Association between elevated plasma fibrinogen and the small, dense low-density lipoprotein phenotype among postmenopausal women

A predominance of small, dense low-density lipoprotein (LDL) particles (sub class pattern B) has been associated with a 2- to threefold increase in cor onary heart disease risk. Recently, it has been reported that LDL subclass pattern B is associated with hyperfibrinogenemia, which is also a coronary heart disease risk factor. The present study examined the relation between hyperfibrinogenemia and LDL subclass pattern in 258 postmenopausal women. A significant univariate correlation was observed between the concentration of cholesterol carried in small, dense LDL particles and plasma fibrinogen concentration (r = 0.17, p = 0.01). The prevalence of LDL subclass pattern B was 41.9% in the highest fibrinogen tertile, compared with 27.9% and 24.4 % in the first and second tertiles, respectively (global chi-square 6.8, p = 0.03). The crude odds ratio (OR) for LDL subclass pattern B among women i n the highest fibrinogen tertile, compared with the lower tertiles, was 2.0 3 (95% confidence interval [CI] 1.18 to 3.51, p = 0.01). After adjustment f or age and plasma lipids (log, triglycerides, LDL cholesterol, and high-den sity lipoprotein cholesterol), the OR was 2.14 (95% CI 1.17 to 3.96, p = 0. 01). Further adjustment for hematocrit, indicators of carbohydrate homeosta sis, body mass index, waist circumference, and several variables related to lifestyle did not attenuate this association (OR 2.56, 95% CI 1.27 to 5.27 , p = 0.01). These data suggest that hyperfibrinogenemia and LDL subclass p attern B may be 2 components of a common syndrome and suggest that hyperfib rinogenemia may contribute to the increased coronary heart disease risk ass ociated with LDL subclass pattern B. (C) 2000 by Excerpta Medica, Inc.