Circulation, Vol 90, 769-774, Copyright © 1994 by American Heart Association
PM Sweetnam, CH Bolton, JW Yarnell, D Bainton, IA Baker, PC Elwood and NE Miller
BACKGROUND: The relative importance of HDL2 and HDL3 cholesterol as risk
factors for ischemic heart disease (IHD) is still uncertain. Their
associations with the incidence of IHD in the Caerphilly and Speedwell
prospective studies are described. METHODS AND RESULTS: The two studies
have a common core protocol and are based on a total of 4860 middle- aged
men from the general population. The first follow-up was at a nearly
constant interval of 5.1 years in Caerphilly and 3.2 years in Speedwell:
251 major IHD events had occurred. Lipid levels were measured on fasting
samples. Different laboratories were used by the two studies. Each
laboratory used ultracentrifugation to separate HDL2 and HDL3. Both
subfractions were inversely associated with risk of IHD. Standardized
relative odds of developing major IHD were 0.95 (95% confidence interval
[CI], 0.80 to 1.14) for HDL2 cholesterol and 0.83 (95% CI, 0.68 to 1.00)
for HDL3 cholesterol in Caerphilly and 0.76 (95% CI, 0.57 to 1.01) for HDL2
and 0.64 (95% CI, 0.49 to 0.83) for HDL3 in Speedwell. The association with
incident IHD appeared to be stronger for HDL3 in both areas. No linear
combination of the two subfractions was a better predictor of IHD than
total HDL cholesterol alone. CONCLUSIONS: In British men, both HDL2 and
HDL3 cholesterol are inversely associated with the incidence of IHD.
However, the prediction of the risk of IHD from total HDL cholesterol alone
could not be improved upon by measurement of the two HDL subfractions. The
relative value of the two HDL subfractions as predictors of risk is still
unresolved. The uncertainty may be due, at least in part, to problems
associated with their measurement.
ARTICLES
Associations of the HDL2 and HDL3 cholesterol subfractions with the development of ischemic heart disease in British men. The Caerphilly and Speedwell Collaborative Heart Disease Studies
MRC Epidemiology Unit, Llandough Hospital, Penarth, South Glamorgan, UK.
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