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Wilkens TL, Sørensen H, Jensen MK, Furtado JD, Dragsted LO, Mukamal KJ. Associations between Alcohol Consumption and HDL Subspecies Defined by ApoC3, ApoE and ApoJ: the Cardiovascular Health Study. Curr Probl Cardiol 2023; 48:101395. [PMID: 36096454 PMCID: PMC9691554 DOI: 10.1016/j.cpcardiol.2022.101395] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 01/03/2023]
Abstract
Alcohol consumption increases circulating high-density lipoprotein cholesterol (HDL-C), but HDL protein cargo may better reflect HDL function. This study examined the associations between alcohol intake and HDL subspecies containing or lacking apoC3, apoE, and apoJ in a well-phenotyped cohort. We performed a cross-sectional analysis of 2092 Cardiovascular Health Study participants aged 70 or older with HDL subspecies measured in stored specimens from 1998 to 1999. Associations between alcohol intake and apoA1 defined HDL subspecies lacking or containing apoC3, apoE, and apoJ, and circulating levels of total apoA1, apoC3, apoE, and apoJ were examined. HDL subspecies lacking and containing apoC3, apoE, and apoJ were all positively associated with alcohol intake, with ∼1% per additional drink per week or ∼7% per additional drink per day (subspecies without the apolipoproteins, P ≤ 2 × 10-9, subspecies with the apolipoproteins, P ≤ 3 × 10-5). Total apoA1 was also directly associated with alcohol consumption, with a 1% increase per additional drink per week (P = 1 × 10-14). Total apoC3 blood levels were 0.5% higher per additional drink per week (P = 0.01), but the association was driven by a few heavily drinking men. Alcohol intake was positively associated with HDL subspecies lacking and containing apoC3, apoE, or apoJ, and with total plasma apoA1. ApoC3 was directly, albeit not as robustly associated with alcohol intake. HDL protein cargo is crucial for its anti-atherosclerotic functions, but it remains to be determined whether HDL subspecies play a role in the putative association between limited alcohol intake and lower risk of coronary heart disease.
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Affiliation(s)
- Trine L. Wilkens
- Department of Nutrition, Exercise and Sports, Section for Preventive and Clinical Nutrition, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg, Denmark
| | - Helle Sørensen
- Department of Mathematical Sciences, Data Science Lab, University of Copenhagen, Universitetsparken 5, DK-2100 Copenhagen East, Denmark
| | - Majken K. Jensen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 36 Riverside Drive Berkley, MA 02779, USA*,Department of Public Health, Section of Epidemiology, University of Copenhagen, Bartholinsgade 6Q, 2. sal, 24 Øster Farimagsgade 5, Bygning: 24-2-08, DK-1356 Copenhagen K, Denmark
| | - Jeremy D. Furtado
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 36 Riverside Drive Berkley, MA 02779, USA*
| | - Lars O. Dragsted
- Department of Nutrition, Exercise and Sports, Section for Preventive and Clinical Nutrition, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg, Denmark
| | - Kenneth J. Mukamal
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 36 Riverside Drive Berkley, MA 02779, USA*,Beth Israel Deaconess Medical Center, Division of General Medicine Research Section, 1309 Beacon Street, 2nd Floor, Brookline, MA 02446Boston, MA, USA
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Sacks F, Furtado J, Jensen M. Protein-based HDL subspecies: Rationale and association with cardiovascular disease, diabetes, stroke, and dementia. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159182. [DOI: 10.1016/j.bbalip.2022.159182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/09/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022]
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Abstract
PURPOSE OF REVIEW Dietary fat compared to carbohydrate increases the plasma concentration of high-density lipoprotein (HDL)-cholesterol. However, neither the mechanism nor its connection to cardiovascular disease is known. RECENT FINDINGS Protein-based subspecies of HDL, especially those containing apolipoprotein E (apoE) or apolipoprotein C3 (apoC3), offer a glimpse of a vast metabolic system related to atherogenicity, coronary heart disease (CHD) and other diseases. ApoE stimulates several processes that define reverse cholesterol transport through HDL, specifically secretion of active HDL subspecies, cholesterol efflux to HDL from macrophages involved in atherogenesis, size enlargement of HDL with cholesterol ester, and rapid clearance from the circulation. Dietary unsaturated fat stimulates the flux of HDL that contains apoE through these protective pathways. Effective reverse cholesterol transport may lessen atherogenesis and prevent disease. In contrast, apoC3 abrogates the benefit of apoE on reverse cholesterol transport, which may account for the association of HDL that contains apoC3 with dyslipidemia, obesity and CHD. SUMMARY Dietary unsaturated fat and carbohydrate affect the metabolism of protein-defined HDL subspecies containing apoE or apoC3 accelerating or retarding reverse cholesterol transport, thus demonstrating new mechanisms that may link diet to HDL and to CHD.
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Affiliation(s)
- Frank M. Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Wilkens TL, Tranæs K, Eriksen JN, Dragsted LO. Moderate alcohol consumption and lipoprotein subfractions: a systematic review of intervention and observational studies. Nutr Rev 2021; 80:1311-1339. [PMID: 34957513 DOI: 10.1093/nutrit/nuab102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Moderate alcohol consumption is associated with decreased risk of cardiovascular disease (CVD) and improvement in cardiovascular risk markers, including lipoproteins and lipoprotein subfractions. OBJECTIVE To systematically review the relationship between moderate alcohol intake, lipoprotein subfractions, and related mechanisms. DATA SOURCES Following PRISMA, all human and ex vivo studies with an alcohol intake up to 60 g/d were included from 8 databases. DATA EXTRACTION A total of 17 478 studies were screened, and data were extracted from 37 intervention and 77 observational studies. RESULTS Alcohol intake was positively associated with all HDL subfractions. A few studies found lower levels of small LDLs, increased average LDL particle size, and nonlinear relationships to apolipoprotein B-containing lipoproteins. Cholesterol efflux capacity and paraoxonase activity were consistently increased. Several studies had unclear or high risk of bias, and heterogeneous laboratory methods restricted comparability between studies. CONCLUSIONS Up to 60 g/d alcohol can cause changes in lipoprotein subfractions and related mechanisms that could influence cardiovascular health. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. 98955.
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Affiliation(s)
- Trine L Wilkens
- Department of Nutrition, Exercise and Sports, Section for Preventive and Clinical Nutrition, University of Copenhagen, Denmark
| | - Kaare Tranæs
- Department of Nutrition, Exercise and Sports, Section for Preventive and Clinical Nutrition, University of Copenhagen, Denmark
| | - Jane N Eriksen
- Department of Nutrition, Exercise and Sports, Section for Preventive and Clinical Nutrition, University of Copenhagen, Denmark
| | - Lars O Dragsted
- Department of Nutrition, Exercise and Sports, Section for Preventive and Clinical Nutrition, University of Copenhagen, Denmark
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The Association between Breastfeeding Duration and Lipid Profile among Children and Adolescents. Nutrients 2021; 13:nu13082728. [PMID: 34444888 PMCID: PMC8401711 DOI: 10.3390/nu13082728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022] Open
Abstract
To investigate the relationship between breastfeeding duration and lipid profile among children and adolescents, a cross-sectional survey using random cluster sampling was performed, and a national sample of 12,110 Chinese children and adolescents aged 5–19 years were collected. Breastfeeding duration and sociodemographic factors were collected by questionnaires. Fasting blood samples were obtained to test the lipid profile. Linear regression and logistic regression models were employed to evaluate the association between breastfeeding duration and lipid profile. We found that prolonged breastfeeding was related with a low level of total cholesterol (TC), LDL-C, HDL-C, and TC/HDL-C in children and adolescents. With an increased duration of breastfeeding, the magnitude of the association between breastfeeding and lipid profile enlarged. The levels of TC, LDL-C, HDL-C, and TC/HDL-C in participants who were breastfed for more than 12 months decreased by 6.225 (95% CI: −8.390, −4.059), 1.956 (95% CI: −3.709, −0.204), 1.273 (95% CI: −2.106, −0.440) mg/dL, and 0.072 (95%CI: −0.129, −0.015), respectively, compared with those who were not breastfed. The corresponding risk of high TC declined by 43% (aOR: 0.570, 95% CI: 0.403, 0.808). The association was similar in both boys and girls, but only statistically significant in children and young adolescents aged 5–14 years. This suggested that prolonged breastfeeding duration was related with low lipid levels and decreased abnormal lipid risk, especially in children and young adolescents. These findings support the intervention of prompting a prolonged duration of breastfeeding to improve the childhood lipid profile.
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Yamamoto R, Jensen MK, Aroner S, Furtado JD, Rosner B, Hu FB, Balkau B, Natali A, Ferrannini E, Baldi S, Sacks FM. HDL Containing Apolipoprotein C-III is Associated with Insulin Sensitivity: A Multicenter Cohort Study. J Clin Endocrinol Metab 2021; 106:e2928-e2940. [PMID: 33839794 PMCID: PMC8277219 DOI: 10.1210/clinem/dgab234] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Indexed: 12/26/2022]
Abstract
CONTEXT High density lipoprotein (HDL) in humans is composed of a heterogeneous group of particles varying in protein composition as well as biological effects. OBJECTIVE We investigated the prospective associations between HDL subspecies containing and lacking apolipoprotein (apo) C-III at baseline and insulin sensitivity at year 3. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study of 864 healthy volunteers drawn from the relationship between insulin sensitivity and cardiovascular disease (RISC) study, a multicenter European clinical investigation, whose recruitment initiated in 2002, with a follow-up of 3 years. MAIN MEASURES Insulin sensitivity was estimated from an oral glucose tolerance test at baseline and year 3, and by euglycemic-hyperinsulinemic clamp at baseline only. The apolipoprotein concentrations were measured at baseline by a sandwich enzyme-linked immunosorbent assay (ELISA)-based method. RESULTS The 2 HDL subspecies demonstrated significantly opposite associations with insulin sensitivity at year 3 (P-heterogeneity = 0.004). The highest quintile of HDL containing apoC-III was associated with a 1.2% reduction in insulin sensitivity (P-trend = 0.02), while the highest quintile of HDL lacking apoC-III was associated with a 1.3% increase (P-trend = 0.01), compared to the lowest quintile. No significant association was observed for total HDL, and very low density lipoprotein (VLDL) and low density lipoprotein (LDL) containing apoC-III. ApoC-III contained in HDL was associated with a decrease in insulin sensitivity even more strongly than plasma total apoC-III. CONCLUSION Both HDL containing apoC-III and apoC-III in HDL adversely affect the beneficial properties of HDL on insulin response to glucose. Our results support the potential of HDL-associated apoC-III as a promising target for diabetes prevention and treatment.
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Affiliation(s)
- Rain Yamamoto
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Correspondence: R. Yamamoto, Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. E-mail:
| | - Majken K Jensen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sarah Aroner
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jeremy D Furtado
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Beverley Balkau
- INSERM 1018, CESP, Clinical Epidemiology, University Paris-Saclay, UVSQ-UPS, 94800, Villejuif, France
| | - Andrea Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Simona Baldi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Frank M Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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Santos Seckler HD, Park HM, Lloyd-Jones CM, Melani RD, Camarillo JM, Wilkins JT, Compton PD, Kelleher NL. New Interface for Faster Proteoform Analysis: Immunoprecipitation Coupled with SampleStream-Mass Spectrometry. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2021; 32:1659-1670. [PMID: 34043341 PMCID: PMC8530194 DOI: 10.1021/jasms.1c00026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Different proteoform products of the same gene can exhibit differing associations with health and disease, and their patterns of modifications may offer more precise markers of phenotypic differences between individuals. However, currently employed protein-biomarker discovery and quantification tools, such as bottom-up proteomics and ELISAs, are mostly proteoform-unaware. Moreover, the current throughput for proteoform-level analyses by liquid chromatography mass spectrometry (LCMS) for quantitative top-down proteomics is incompatible with population-level biomarker surveys requiring robust, faster proteoform analysis. To this end, we developed immunoprecipitation coupled to SampleStream mass spectrometry (IP-SampleStream-MS) as a high-throughput, automated technique for the targeted quantification of proteoforms. We applied IP-SampleStream-MS to serum samples of 25 individuals to assess the proteoform abundances of apolipoproteins A-I (ApoA-I) and C-III (ApoC-III). The results for ApoA-I were compared to those of LCMS for these individuals, with IP-SampleStream-MS showing a >7-fold higher throughput with >50% better analytical variation. Proteoform abundances measured by IP-SampleStream-MS correlated strongly to LCMS-based values (R2 = 0.6-0.9) and produced convergent proteoform-to-phenotype associations, namely, the abundance of canonical ApoA-I was associated with lower HDL-C (R = 0.5) and glycated ApoA-I with higher fasting glucose (R = 0.6). We also observed proteoform-to-phenotype associations for ApoC-III, 22 glycoproteoforms of which were characterized in this study. The abundance of ApoC-III modified by a single N-acetyl hexosamine (HexNAc) was associated with indices of obesity, such as BMI, weight, and waist circumference (R ∼ 0.7). These data show IP-SampleStream-MS to be a robust, scalable workflow for high-throughput associations of proteoforms to phenotypes.
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Affiliation(s)
- Henrique Dos Santos Seckler
- Department of Chemistry, Chemistry of Life Processes Institute and Proteomics Center of Excellence, Northwestern University, Evanston, Illinois 60208, United States
| | - Hae-Min Park
- Department of Chemical Engineering and Applied Chemistry, Chungnam National University, Daejeon 34134, South Korea
| | - Cameron M Lloyd-Jones
- Department of Chemistry, Chemistry of Life Processes Institute and Proteomics Center of Excellence, Northwestern University, Evanston, Illinois 60208, United States
| | - Rafael D Melani
- Department of Chemistry, Chemistry of Life Processes Institute and Proteomics Center of Excellence, Northwestern University, Evanston, Illinois 60208, United States
| | - Jeannie M Camarillo
- Department of Chemistry, Chemistry of Life Processes Institute and Proteomics Center of Excellence, Northwestern University, Evanston, Illinois 60208, United States
| | - John T Wilkins
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, United States
| | - Philip D Compton
- Department of Chemistry, Chemistry of Life Processes Institute and Proteomics Center of Excellence, Northwestern University, Evanston, Illinois 60208, United States
- Integrated Protein Technologies, Inc., Evanston, Illinois 60646, United States
| | - Neil L Kelleher
- Department of Chemistry, Chemistry of Life Processes Institute and Proteomics Center of Excellence, Northwestern University, Evanston, Illinois 60208, United States
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Benefits and hazards of alcohol-the J-shaped curve and public health. DRUGS AND ALCOHOL TODAY 2020. [DOI: 10.1108/dat-09-2020-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is a review of updated evidence of a J-shaped association between alcohol consumption and the risk of coronary heart disease (CHD) and all-cause mortality in relation to public health issues to create a basis for sensible individual health deliberations.
Design/methodology/approach
A review of the evidence from the first observation of a J-shaped association between a moderate alcohol intake and CHD in 1926 to recent studies of the effect of healthy lifestyles (including moderate alcohol intake) on life expectancy free of cardiovascular disease (CVD), cancer and Type 2 diabetes. An update on the biological plausibility of the J-shaped association with focus on recent findings of the association of alcohol intake and blood lipid levels.
Findings
Plausible J-shaped relations between light to moderate alcohol consumption and the risk of CHD, CVD mortality and all-cause mortality have been found in a large number of robust epidemiological studies. Among the potential mechanisms underlying the proposed protective effects are higher levels of high-density lipoprotein lacking apolipoprotein C3, reduced platelet aggregability, increased level of endothelial cell fibrinolysis, increased insulin sensitivity and decreased inflammation.
Originality/value
The existence of a J-shaped association between alcohol consumption and the risk of CHD and all-cause mortality is based on observational evidence and accordingly challenged by a degree of uncertainty leading some public health circles to state: “there is no safe level of alcohol consumption.” The authors propose that communication on the pros and cons of alcohol intake should emphasize the nadir of a J-shaped curve as a healthy range for the general population while advice regarding the consumption of alcohol should be adjusted to factor in the risks and potential benefits for each individual patient considering age, sex, family history, personal drinking history and specific medical history.
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Associations of HDL Subspecies Defined by ApoC3 with Non-Alcoholic Fatty Liver Disease: The Multi-Ethnic Study of Atherosclerosis. J Clin Med 2020; 9:jcm9113522. [PMID: 33142714 PMCID: PMC7693421 DOI: 10.3390/jcm9113522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/24/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023] Open
Abstract
Previously, we reported that inverse associations of high-density lipoprotein (HDL) with cardiovascular disease and diabetes were only observed for HDL that lacked the pro-inflammatory protein apolipoprotein C3 (apoC3). To provide further insight into the cardiometabolic properties of HDL subspecies defined by the presence or absence of apoC3, we aimed to examine these subspecies with liver fat content and non-alcoholic fatty liver disease (NAFLD). We investigated cross-sectional associations between ELISA-measured plasma levels of apoA1 in HDL that contained or lacked apoC3 and computed tomography-determined liver fat content and NAFLD (<51 HU) at baseline (2000–2002) among 5007 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) without heavy alcohol consumption (>14 drinks/week in men and >7 drinks/week in women). In multivariable-adjusted regression models, apoA1 in HDL that contained or lacked apoC3 was differentially associated with liver fat content (Pheterogeneity = 0.048). While apoA1 in HDL that lacked apoC3 was inversely associated with liver fat content (Ptrend < 0.0001), apoA1 in HDL that contained apoC3 was not statistically significantly associated with liver fat content (Ptrend = 0.57). Higher apoA1 in HDL that lacked apoC3 was related to a lower prevalence of NAFLD (OR per SD: 0.80; 95% CI: 0.72, 0.89), whereas no association was found for apoA1 in HDL that contained apoC3 (OR per SD: 0.95; 95% CI: 0.85, 1.05; Pheterogeneity = 0.09). Higher apoA1 in HDL that lacked apoC3 was associated with less liver fat content and a lower prevalence of NAFLD. This finding extends the inverse association of HDL lacking apoC3 from cardiovascular disease to NAFLD. Lack of biopsy-proven hepatic steatosis and fibrosis data requires the replication of our study in further studies.
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Sacks FM, Liang L, Furtado JD, Cai T, Davidson WS, He Z, McClelland RL, Rimm EB, Jensen MK. Protein-Defined Subspecies of HDLs (High-Density Lipoproteins) and Differential Risk of Coronary Heart Disease in 4 Prospective Studies. Arterioscler Thromb Vasc Biol 2020; 40:2714-2727. [PMID: 32907368 DOI: 10.1161/atvbaha.120.314609] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE HDL (high-density lipoprotein) contains functional proteins that define single subspecies, each comprising 1% to 12% of the total HDL. We studied the differential association with coronary heart disease (CHD) of 15 such subspecies. Approach and Results: We measured plasma apoA1 (apolipoprotein A1) concentrations of 15 protein-defined HDL subspecies in 4 US-based prospective studies. Among participants without CVD at baseline, 932 developed CHD during 10 to 25 years. They were matched 1:1 to controls who did not experience CHD. In each cohort, hazard ratios for each subspecies were computed by conditional logistic regression and combined by meta-analysis. Higher levels of HDL subspecies containing alpha-2 macroglobulin, CoC3 (complement C3), HP (haptoglobin), or PLMG (plasminogen) were associated with higher relative risk compared with the HDL counterpart lacking the defining protein (hazard ratio range, 0.96-1.11 per 1 SD increase versus 0.73-0.81, respectively; P for heterogeneity <0.05). In contrast, HDL containing apoC1 or apoE were associated with lower relative risk compared with the counterpart (hazard ratio, 0.74; P=0.002 and 0.77, P=0.001, respectively). CONCLUSIONS Several subspecies of HDL defined by single proteins that are involved in thrombosis, inflammation, immunity, and lipid metabolism are found in small fractions of total HDL and are associated with higher relative risk of CHD compared with HDL that lacks the defining protein. In contrast, HDL containing apoC1 or apoE are robustly associated with lower risk. The balance between beneficial and harmful subspecies in a person's HDL sample may determine the risk of CHD pertaining to HDL and paths to treatment.
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Affiliation(s)
- Frank M Sacks
- Department of Nutrition (F.M.S., J.F.D., M.K.J., E.B.R.), Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R., F.M.S.)
| | - Liang Liang
- Department of Biostatistics (Z.H., T.C., L.L.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jeremy D Furtado
- Department of Nutrition (F.M.S., J.F.D., M.K.J., E.B.R.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Tianxi Cai
- Department of Biostatistics (Z.H., T.C., L.L.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - W Sean Davidson
- Department of Pathology and Laboratory Medicine, University of Cincinnati, OH (W.S.D.)
| | - Zeling He
- Department of Biostatistics (Z.H., T.C., L.L.), Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Eric B Rimm
- Department of Nutrition (F.M.S., J.F.D., M.K.J., E.B.R.), Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R., F.M.S.)
| | - Majken K Jensen
- Department of Nutrition (F.M.S., J.F.D., M.K.J., E.B.R.), Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology (M.K.J., E.B.R), Harvard T.H. Chan School of Public Health, Boston, MA
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Lamprea-Montealegre JA, McClelland RL, Otvos JD, Mora S, Koch M, Jensen MK, de Boer IH. Association of High-Density Lipoprotein Particles and High-Density Lipoprotein Apolipoprotein C-III Content With Cardiovascular Disease Risk According to Kidney Function: The Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc 2019; 8:e013713. [PMID: 31818211 PMCID: PMC6951074 DOI: 10.1161/jaha.119.013713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Chronic kidney disease is associated with structural and compositional abnormalities in high‐density lipoprotein particles (HDLp). We examined associations of HDLp size, particle subfractions, and apolipoprotein C‐III content with incident cardiovascular disease (CVD) events across categories of estimated glomerular filtration rate (eGFR). Methods and Results Analyses included 6699 participants in MESA (Multi‐Ethnic Study of Atherosclerosis) with measurements of HDLp and 5723 participants with measurements of HDL apolipoprotein C‐III. Cox‐regression methods were used to evaluate associations between HDLp and apolipoproteins with CVD events. Larger HDLp size was associated with lower CVD risk in participants with lower eGFR: hazard ratio (95% CI) per SD higher mean HDL size was 1.00 (0.90–1.11) in eGFR ≥60 mL/min per 1.73 m2, 0.65 (0.48–0.86) in eGFR 45 to 59 mL/min per 1.73 m2, and 0.48 (0.25–0.93) in eGFR <45 mL/min per 1.73 m2 (P for interaction=0.05). Associations of HDLp subfractions with CVD varied significantly by eGFR (P for interaction=0.04), with significant inverse associations between higher concentrations of large HDLp and CVD events across categories of kidney function, but nonsignificant results for small HDLp. Only HDLp without apolipoprotein C‐III was associated with lower risk of CVD events, with seemingly (albeit not statistically significant) stronger associations among participants with lower eGFR (P for interaction=0.19). Conclusions HDL particles of larger size and higher concentrations of large HDL and of HDL without apolipoprotein C‐III were associated with lower CVD risk, with risk estimates seemingly stronger among participants with lower eGFR. Future larger studies are needed to corroborate these findings.
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Affiliation(s)
| | | | - James D Otvos
- Laboratory Corporation of America Holdings Morrisville NC
| | - Samia Mora
- Divisions of Cardiovascular and Preventive Medicine Center for Lipid Metabolomics Brigham and Women's Hospital and Harvard Medical School Harvard University Boston MA
| | - Manja Koch
- Harvard T.H. Chan School of Public Health Harvard University Boston MA
| | - Majken K Jensen
- Harvard T.H. Chan School of Public Health Harvard University Boston MA
| | - Ian H de Boer
- Division of Nephrology Department of Medicine Department of Epidemiology Kidney Research Institute University of Washington Seattle WA
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12
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Koch M, Fitzpatrick AL, Rapp SR, Nahin RL, Williamson JD, Lopez OL, DeKosky ST, Kuller LH, Mackey RH, Mukamal KJ, Jensen MK, Sink KM. Alcohol Consumption and Risk of Dementia and Cognitive Decline Among Older Adults With or Without Mild Cognitive Impairment. JAMA Netw Open 2019; 2:e1910319. [PMID: 31560382 PMCID: PMC6777245 DOI: 10.1001/jamanetworkopen.2019.10319] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Substantial heterogeneity and uncertainty exist in the observed associations between alcohol consumption and dementia. OBJECTIVE To assess the association between alcohol consumption and dementia and the roles of mild cognitive impairment (MCI) and apolipoprotein E ε4 (APOE E4) genotype in modifying this association. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Ginkgo Evaluation of Memory Study, conducted from 2000 to 2008 among US community-dwelling participants. This study analyzed 3021 participants aged 72 years and older who were free of dementia. Data analysis was performed from 2017 to 2018. EXPOSURES Self-reported alcohol consumption, drinking frequency, and quantity. MAIN OUTCOMES AND MEASURES Using multivariable proportional hazards regression and linear mixed models, the risk of dementia and the rate of change over time in the Modified Mini-Mental State Examination were estimated. RESULTS Among 3021 participants, the median (interquartile range) age was 78 (76-80) years; 1395 (46.2%) were female. During a median (interquartile range) follow-up of 6.0 (4.9-6.5) years, 512 cases of dementia occurred. For 7.1 to 14.0 drinks per week compared with less than 1.0 drink per week, the hazard ratios for dementia were 0.63 (95% CI, 0.38-1.06) among 2548 participants without MCI and 0.93 (95% CI, 0.47-1.84) among 473 participants with MCI. Among participants with MCI, the hazard ratio for dementia was 1.72 (95% CI, 0.87-3.40) for more than 14.0 drinks per week compared with less than 1.0 drink per week. The association of alcohol intake with dementia differed for participants with and without baseline MCI (P for interaction = .03). Among participants without MCI, daily low-quantity drinking was associated with lower dementia risk than infrequent higher-quantity drinking (hazard ratio, 0.45; 95% CI, 0.23-0.89; P = .02). Findings were consistent when stratified by sex, age, and APOE E4 genotype. Compared with drinking less than 1.0 drink per week, complete abstention (in participants without MCI) and the consumption of more than 14.0 drinks per week (in participants with MCI) were associated with lower Modified Mini-Mental State Examination scores (mean difference at follow-up compared with baseline, -0.46 point [95% CI, -0.87 to -0.04 point] and -3.51 points [95% CI, -5.75 to -1.27 points], respectively). CONCLUSIONS AND RELEVANCE In this study, complete abstention and consuming more than 14.0 drinks per week (compared with drinking <1.0 drink per week) were associated with lower cognitive scores among participants aged 72 years and older. Particular caution is needed among individuals with MCI who continue to drink alcohol.
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Affiliation(s)
- Manja Koch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Richard L Nahin
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
| | - Jeff D Williamson
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Oscar L Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Lewis H Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rachel H Mackey
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kenneth J Mukamal
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Majken K Jensen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Christopoulou E, Tsimihodimos V, Filippatos T, Elisaf M. Apolipoprotein CIII and diabetes. Is there a link? Diabetes Metab Res Rev 2019; 35:e3118. [PMID: 30557902 DOI: 10.1002/dmrr.3118] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/09/2018] [Accepted: 12/11/2018] [Indexed: 12/24/2022]
Abstract
Apolipoprotein CIII (ApoCIII), a small protein that resides on the surface of lipoprotein particles, is a key regulator of triglyceride metabolism. The inhibition of lipoprotein lipase (LPL), the increased assembly and secretion of very low-density lipoproteins (VLDL) and the decreased reuptake of triglyceride-rich lipoproteins (TRLs) by the liver are mechanisms associating elevated serum ApoCIII levels and hypertriglyceridemia. ApoCIII concentration is high in individuals with diabetes mellitus, indicating a possible positive correlation with impairment of glucose metabolism. The aim of this review (based on a Pubmed search until August 2018) is to present the possible mechanisms linking ApoCIII and deterioration of carbohydrate homeostasis. ApoCIII enhances pancreatic β-cells apoptosis via an increase of the cytoplasmic Ca2+ levels in the insulin-producing cells. In addition, overexpression of ApoCIII enhances non-alcoholic fatty liver disease and exacerbates inflammatory pathways in skeletal muscles, affecting insulin signalling and thereby inducing insulin resistance. Moreover, recent studies reveal a possible mechanism of body weight increase and glucose production through a potential ApoCIII-induced LPL inhibition in the hypothalamus. Also, the presence of ApoCIII on the surface of high-density lipoprotein particles is associated with impairment of their antiglycemic and atheroprotective properties. Modulating ApoCIII may be a potent therapeutic approach to manage hypertriglyceridemia and improve carbohydrate metabolism.
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Affiliation(s)
- Eliza Christopoulou
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Vasilios Tsimihodimos
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Theodosios Filippatos
- Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Moses Elisaf
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
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Wilkins JT, Seckler HS. HDL modification: recent developments and their relevance to atherosclerotic cardiovascular disease. Curr Opin Lipidol 2019; 30:24-29. [PMID: 30531230 PMCID: PMC6439474 DOI: 10.1097/mol.0000000000000571] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW In the last 2 years, significant advances in the understanding of HDL particle structure and the associations between particle structure, function, and atherosclerosis have been made. We will review and provide clinical and epidemiological context to these recent advances. RECENT FINDINGS Several recent studies have analyzed the associations between HDL particle size distribution, number, and particle function and specific environmental, behavioral, and pharmacologic exposures. Detailed phenotyping of HDL-associated protein complements, particularly apolipoproteins, strongly suggests structural subspecies of HDL exist with differential associations with HDL function and ASCVD risk. SUMMARY The recent data on biological and structural variation in HDL suggests the existence of relatively discrete particle species, which share a similar structure and function. We propose that the classical taxonomy that clusters HDL particles by cholesterol content is incomplete. Detailed phenotyping of HDL subspecies in clinical and epidemiological research may yield insights into new risk markers and biochemical pathways that could provide targets for atherosclerotic cardiovascular disease (ASCVD) therapy and prevention in the future.
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Affiliation(s)
- John T. Wilkins
- Department of Medicine (Cardiology), Feinberg School of Medicine, Northwestern University, Chicago
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago
- Departments of Chemistry and Molecular Biosciences and the Proteomics Center of Excellence
| | - Henrique S. Seckler
- Departments of Chemistry and Molecular Biosciences and the Proteomics Center of Excellence
- Chemistry of Life Processes Institute, Northwestern University, Evanston, Illinois, USA
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15
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Sacks FM, Jensen MK. From High-Density Lipoprotein Cholesterol to Measurements of Function: Prospects for the Development of Tests for High-Density Lipoprotein Functionality in Cardiovascular Disease. Arterioscler Thromb Vasc Biol 2018; 38:487-499. [PMID: 29371248 DOI: 10.1161/atvbaha.117.307025] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/05/2018] [Indexed: 01/13/2023]
Abstract
The evidence is strong that biological functions contained in high-density lipoproteins (HDL) are antiatherogenic. These functions may track with HDL cholesterol or apolipoprotein A1 concentration to explain the strongly inverse risk curve for cardiovascular disease. Moreover, there are harmful as well as protective HDL subspecies in regard to cardiovascular disease, which could be responsible for paradoxical responses to HDL-directed treatments. Recent metabolic studies show that apolipoprotein A1-containing HDL is secreted into the circulation as mostly spherical cholesterol ester-rich lipoproteins that span the HDL size range. Most of the flux of apolipoprotein A1 HDL into and out of the circulation occurs in these spherical cholesterol-replete particles. Discoidal cholesterol-poor HDL comprises a minority of HDL secretion. We propose that much cholesterol in reverse cholesterol transport enters and exits medium and large size HDL without changing a size category, and its flux may be estimated provisionally from holoparticle clearance of cholesterol ester-rich HDL. An accurate framework for metabolism of HDL is essential to finding steady-state biomarkers that reflect HDL function in vivo. Whereas cholesterol efflux from cells to mainly discoidal HDL, mediated by ABCA1 (ATP-binding cassette transporter ABCA1), predicts cardiovascular disease, cholesterol transfers to spherical HDL also can be measured and may be relevant to protection against atherosclerosis. We propose several investigative paths on which human HDL biology may be investigated leading to convenient biomarkers of HDL quality and function having potential not only to improve risk prediction but also to more accurately target drug treatments.
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Affiliation(s)
- Frank M Sacks
- From the Departments of Nutrition and Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Majken K Jensen
- From the Departments of Nutrition and Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, MA
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