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.