High-density lipoprotein antioxidant function is associated with lipid profiles and lipid-lowering therapy

Dyslipidemia is an important risk factor for coronary artery disease (CAD). However, the relationship between high-density lipoprotein (HDL) antioxidant function and plasma lipid profile has not been fully investigated. Lipid-lowering therapy is recommended in patients with CAD. The relationship between HDL antioxidant function and lipid-lowering therapy remains unclear. This study aimed to analyze the association between HDL antioxidant function, lipid profiles, and lipid-lowering therapy in patients with CAD. To investigate this, we recruited 1,000 patients with CAD and 200 healthy subjects. HDL lipid peroxide content was measured and normalized by HDL cholesterol (HDL-C) levels to represent HDL antioxidant function (nHDLox). nHDLox levels were compared across different CAD severities. The association between nHDLox and lipid profiles was also analyzed. The difference in nHDLox between patients who received lipid-lowering therapy and those who did not was analyzed. A correlation analysis was performed to investigate the association between nHDLox and fasting blood glucose and inflammatory markers. Results demonstrated that nHDLox levels were elevated in patients with CAD compared to healthy subjects, and were also higher in patients with acute coronary syndrome and CAD combined with three-vessel disease. Receiver operating characteristic curve analysis showed that nHDLox was better than triglyceride-glucose index and HDL-C levels in predicting CAD. nHDLox positively correlated with total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels. Further analysis showed an approximately "L"-shaped relationship between nHDLox and HDL-C levels. Moreover, among CAD patients with LDL-C < 3.0 mmol/L, nHDLox was significantly reduced in the lipid-lowering therapy group compared to that in the group without lipid-lowering therapy. Furthermore, nHDLox positively correlated with fasting blood glucose levels and inflammatory markers. In conclusion, HDL antioxidant function is associated with lipid profiles. Lipid-lowering therapy improves HDL antioxidant function in patients with CAD, and nHDLox may serve as an indicator for the efficacy of such treatment.