Early vascular damage in primary hypoalphalipoproteinemia☆☆☆

The relationship between hypoalphalipoproteinemia (hypoα), a metabolic disorder characterized by reduced high-density lipoprotein (HDL) cholesterol levels, and atherosclerotic disease is not completely understood. We investigated arterial functional and structural changes in 19 subjects with hypoα (HDL cholesterol ≤ 0.7 mmol/L for men and ≤ 0.8 mmol/L for women; 13 men; 47 ± 7 years) and in 21 healthy control subjects (11 men; 46 ± 13 years). Brachial-artery flow-mediated vasodilation (FMV) and intima-media thickness (IMT) of the carotid and femoral arteries were determined in all subjects. FMV was significantly lower in hypoα than in controls (5.6% ± 4.3% v 8.2% ± 2.7%; P < .05). IMT was greater in hypoα than in controls at both the internal carotid (0.83 ± 0.1 mm v 0.69 ± 0.1 mm) and superficial femoral level (0.83 ± 0.2 mm v 0.68 ± 0.1 mm; both P < .05). FMV had a positive correlation with HDL cholesterol (r = .42, P = .06) and a negative one with triglycerides (r = −0.38, P = .01). An inverse relationship was found between HDL cholesterol and internal carotid and superficial femoral IMT (r = −0.64 and r = −0.60, respectively; P < .01 for both) and a positive one between triglycerides and internal carotid and superficial femoral IMT (r = .53 and r = .47, P < .05). In a multivariate regression analysis, brachial FMV was predicted by HDL cholesterol and brachial diameter (β = .42 and −0.43, respectively; both P < .05). HDL cholesterol was the only significant predictor of internal carotid and superficial femoral IMT (β = −0.45 and −0.49, respectively; both P < .05). In conclusion, subjects with primary hypoα, without overt cardiovascular disease, are characterized by an impaired endothelial function and by an increase in large-artery IMT. Copyright 2003, Elsevier Science (USA). All rights reserved.