Is HDL particle number a better predictor of CVD events? Looking at the 319 patients in MESA who had CVD events, we can see that the large, cholesterol-enriched HDL particles are more inversely related to risk of a first CVD event than the smaller, cholesterol-depleted HDL particles. However, when one adjusts for LDL particle concentration, those relationships change: the importance of large HDL particle concentration diminishes as the concentration of small HDL particles increases.[49]
If we then adjust for LDL particle concentration and triglycerides (which are inversely related to serum HDL cholesterol), the result is that the risk ratios associated with large, medium, and small HDL particles remain about the same. This tells us that certain HDL subclasses are interacting more in a statistical manner with LDL particles and triglycerides than others, and if we adjust for them, we find that high levels of all of the HDL subclasses are associated with a lower risk of future CVD events.
J Clin Lipidol. 2011; 5(6).[49]Mackey RH, Greenland P, Goff DC, et al. The relationship of HDL cholesterol and HDL particles to carotid atherosclerosis and incident cardiovascular events: The Multi- Ethnic Study of Atherosclerosis. Abstracts from the American Heart Association Joint Conference: Nutrition, Physical Activity and Metabolism and Metabolism and CVD Epidemiology and Prevention 2011 Scientific Sessions. 2011;331. Abstract P410.
