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Comparative Study
. 2018 Apr;72(2):103-107.
doi: 10.5455/medarh.2018.72.103-107.

The Ratio of Unesterified/esterified Cholesterol is the Major Determinant of Atherogenicity of Lipoprotein Fractions

Babak Bagheri  1 , Asal Alikhani  2 , Hossein Mokhtari  2 , Mehdi Rasouli  2
Affiliations
Comparative Study

The Ratio of Unesterified/esterified Cholesterol is the Major Determinant of Atherogenicity of Lipoprotein Fractions

Babak Bagheri et al. Med Arch. 2018 Apr.

Abstract

Background: The hypothesis is proposed that the atherogenicity of lipoporotein fractions is correlated with the content of unesterified cholesterol.

Objectives: To evaluate the role and prognostic values of unesterified and esterified cholesterol in lipoprotein fractions for coronary artery disease (CAD).

Design and methods: The study population consisted of 400 patients who were divided to CAD controls and cases according to the data of coronary angiography. Fractional cholesterol esterification (FCE) as well as the complete profile of lipids and (apo)lipoproteins were determined.

Results: Total cholesterol was increased significantly in CAD patients (196.3 ± 52.3 mg/dL vs. 185.7 ± 48.0, p≤ 0.049) and the increment occurred totally in unesterified portion (77.2 ± 28.4 mg/dL vs. 71.1 ± 24.4, p≤ 0.031). HDL cholesterol showed a significant decrease in CAD group (39.9 ± 9.5 mg/dL vs. 44.6 ± 10.5, p≤ 0.001), but the decrement occurred wholly in the esterified portion (26.2 ± 9.2 mg/dL vs. 31.1 ± 8.1, p≤ 0.001). NonHDL cholesterol was increased significantly in CAD group (156.8 ± 48.3 mg/dL vs. 140.3 ± 43.6, p≤ 0.001), and the changes occurred in both un- and esterified portions. FCE in HDL was diminished significantly in CAD patients (64.8 ± 13.9% vs. 69.3 ± 7.9, p≤ 0.01). In multivariate logistic regression analysis, unesterified cholesterol in NonHDL (UeNonHDLc) and esterified cholesterol in HDL (EsHDLc) excluded total cholesterol and HDLc respectively from the regression equation. In ROC analysis, the ratio of UeNonHDLc/EsHDLc was the strongest predictor for CAD among cholesterol subfractions.

Conclusions: The results confirm that UeNonHDLc is atherogenic and EsHDLc is antiatherogenic and are independent risk factors for CAD.

Keywords: CAD; Cholesterol; Esterification; LDL; Lipoproteins; Unesterified.

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Figures

Figure 1.
Figure 1.. The changes of fractional cholesterol esterification (FCE) in CAD. FCE was calculated as the ratio of esterified- per total- cholesterol in each fraction of lipoproteins. The study population was divided into two groups according to have CAD. The number of subjects in each group was 150 and 250 respectively. * Indicates p<0.01
Figure 2.
Figure 2.. ROC analysis for the ratio of UeNonLDLc/EsHDLc. The AUC was 0.654 ± 0.028, p<0.001
See this image and copyright information in PMC

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