acyltransferase and risk offuture coronary artery disease in apparently healthy men and women: aprospective case-control analysis nested in the EPIC-Norfolk populationstudy. J Lipid Res 2010; 51:416-21. [DOI: 10.1194/p900038-jlr200] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
|
9
|
Amar MJA, Shamburek RD, Vaisman B, Knapper CL, Foger B, Hoyt RF, Santamarina-Fojo S, Brewer HB, Remaley AT. Adenoviral expression of human lecithin-cholesterol acyltransferase in nonhuman primates leads to an antiatherogenic lipoprotein phenotype by increasing high-density lipoprotein and lowering low-density lipoprotein. Metabolism 2009; 58:568-75. [PMID: 19303980 PMCID: PMC3703629 DOI: 10.1016/j.metabol.2008.11.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Accepted: 11/26/2008] [Indexed: 01/30/2023]
Abstract
Lecithin-cholesterol acyltransferase (LCAT), a key enzyme in high-density lipoprotein (HDL) metabolism, has been proposed to have atheroprotective properties by promoting reverse cholesterol transport. Overexpression of LCAT in various animal models, however, has led to conflicting results on its overall effect on lipoproteins and atherosclerosis. In this study, the effect of overexpression of LCAT in nonhuman primates on lipoprotein metabolism is examined. Human LCAT was expressed with adenovirus in squirrel monkeys (n = 8), resulting on day 4 in a 22-fold increase of LCAT activity (257 +/- 23 vs 5618 +/- 799 nmol mL(-1) h(-1), P < .0001). At its peak, LCAT was found to nearly double the level of HDL cholesterol from baseline (113 +/- 7 vs 260 +/- 24 mg/dL, P < .01). High-density lipoprotein formed after treatment with the adenovirus was larger in size, as assessed by fast protein liquid chromatography (FPLC) analysis. By kinetic studies, it was determined that there was a decrease in apolipoprotein (Apo) A-I resident time (0.373 +/- 0.027 vs 0.685 +/- 0.045 d(-1), P < .0001) and almost a doubling in the ApoA-I synthetic rate (22 +/- 2 vs 41 +/- 3 mg kg(-1) d(-1), P < .0001), but no overall change in ApoA-I levels. In addition, increased expression of LCAT was associated with a 37% reduction of ApoB levels (12 +/- 1 vs 19 +/- 1 mg/dL, P < .05) due to increased low-density lipoprotein catabolism (fractional catabolic rate = 1.7 +/- 0.1 d(-1) in controls vs 4.2 +/- 0.3 d(-1) in LCAT-treated group, P < .05). In summary, overexpression of LCAT in nonhuman primates leads to an antiatherogenic lipoprotein profile by increasing HDL cholesterol and lowering ApoB, thus making LCAT a potential drug target for reducing atherosclerosis.
Collapse
Affiliation(s)
- Marcelo J A Amar
- Lipoprotein Metabolism Section, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Dullaart RPF, Perton F, Sluiter WJ, de Vries R, van Tol A. Plasma lecithin: cholesterol acyltransferase activity is elevated in metabolic syndrome and is an independent marker of increased carotid artery intima media thickness. J Clin Endocrinol Metab 2008; 93:4860-6. [PMID: 18782872 DOI: 10.1210/jc.2008-1213] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
CONTEXT Lecithin:cholesterol acyltransferase (LCAT), which esterifies free cholesterol to cholesteryl esters, is required for normal plasma lipoprotein structure and is instrumental in high density lipoprotein (HDL) remodeling, but the relationship of variation in plasma LCAT activity with subclinical atherosclerosis is unclear. OBJECTIVES The aim of the study was to determine the effect of the metabolic syndrome (MetS) on plasma LCAT activity and its relationship with carotid artery intima media thickness (IMT). SETTING The study was conducted at the vascular laboratory of a university medical center. METHODS In 74 subjects with MetS and 90 subjects without MetS (National Cholesterol Education Program Adult Treatment Panel III criteria), mean carotid artery IMT, plasma lipids, LCAT activity (exogenous substrate method), high-sensitive C-reactive protein, and homeostasis model assessment insulin resistance (HOMA(ir)) were documented. RESULTS IMT was greater (P = 0.01) and plasma LCAT activity was higher (P < 0.001) in subjects with MetS compared to subjects without MetS. Similar increases in IMT and LCAT were found in MetS subjects without type 2 diabetes mellitus. Multiple linear regression analysis demonstrated that plasma LCAT activity was independently and positively related to HOMA(ir), plasma triglycerides, non-HDL cholesterol, and HDL cholesterol (all P < 0.001). After adjustment for age and sex, IMT was positively associated with LCAT activity (P < 0.01), independently of the presence of MetS (or alternatively of plasma lipids), HOMA(ir), and high-sensitive C-reactive protein. CONCLUSIONS Plasma LCAT activity is elevated in MetS and may be a marker of subclinical atherosclerosis. Our findings do not support the contention that strategies to elevate LCAT are necessarily beneficial for cardioprotection.
Collapse
Affiliation(s)
- Robin P F Dullaart
- Department of Endocrinology, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
| | | | | | | | | |
Collapse
|
11
|
Zhang K, Zhang S, Zheng K, Hou Y, Liao L, He Y, Zhang L, Nebert DW, Shi J, Su Z, Xiao C. Novel P143L polymorphism of the LCAT gene is associated with dyslipidemia in Chinese patients who have coronary atherosclerotic heart disease. Biochem Biophys Res Commun 2004; 318:4-10. [PMID: 15110745 DOI: 10.1016/j.bbrc.2004.03.177] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2003] [Indexed: 02/05/2023]
Abstract
Coronary atherosclerotic heart disease (CAD) is a multifactorial disorder resulting from numerous gene-gene and gene-environment interactions. Lecithin:cholesterol acyltransferase (LCAT), a key enzyme in reverse cholesterol transport and the metabolism of high-density lipoprotein (HDL), is thought to be a candidate gene related to dyslipidemia and CAD. Variations in the LCAT gene were investigated in 190 CAD patients and 209 age- and gender-matched controls by denaturing high-performance liquid chromatography, and confirmed by sequencing and RFLP assay. In CAD patients, a novel single-nucleotide polymorphism (P143L) in exon 4 of the LCAT gene was discovered in nine males and two females (frequency of 5.79%), which was found in none of 209 controls. The genotype and allele distribution of P143L is significantly (P<0.04 ) higher in the low HDL-C subgroup than in the normal HDL-C subgroup in both male patients and all CAD patients. P143L was also found to be significantly (P<0.01) associated with the low HDL-C phenotype in both male patients and all CAD patients, with odds-ratios of 7.003 (95% CI 2.243-21.859) and 5.754 (95% CI 1.893-13.785), respectively. Thus, the P143L polymorphism may play a role in causing decreased HDL-C levels, leading to increased risk of dyslipidemia and CAD in Chinese.
Collapse
Affiliation(s)
- Kelan Zhang
- Department of Medical Genetics, West China Hospital, Sichuan University, Chengdu 610041, China.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Santamarina-Fojo S, Lambert G, Hoeg JM, Brewer HB. Lecithin-cholesterol acyltransferase: role in lipoprotein metabolism, reverse cholesterol transport and atherosclerosis. Curr Opin Lipidol 2000; 11:267-75. [PMID: 10882342 DOI: 10.1097/00041433-200006000-00007] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the past several years significant advances have been made in our understanding of lecithin-cholesterol acyltransferase (LCAT) function. LCAT beneficially alters the plasma concentrations of apolipoprotein B-containing lipoproteins, as well as HDL. In addition, its proposed role in facilitating reverse cholesterol transport and modulating atherosclerosis has been demonstrated in vivo. Analysis of LCAT transgenic animals has established the importance of evaluating HDL function, as well as HDL plasma levels, to predict atherogenic risk.
Collapse
Affiliation(s)
- S Santamarina-Fojo
- Molecular Disease Branch, National Heart, Lung, and Blood Institute, National Institute of Health, Bethesda, Maryland, USA.
| | | | | | | |
Collapse
|
13
|
Murakami T, Michelagnoli S, Longhi R, Gianfranceschi G, Pazzucconi F, Calabresi L, Sirtori CR, Franceschini G. Triglycerides are major determinants of cholesterol esterification/transfer and HDL remodeling in human plasma. Arterioscler Thromb Vasc Biol 1995; 15:1819-28. [PMID: 7583561 DOI: 10.1161/01.atv.15.11.1819] [Citation(s) in RCA: 130] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Lecithin:cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) are responsible for the esterification of cell-derived cholesterol and for the transfer of newly synthesized cholesteryl esters (CE) from HDL to apoB-containing lipoproteins in human plasma. LCAT and CETP are also crucial factors in HDL remodeling, a process by which HDL particles with a high capacity for cell cholesterol uptake are generated in plasma. In the present study, cholesterol esterification and transfer were evaluated in 60 patients with isolated hypercholesterolemia (HC, n = 20) and isolated (HTG, n = 20) or mixed hypertriglyceridemia (MHTG, n = 20) and in 20 normolipidemic healthy individuals (NL). Cholesterol esterification rate (CER) and net CE transfer rate (CETR) were measured in whole plasma. LCAT and CETP concentrations were determined by specific immunoassays. HDL remodeling was analyzed by monitoring changes in HDL particle size distribution during incubation of whole plasma at 37 degrees C. Mean CER and CETR were 48% and 73% higher, respectively, in hypertriglyceridemic (HTG + MHTG) versus normotriglyceridemic individuals. HDL remodeling was also significantly accelerated in plasma from hypertriglyceridemic patients. Strong positive correlations were found in the total sample between plasma and VLDL triglyceride levels and CER (r = .722 and r = .642, respectively), CETR (r = .510 and r = .491, respectively), and HDL remodeling (r = .625 and r = .620, respectively). No differences in plasma LCAT and CETP concentrations were found among the various groups except for a tendency toward higher CETP levels in hypercholesterolemic patients (+51% in MHTG and +20% in HC) versus control subjects (NL). By stepwise regression analysis, VLDL triglyceride level was the sole significant predictor of CER and CETR and contributed significantly together with baseline HDL particle distribution to HDL remodeling. These results indicate that plasma triglyceride level is a major factor in the regulation of cholesterol esterification/transfer and HDL remodeling in human plasma, whereas LCAT/CETP concentrations play a minor role in the modulation of reverse cholesterol transport.
Collapse
Affiliation(s)
- T Murakami
- Center E. Grossi Paoletti, Institute of Pharmacological Sciences, University of Milano, Italy
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Ohta T, Saku K, Takata K, Nakamura R, Ikeda Y, Matsuda I. Different effects of subclasses of HDL containing apoA-I but not apoA-II (LpA-I) on cholesterol esterification in plasma and net cholesterol efflux from foam cells. Arterioscler Thromb Vasc Biol 1995; 15:956-62. [PMID: 7600128 DOI: 10.1161/01.atv.15.7.956] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We investigated the effects of subclasses of plasma LpA-I (HDL containing apoA-I but not apoA-II) on cholesterol esterification in plasma and net cholesterol efflux from foam cells. LpA-I was composed of particles of three diameters: large (11.1 nm; Lg-LpA-I), medium (8.8 nm; Md-LpA-I), and small (7.7 nm; Sm-LpA-I). Plasma concentrations of LpA-I were positively correlated only with the level of Lg-LpA-I. Plasma concentrations of Lg-LpA-I were inversely correlated with the rate of cholesterol esterification in plasma and VLDL- and LDL-depleted plasma. Plasma concentrations of Md-LpA-I and Sm-LpA-I did not correlate with the rate of cholesterol esterification in plasma or VLDL- and LDL-depleted plasma. When macrophage foam cells were incubated with Md- and Sm-LpA-I, cellular cholesterol mass was reduced by approximately 70%. In contrast, the cellular cholesterol-reducing capacity of Lg-LpA-I was negligible. Lg-LpA-I inhibited net cholesterol removal from foam cells that was mediated by Md- and Sm-LpA-I and cholesteryl ester production with these particles. These results suggest that Md- and Sm-LpA-I may actively participate in cellular cholesterol removal and cholesterol esterification in plasma and HDL, while Lg-LpA-I may regulate these functions of Md- and Sm-LpA-I.
Collapse
Affiliation(s)
- T Ohta
- Department of Pediatrics, Kumamoto University School of Medicine, Japan
| | | | | | | | | | | |
Collapse
|
15
|
Abstract
Reverse cholesterol transport identifies a series of metabolic events resulting in the transport of excess cholesterol from peripheral tissues to the liver. High-density lipoproteins (HDL) are the vehicle of cholesterol in this reverse transport, a function believed to explain the inverse correlation between plasma HDL levels and atherosclerosis. An attempt to stimulate, by the use of drugs, this transport process may hold promise in the prevention and treatment of arterial disease. Among the agents affecting lipoprotein metabolism, only probucol exerts significant effects on reverse cholesterol transport, by stimulating the activity of the cholesteryl ester transfer protein and, consequently, altering HDL subfraction composition/distribution. Another approach to the stimulation of reverse cholesterol transport consists of raising plasma HDL levels; studies in animals, either by exogenous supplementation or by endogenous overexpression, have shown a consistent benefit in terms of atherosclerosis regression and/or non-progression. Thus, it is time to consider different future treatments of atherosclerosis, combining the classical lipid-lowering treatments with innovative methods to promote cholesterol removal from the arterial wall.
Collapse
|
16
|
Kammerer CM, Hixson JE, Mott GE. A DNA polymorphism for lecithin:cholesterol acyltransferase (LCAT) is associated with high density lipoprotein cholesterol concentrations in baboons. Atherosclerosis 1993; 98:153-63. [PMID: 8457258 DOI: 10.1016/0021-9150(93)90125-e] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We investigated the effects of a polymorphic PvuII site in the gene for lecithin:cholesterol acyltransferase (LCAT) on serum high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apo A-I) concentrations in a population of 750 pedigreed baboons. We also tested for genotype by diet interactions using data on HDL-C and apo A-I concentrations on two diets (chow and high-cholesterol, saturated fat). A significant (P < 0.001) association between the LCAT genotypes and HDL-C levels was observed. On both diets, animals homozygous for the less common allele had HDL-C levels that averaged 18-19% lower than animals homozygous for the more common allele. HDL-C levels of the heterozygotes were intermediate. The LCAT RFLP accounted for approximately 5% of the variation in HDL-C levels on the two diets. We observed no strong evidence for an LCAT genotype by diet interaction effect.
Collapse
Affiliation(s)
- C M Kammerer
- Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX 78228
| | | | | |
Collapse
|
17
|
Rainwater DL, Blangero J, Hixson JE, Birnbaum S, Mott GE, VandeBerg JL. A DNA polymorphism for LCAT is associated with altered LCAT activity and high density lipoprotein size distributions in baboons. ACTA ACUST UNITED AC 1992; 12:682-90. [PMID: 1350465 DOI: 10.1161/01.atv.12.6.682] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A polymorphic Pvu II site was mapped to intron 5 of LCAT, the gene encoding baboon lecithin: cholesterol acyltransferase (LCAT). In a study of 83 baboons, heterozygous baboons (Pv1/Pv2) had significantly higher LCAT enzyme activity levels than did baboons homozygous for the more common allele (Pv1/Pv1). LCAT genotype explained 6% of the total variation in LCAT enzyme activity. To test for allelic effects on cholesterol metabolism, we compared serum concentrations of high density lipoprotein (HDL) cholesterol and apolipoprotein A-I (apo A-I). We also compared distributions of cholesterol and apo A-I among three HDL size classes (HDL1, HDL2, and HDL3). All measurements were obtained for each baboon after long-term feeding of a basal diet low in cholesterol and fat and again after 7 weeks on an atherogenic diet. Heterozygous baboons had significantly lower serum levels of total cholesterol than did homozygotes. In addition, we detected significant effects of LCAT genotype on size distributions of HDL cholesterol and apo A-I on both diets but did not detect any genotype-by-diet interaction. Heterozygotes had increased amounts of cholesterol and apo A-I in HDL3 particles and lower amounts of cholesterol and apo A-I in the larger HDL size classes by comparison with homozygotes. Overall, the LCAT polymorphism explained a significant proportion of total variation in cholesterol (4-10%) and apo A-I (13%) distributions on both diets. Thus, the results indicate that the LCAT polymorphism is associated with significant differences in LCAT enzyme activity and with alterations in HDL compositions.
Collapse
Affiliation(s)
- D L Rainwater
- Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX 78228-0147
| | | | | | | | | | | |
Collapse
|
18
|
Desager JP, Horsmans Y, Harvengt C. Lecithin: cholesterol acyltransferase activity in familial hypercholesterolemia treated with simvastatin and simvastatin plus low-dose colestipol. J Clin Pharmacol 1991; 31:537-42. [PMID: 1880219 DOI: 10.1002/j.1552-4604.1991.tb03734.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In 19 patients with heterozygous familial hypercholesterolemia (FH), the effects of simvastatin (S) 20 mg/d, 40 mg/d, and 40 mg/d plus low-dose colestipol (10 g/d) on plasma lipids, plasma lipoproteins, and plasma lecithin: cholesterol acyltransferase (LCAT) activity were investigated after an original dose-range escalation/descalation design. The drug regimen was changed every 8 weeks. A significant reduction in total cholesterol and LDL-cholesterol was observed, reaching 39% and 54% for the drug combination (week 28), and total apoprotein B and LDL-apoprotein B were reduced by 39% and 50%, respectively. Triglycerides were significantly lowered by S alone (up to 29% with 40 mg/d). HDL-cholesterol increased during therapy but the cholesterol content in HDL2-HDL3 fractions (isolated by ultracentrifugation) did not change significantly during the different steps. The ratio LDL-C/HDL-C fell by 57% at week 28. Plasma LCAT activity expressed as FER was significantly enhanced by S alone (+33%), and a further increase on drug combination regimen (+58%) was observed. This effect could be considered as a consequence of the increased fractional clearance of LDL-C. It tended to be sustained during the descalation part of the study. Biochemical adverse effects were scarce and transient. In conclusion, the combination therapy increased the plasma LCAT/FER activity without a preferential enhancement in HDL2-C concentration. This original design allowed to define the most appropriate individual cholesterol-lowering drug dosage in FH patients.
Collapse
Affiliation(s)
- J P Desager
- Laboratoire de Pharmacothérapie, Université Catholique de Louvain, Brussels, Belgium
| | | | | |
Collapse
|
19
|
Leszczynski DE, Schafer RM. Metabolic conversion of six steroid hormones by human plasma high-density lipoprotein. BIOCHIMICA ET BIOPHYSICA ACTA 1991; 1083:18-28. [PMID: 2031935 DOI: 10.1016/0005-2760(91)90120-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sixteen different steroid hormones were individually tested in equilibrium dialysis against plasma high-density, low-density and very-low-density lipoproteins (HDL, LDL, VLDL) under physiological conditions. Six steroid hormones (androstenediol (AEDOL), estradiol (E2), dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), pregnenolone (P5), and progesterone (P4)) demonstrated metabolic interaction with HDL, particularly HDL3. In four cases (AEDOL-HDL, E2-HDL, DHEA-HDL and P5-HDL) the interaction products were more lipophilic, while in the other two cases (DHT-HDL, P4-HDL) they were hydrophilic compared to the original steroid hormone substrates. The lipophilic products appeared to be long-chain fatty acid steroid hormone esters at the C-3 position of the steroid hormone. This was confirmed, in preparative incubations, for the two strongest steroid hormone reactants (DHEA and P5) by gas chromatography-mass spectroscopy (GC-MS). Naturally occurring DHEA and P5 esters were identified in normal fresh human plasma by GC-MS, and their fatty acid compositions were similar to that of native HDL3 cholesterol esters. It was deduced that lecithin-cholesterol acyl transferase enzyme was responsible for the lipophilic type conversion activity with P5 greater than DHEA greater than AEDOL greater than E2. For DHT and P4, which exhibit a fundamentally different (hydrophilic) type of metabolic conversion, a totally different form of HDL-associated metabolic activity is indicated. These newly discovered steroid hormone-lipoprotein interactions may be important for steroid hormone processing in plasma and/or steroid hormone delivery to cells.
Collapse
|
20
|
Frey I, Baumstark MW, Berg A, Keul J. Influence of acute maximal exercise on lecithin:cholesterol acyltransferase activity in healthy adults of differing aerobic performance. EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY AND OCCUPATIONAL PHYSIOLOGY 1991; 62:31-5. [PMID: 2007393 DOI: 10.1007/bf00635630] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To document the possible influence of a single episode of maximal aerobic stress on the serum lecithin:cholesterol acyltransferase (LCAT) activity in subjects with differing histories of training, two groups of healthy male adults [controls (C), n = 18, 28.6 years, SD 5.2, 50.1 ml.kg-1.min-1 maximal O2 uptake (VO2max), SD 5.3; endurance trained athletes (T), n = 18, 31.4 years, SD 8.8, 65.0 ml.kg-1.min-1 VO2max, SD 2.8] were examined in a maximal aerobic stress test. In addition to the routine assessment of lipid status, LCAT activity was measured immediately before and after exercise. At rest nearly identical LCAT activity values were found in both groups: C 64.4 nmol.ml-1.h-1, SD 16.7 vs T 65.0 nmol.ml-1.h-1, SD 20.9. The post-exercise LCAT values induced by the maximal stress test increased significantly to (C) 95.7 nmol.ml-1.h-1, SD 23.5, +48.6%, P less than 0.001; (T) 83.5 nmol.ml-1.h-1, SD 24.3, +29.1%, P less than 0.01. Neither the pre nor the postexercise individual LCAT activity values showed any significant correlation to the corresponding data on physical performance.
Collapse
Affiliation(s)
- I Frey
- Department of Physical Performance Medicine, University of Freiburg, Federal Republic of Germany
| | | | | | | |
Collapse
|
21
|
Miller NE. Raising high density lipoprotein cholesterol. The biochemical pharmacology of reverse cholesterol transport. Biochem Pharmacol 1990; 40:403-10. [PMID: 2200405 DOI: 10.1016/0006-2952(90)90536-t] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- N E Miller
- Department of Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27103
| |
Collapse
|
22
|
Franceschini G, Baio M, Calabresi L, Sirtori CR, Cheung MC. Apolipoprotein AIMilano. Partial lecithin:cholesterol acyltransferase deficiency due to low levels of a functional enzyme. BIOCHIMICA ET BIOPHYSICA ACTA 1990; 1043:1-6. [PMID: 2106917 DOI: 10.1016/0005-2760(90)90102-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The cholesterol esterification process was analyzed in 19 carriers of the apolipoprotein AIMilano (AIM) variant and in 19 age-sex matched controls by measuring lecithin:cholesterol acyltransferase (LCAT) mass, activity (i.e., cholesterol esterification with a standard proteoliposome substrate) and cholesterol esterification rate (i.e., cholesterol esterification in the presence of the endogenous substrate). The AIM subjects had lower LCAT mass (3.30 +/- 0.85 micrograms/ml), activity (71.1 +/- 36.4 nmol/ml per h) and cholesterol esterification rate (23.6 +/- 12.5 nmol/ml per h) compared to controls (5.22 +/- 0.74 micrograms/ml, 121.6 +/- 54.6 nmol/ml per h and 53.6 +/- 29.9 nmol/ml per h, respectively). The specific LCAT activity, i.e., LCAT activity per microgram of LCAT, was similar in the two groups, indicating that the LCAT protein in the AIM carriers is structurally and functionally normal. However, the specific cholesterol esterification rate was 23% lower in the AIM subjects (8.03 +/- 6.01 nmol/h per microgram) compared to controls (10.49 +/- 5.86 nmol/h per microgram; P less than 0.05). The capacity of HDL3, purified from both AIM and control plasma, to act as substrates for cholesterol esterification was similar, thus suggesting that other mechanism(s) may be in play. Carriers with a relative abundance of abnormal, small HDL3b particles had the most altered cholesterol esterification pattern. Upon evaluating all AIM subjects, a complex relationship between HDL structure, plasma lipid-lipoprotein levels and cholesterol esterification emerged, making the AIMilano condition a unique model for the study of the mechanisms regulating the cholesterol esterification-transfer process in man.
Collapse
Affiliation(s)
- G Franceschini
- Center E. Grossi Paoletti, Institute of Pharmacological Sciences, University of Milan, Italy
| | | | | | | | | |
Collapse
|
23
|
Bard JM, Parra HJ, Douste-Blazy P, Fruchart JC. Effect of pravastatin, an HMG CoA reductase inhibitor, and cholestyramine, a bile acid sequestrant, on lipoprotein particles defined by their apolipoprotein composition. Metabolism 1990; 39:269-73. [PMID: 2106607 DOI: 10.1016/0026-0495(90)90046-f] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study compares the effects of cholestyramine (16 g/d) and pravastatin (40 mg/d) on lipoprotein particles defined by their apolipoprotein composition (Lp A-I, Lp A-II:A-I, Lp E:B, and Lp C-III:B). Analysis was performed after 4, 8, and 12 weeks of therapy. Low-density lipoprotein (LDL) cholesterol decreased by 25.1% to 35.0% with cholestyramine and 26.2% to 30.7% with pravastatin, while triglycerides decreased slightly with pravastatin therapy and increased slightly during cholestyramine administration. The fall in cholesterol was mainly due to a decrease in very-low-density lipoprotein (VLDL) and LDL cholesterol; high-density lipoprotein (HDL) cholesterol increased. Apolipoprotein B was reduced dramatically (by 21.7% to 30.5% with cholestyramine and 27.7% to 37.4% with pravastatin). No significant effect on apolipoproteins C-III and E was observed with cholestyramine, while pravastatin reduced these parameters slightly. Apolipoprotein A-I increased during therapy with both drugs, while apolipoprotein A-II was slightly decreased. Although the drugs had nearly the same effects on plasma lipids, their influence on lipoprotein particles defined by their apolipoprotein composition was substantially different. Lp A-II:A-I was increased by both drugs (+8.1% to +41.2% for cholestyramine and +7.2% to +32.6% for pravastatin). Lp A-I was also increased with both drugs, but cholestyramine had a more constant and pronounced effect than pravastatin (+15.1% to +21.7% for cholestyramine and +1.7% to +13.0% for pravastatin). Lp E:B and Lp C-III:B were consistently decreased by pravastatin (-10.2% to -36.5% for LP E:B and -7.2% to -20.9% for Lp C-III:B), while cholestyramine had variable effects on these particles.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
24
|
Tissue-Specific Expression, Developmental Regulation, and Chromosomal Mapping of the Lecithin: Cholesterol Acyltransferase Gene. J Biol Chem 1989. [DOI: 10.1016/s0021-9258(20)88222-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|