Background: It is well known that lipid and lipoprotein disturbances play an important role in the development of atherosclerosis. However, the changes in the high density lipoprotein (HDL) composition in patients with peripheral vascular disease (PVD) and its relation to the severity of ischemia of the lower limbs need to be clarified.
Methods: HDL abnormalities have been studied in 102 men with PVD and in 100 age-sex-matched controls. History of smoking was recorded in 88 patients, but only 58 were smokers at the time of the study; 35 of controls were smokers.
Results: Serum triglycerides were 1.66 +/- 0.85 mmol/L (mean +/- SD) in patients and 1.29 +/- 0.61 mmol/L in controls (p less than 0.001). HDL-cholesterol was 0.97 +/- 0.27 mmol/L and 1.08 +/- 0.28 mmol/L (p less than 0.01) respectively; HDL-proteins were 1.16 +/- 0.21 g/L and 1.25 +/- 0.17 g/L (p less than 0.005) respectively. No significant differences were observed when serum apoprotein (apo) A-I and HDL-triglycerides levels were compared between patients and controls. Smoker patients showed a significant increase in serum triglycerides (p less than 0.005) and a lower HDL-cholesterol concentrations (p less than 0.005) compared with non smoker patients. Patients with more severe distal involvement according to the arm-ankle pressure index showed a significantly greater reduction in HDL-cholesterol (p less than 0.05).
Conclusions: HDL-cholesterol is the best marker of PVD, and the degree of severity of ischemia was associated with greater decrease in HDL-cholesterol. Apo A-I has not been revealed as a risk marker for PVD.