Fractional esterification rate of cholesterol in high-density lipoprotein associates with risk of coronary heart disease

Background: Fractional esterification rate of cholesterol in high-density lipoprotein (FER_HDL) has been found to be closely correlated with atherosclerotic dyslipidemia, especially lipoprotein distributions, and is a potentially useful predictor for coronary heart disease (CHD). The associations of FER_HDL, measured by the simple and precise HPLC method, with angiographically defined CHD and its related risk factors in Chinese patients were evaluated.

Methods: Two hundred and fifty eight Chinese patients who had indications for angiography were enrolled in this study. Coronary angiograms were obtained by the standard techniques. FER_HDL was determined by the HPLC method. Cholesterol levels in serum HDL, LDL and subfractions were measured by ultracentrifugation/HPLC method. Associations between FER_HDL and CHD and CHD risk factors were analyzed.

Results: FER_HDL was correlated with almost all the CHD risk factors. Compared with the non-CHD group, the CHD patients had higher values of FER_HDL (20.9 ± 7.9%/h vs 17.7 ± 7.1%/h, p = 0.001). FER_HDL was found to be independently and positively correlated with log TG (β = 0.386, P < 0.001) and log (LDLb-C) (β = 0.165, P = 0.020), respectively, and negatively correlated with log (HDL2-C)(β = -0.351, P < 0.001). Logistic regression analysis demonstrated that age, diabetes mellitus, smoking and FER_HDL (OR = 1.056-1.080, p < 0.05) were independent risk factors for CHD.

Conclusion: FER_HDL significantly correlated with both HDL2-C and LDLb-C, and therefore, is the predictor of lipoprotein distributions. In addition, after correcting for the presence of classic risk factors, FER_HDL was independently associated with the presence of angiographically defined CHD.