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Serum Total and High-Density Lipoprotein Phospholipid Levels in a Population-Based Study and Relationship to Risk of Metabolic Syndrome and Coronary Disease

Biology Department, Yildiz Technical University

Altan Onat, MD

Turkish Society of Cardiology, Yidiz Technical University, tkd{at}tkd.org.tr

Ibrahim Sar, MD

S. Ersek Cardiovascular Surgery Center Istanbul

Mehmet Yazc, MD

Cardiology Department of I. Baysal U. Düzce Medical Faculty Düzce

Beyhan Eryonucu, MD

Cardiology Department of Centennial U. Medical Faculty Van, Turkey

Günay Can, MD

Turkish Society of Cardiology, Yidiz Technical University, Cerrapasa Medical Faculty, Istanbul University

The aim of study was to investigate the role of serum total (TPL) and high-density lipoprotein phospholipids (HDL-pl) as a risk factor in coronary heart disease (CHD) and metabolic syndrome (MS). In a random sample, total and HDL-pl were measured in 1088 and 642 adults from Turkey, respectively, who have a high prevalence of MS; this was done with an enzymatic method that measures total phosphatidylcholine, sphingomyelin, and lysophosphatidylcholine. Serum TPL and HDL-pl levels were significantly higher in women (TPL, 2.8 mmol/L; HDL-pl, 1.21 mmol/L) than in men. Strong correlations existed between serum TPL levels and non-HDL cholesterol (HDL-C), triglycerides, apolipoprotein (apo) B, complement C3, and -glutamyltransferase. Non—HDL-C, HDL triglyceride, and apo A-I were strongly correlated with HDL-pl. Linear regression analyses revealed HDL-C, apo B, triglycerides, diabetes, and female gender as independent significant determinants of TPL levels in adults. HDL-C and impaired glucose regulation were sole significant variables, together contributing one-quarter of serum HDL-pl. Individuals with MS or diabetes had significantly higher TPL concentrations. The gender- and age-adjusted odds ratio (OR) of TPL for MS was 1.73 (95% confidence interval, 1.35-2.21), whereas the multiadjusted OR of HDL-pl per 1 SD increment corresponded to a significantly reduced independent MS likelihood by 26% in women (and 18% in the entire group). The multiadjusted OR of HDL-pl for CHD in men and women combined was 0.32 (P = .057) corresponding to a reduced CHD likelihood by 32% per 1 SD increment of HDL-pl. Plasma TPL levels point to an adverse relationship to MS, whereas their role in CHD risk needs further investigation. HDL-pls, in contrast, mark substantial protection from MS as well as from CHD.

Key Words: phospholipids • population-based study • coronary heart disease • metabolic syndrome

Angiology, Vol. 59, No. 1, 26-35 (2008)
DOI: 10.1177/0003319706291145


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