Analysis of the high-density lipoprotein subfractional profile depending on femoral artery atherosclerosis and obesity

Aim. To determine and characterize the features of the high-density lipoprotein (HDL) subfractional profile in patients with or without femoral artery (FA) atherosclerosis, as well as in relation to obesity status.

Material and methods. The study included 97 patients aged 34-80 years (mean age 59 years), with (n=47) or without (n=50) FA atherosclerosis, confirmed by imaging methods. Lipid profiles were determined using standard biochemical methods. The HDL subfraction profile was analyzed by electrophoresis in 3% polyacrylamide gel using the Lipoprint HDL Subfractions Testing System (Quantimetrix, USA). Additionally, we analyzed HDL subfractional profile in patients with FA atherosclerosis depending on the presence (n=23) or absence (n=24) of obesity (body mass index ≥30 kg/m²).

Results. No significant differences in the levels of standard lipid profile parameters were found between patients with and without FA atherosclerosis. However, differences in the HDL subfractional profile were found in the form of a lower proportion of large HDL_1-3 subfractions and the accumulation of small HDL_8-10 in patients with FA atherosclerosis. According to multivariate regression analysis, the association between the distribution pattern of HDL subfractions and FA atherosclerosis remained after adjustment for sex, age, and obesity. The small/large HDL subfraction ratio was significantly associated with FA atherosclerosis and demonstrated satisfactory discriminatory power in ROC analysis. In the group of patients with FA atherosclerosis, obesity was associated with an additional shift in the HDL subfractional profile toward a less atheroprotective profile.

Conclusion. FA atherosclerosis is associated with a lower proportion of large HDL particles and the accumulation of small subfractions. These features are qualitative in nature and are not detected by standard assessment of lipid profile parameters, which emphasizes the importance of HDL subfractional profile analysis. In patients with FA atherosclerosis, obesity was associated with an additional shift in the HDL subfractional profile toward particles with potentially lower atheroprotective activity.

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