LIPID-METABOLISM AND APOLIPOPROTEIN-E PHENOTYPES IN PATIENTS WITH XANTHELASMA

PURPOSE: To know the prevalence and types of dyslipidemia associated w ith xanthelasma. PATIENTS AND METHODS: One hundred fifteen patients wi th xanthelasma and 105 age-matched control subjects without xanthelasm a were evaluated in a cross-sectional study. Univariate and multivaria te comparisons of lipid variables (including total cholesterol; trigly cerides; very-low-, low-, and high-density lipoprotein cholesterol [VL DL-C, LDL-C, and HDL-C, respectively]; cholesterol of high density lip oprotein [HDL] subfractions 2 and 3 [HDL(2)-C and HDL(3)-C]; apolipopr otein (ape) A-I and B; and apo E phenotypes) and nonlipid coronary ris k factors were made between patients with and without xanthelasma. RES ULTS: Patients with xanthelasma had higher levels of cholesterol, LDL- C, and apo B, and lower levels of HDL(2)-C than control subjects. The prevalence of the apo E4/E3 phenotype was higher in cases than in cont rols (P <0.05). Patients with xanthelasma had a higher prevalence of p ersonal and familiar history of cardiovascular disease and were more o verweight than control subjects. A stepwise discriminant analysis disc losed an independent association of xanthelasma with lower HDL-C, HDL( 2)-C, and HDL(3)-C levels in men, and with higher total cholesterol an d lower HDL(2)-C levels in women. CONCLUSIONS: Xanthelasma appears to be associated with qualitative and quantitative abnormalities of lipid metabolism that may favor lipid deposition in the skin and arterial w all. The findings support the notion that xanthelasma is a marker of d yslipidemia, and underline the need to determine a full lipid profile in these patients to detect those potentially at increased risk of car diovascular disease.