Cholesterol uptake capacity for cardiovascular disease risk assessment in the MASHAD cohort study population

Background: The efficacy of cholesterol uptake capacity (CUC) by HDL to reverse cholesteroltransport (RCT), was exploited to evaluate the functions of HDL to predict the risk of cardiovasculardisease. Therefore, we used a newly developed assay to investigate CUC as a robust measurementof HDL functionality.Method: The study population samples of the Mashhad-Stroke and Heart-Atherosclerotic-Disorders(MASHAD) cohort included ۱۵۳ individuals without CVD at baseline who then developedCVD over ۱۰ years of follow-up (CVD group) and ۳۵۰ samples without CVD. We used the modified(CUC) method, a cell-free, simple, and high-throughput assay to evaluate the HDL functionalityof serum samples at the baseline of the study.Result: This assay system exhibited high reproducibility; the Inter- and Intra- assay of the CUCcriterion were detected as CV=۱۳.۰۷ and ۶.۶۵, respectively. Our data showed that the mean valueof CUC was significantly lower in the CVD group (۱.۰۷±۰.۴۷) compared to healthy individuals(۱.۲۱±۰.۶۲) in the baseline study. Neither HDL-C changes over time were not significantly associatedwith the risk of progressing CVD, while a significantly negative association was foundbetween CUC at the baseline samples and reduced risk of clinical CVD (OR=۰.۵۴, ۹۵%CI=۰.۳۵–۰.۸۲, P=۰.۰۰۵). Also, a decreased CUC was independently reverse-associated with the CVDevent (HR, ۰.۶۲; ۹۵% CI, ۰.۴۱-۰.۹۴, P=۰.۰۲). We determined the optimum cut-off point of ۱.۷ forcholesterol uptake capacity in the MASHAD cohort population (p=۰.۰۰۳). Furthermore, the CUCvalue was the third parameter that is significantly effective in assigning the CVD risk stratification-derived data mining analysis.Conclusions: Reducing uptake capacity or impaired HDL functionality can be used as a markerfor the prediction of progressive CVD. This high-throughput, sensitive, and cell-free assay, couldpossibly be used for the assessment of CVD risk in clinical settings.