Key result
Small LDL and HDL particle sizes measured by NMR or GGE were associated with increased CHD risk (unadjusted OR 1.74 for NMR LDL), but this relationship was no longer significant after adjusting for confounders.
Why the study?
Does NMR spectroscopy predict coronary heart disease risk better than gradient gel electrophoresis when measuring LDL and HDL particle size in apparently healthy adults?
Case-Control (n=2,940)
Does NMR spectroscopy predict coronary heart disease risk better than gradient gel electrophoresis when measuring LDL and HDL particle size in apparently healthy adults?
Both NMR and GGE measurements of LDL and HDL particle size lose their predictive value for incident CHD after adjusting for potential confounders.
Particle sizes by NMR or GGE lose independent CHD prediction after adjustment; leaves open incremental value beyond standard risk factors.
BACKGROUND: Gradient gel electrophoresis (GGE) and nuclear magnetic resonance (NMR) spectroscopy are both widely accepted methods for measuring LDL and HDL particle size. However, whether or not GGE- or NMR-measured LDL or HDL particle size predicts coronary heart disease (CHD) risk to a similar extent is currently unknown. METHODS: We used GGE and NMR to measure LDL and HDL particle size in a nested case-control study of 1025 incident cases of CHD and 1915 controls from the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk study. The study sample included apparently healthy men and women age 45-79 years followed for an average of 6 years. RESULTS: Pearson correlation coefficients showed that the overall agreement between NMR and GGE was better for the measurement of HDL size (r = 0.78) than for LDL size (r = 0.47). The odds ratio for future CHD among participants in the bottom tertile of LDL size (smallest LDL particles) was 1.35 (95% CI, 1.12-1.63) for GGE and 1.74 (1.41-2.15) for NMR. For HDL size, these respective odds ratios were 1.41 (1.16-1.72) and 1.85 (1.47-2.32). After adjustment for potential confounders, the relationship between small LDL or HDL particles and CHD was no longer significant, irrespective of the method. CONCLUSIONS: In this prospective population study, we found that the relationships between NMR-measured LDL and HDL sizes and CHD risk were slightly higher than those obtained with GGE.
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Arsenault et al. (2010) conducted a case-control in Coronary heart disease (n=2,940). Small LDL and HDL particle size (bottom tertile) vs. Larger particle sizes was evaluated on Future coronary heart disease (OR 1.74, 95% CI 1.41-2.15). Small LDL and HDL particle sizes measured by NMR or GGE were associated with increased CHD risk (unadjusted OR 1.74 for NMR LDL), but this relationship was no longer significant after adjusting for confounders.
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