Low-density lipoprotein particle size, triglycerides, and high-density lipoprotein cholesterol as risk factors for coronary heart disease in older Japanese-American men

Decreased low-density lipoprotein (LDL) particle size is associated with co ronary heart disease (CHD) risk among middle-aged Caucasian populations, an d has been consistently correlated with increased plasma levels of triglyce ride and decreased levels of high-density lipoprotein (HDL) cholesterol. Th is study examines whether these risk factors predict CHD among older Japane se-American men. With use of the Honolulu Heart Program Lipoprotein from 3 (1980 to 1982) as baseline, and 12-year follow-up for CHD events, a nested, case-control study was designed. One hundred forty-five incident CHD cases were identified and matched to 2 controls each. LDL particle diameter (siz e) was determined by gradient gel electrophoresis, A 10-angstrom (Angstrom) decrease in LDL size at baseline was associated with increased risk of inc ident CHD (relative risk 1.28, 95% confidence interval 1.01 to 1.63), After adjustment for baseline risk factors, the LDL size association was no long er statistically significant (relative risk 1.13, 95% confidence interval 0 .86 to 1.49). When principal components analysis was used to define a compo site variable for LDL size, triglycerides, and HDL cholesterol, this compon ent predicted CHD independent of smoking, alcohol consumption, physical act ivity, body mass index, hypertension, diabetes, and beta-blocker use (p <0. 01), Therefore, this prospective analysis of data from older, Japanese-Amer ican men demonstrated that decreased LDL size is a univariate predictor of incident CHD, and that a composite risk factor of LDL size, triglyceride, a nd HDL cholesterol was a risk factor for CHD independent of other risk fact ors. (C)2000 by Excerpta Medico, Inc.