Assessment of HDL functionality by a newly cell free method: Cholesterol Uptake Capacity (CUC)

Background: The efficacy of HDL cholesterol uptake capacity (CUC) to reverse cholesterol transport(RCT), was exploited to evaluating the anti-atherosclerotic functions of HDL that are consideredas a new clinical index to predict the risk of cardiovascular disease. We aimed to investigateserum CUC by a novel technic in subjects from Birjand longitudinal aging cohort study (BLAS).Method: This cross-sectional cohort study was conducted of ۱۲۹ cardiovascular patients and۲۳۱ healthy ones from bassline of BLAS. We used a modified CUC method to investigate serumhigh density lipoprotein (HDL) cholesterol uptake capacity in subjects Result: The meanserum cholesterol uptake capacity was significantly higher in the healthy subject compared tocardiovascular disease (CVD) ones (p=۰.۰۴). Despite there were no significant differences inserum HDLC between the subjects and also with the risk of progressive CVD, a significantlynegative association was found between CUC serum samples and risk of CVD in the unadjustedmodel so that with increasing level of CUC, the risk of heart disease decreases (p <۰.۰۵). Multivariatelogistic regression analysis represent that there was a significantly negative associationbetween CUC and risk of CVA with the elimination of confounding parameters (OR=۰.۳۳, ۹۵%CI= ۰.۱۲–۰.۹۳, P=۰.۰۳). Using a decision tree based on the results from analysis and data miningin the study population, we investigated the most important parameters which can be used toevaluate cardiovascular patients. The decision tree has ۵ layers of different risk factors contributingto the risk of CVD. According to the results, there was a subgroup of samples with a historyof hypertension (HTN) which had a CUC>۱.۶; half of which got elected as the cardiovasculardisease group. For the control group, ۸۸% of samples that had a history of HTN and a CUC≥۱.۶got elected. As is reflected in nominal logistics table for evaluating the risk of CVD, the resultsshowed that male sex and high blood pressure were simultaneously the most prominent risk factorsassociated with cardiovascular diseases. Age was the third factor associated with an increasedrisk of cardiovascular disease. We found that the CUC rate is statistically associated with therisk of CVD. Discussion: According to this study’s results, there was no significant difference inthe HDL levels between the CVD group and the group with no history of CVD. Also, there wasno significant association between HDL levels and the progression of cardiovascular disease.However, changes in the functionality of HDL were statistically significant and an increase in thefunctionality of HDL could reduce cardiovascular diseases; as median CUC rates in the healthygroup were significantly higher than in the CVD group. The results from the study of Aghasizadeet al. corroborate with the results of this study, showing that the CUC rates in the CVD group aresignificantly lower compared to the control group (p=۰.۰۱) and that changes in the serum HDL-Clevels over time have no significant association with the risk of CVD progression. Furthermore,using the Cox proportional models analysis, we showed that CUC rates have a negative associationwith the risk of CVD (HR=۰.۶۲, ۹۵%CL=۰.۴۱-۰.۹۴, P=۰.۰۲). Also, the results show that the mean HDL levels and Cholesterol uptake capacity (CUC) were significantly different between thestroke group and the group with no history of cerebrovascular accident, and although stroke wasnot associated with HDL levels, there was a negative association between the stroke and CUCrates. Previous studies showed that hypercholesterolemia and hypertriglyceridemia are associatedwith an increase in vascular diseases and strokes, while HDL and LDL levels showed a poorassociation with vascular disease and the outcome of cerebral diseases (۱۴, ۱۵). Corroboratingwith the results of this study, Harada et al. in their study (n=۳۸۹) reported that HDL is statisticallysignificant and odds-relevant to stroke. According to the study conducted in ۲۰۱۷ on ۱۵۶ sampleswith a history of coronary complications, being adjusted for the LDL levels, the only variablethat is significantly associated with the risk of future coronary complications is CUC rates (۱۲).According to the results of this study, there is no significant association between the serum levelsof HDL, CUC, and CAD. However, in another study, researchers using logistic regression analysisshowed that a decrease in the CUC rate is independently correlated to the neo-atherosclerosis(OR، ۰.۷۹؛ P <۰.۰۰۱) and future vascular complications (OR: ۰.۸۸، P=۰.۰۰۳). Conclusions: HDLcholesterol uptake capacity was associate with reverse incidence of heart disease in populationsample from BIRJAND cohort study.

کلیدواژه ها:

cholesterol uptake capacity (CUC) ، HDL function ، cardiovascular disease (CVD) ، cohort study