Dyslipidemia is one of the most common diseases worldwide. It is known as one of the most dangerous “silent killer” due to its late, and usually fatal manifestations. It has a strong association with atherosclerosis [1]. Our study investigates the association between the development of atherosclerosis and the thrombotic risk observed in patients with dyslipidemia. This association is demonstrated by analysis of various lipoprotein particles, including atherogenic and non-atherogenic, and their relation with homocysteine as a marker of thrombosis.
Patients undergoing personalized weight reduction and lifestyle changes program were recruited at the cardiology ambulance of the 1st Department of Internal Medicine, Pavol Jozef Šafárik University in Košice, Slovakia. The selected individuals were divided into the study group (n = 6, average age 36 ± 8 years) and control group (n = 6, average age 31 ± 6 years). The analysis of the cholesterol in low-density lipoprotein and high-density lipoprotein sub-particles was performed by Lipoprint® Lipoprotein Subfractions Testing System. Statistical analysis was performed using SPSS Statistics 22 (IBM).
Dyslipidemic patients included in the study group had total cholesterol (TC) values above 5 mmol/L (average 6.25 ± 0.77 mmol/L) and low-density lipoprotein-cholesterol (LDL-C) above 3 mmol/L (average 4.00 ± 0.68 mmol/L). Control group consisted of individuals without dyslipidemia. Homocysteine values varied widely in both groups.
Pearson's statistical analysis showed that the correlation between homocysteine concentration and the levels of TC, triacylglycerol, LDL-C and high-density lipoprotein-cholesterol (HDL-C) was not significant, but we did not even find the expected positive correlation between homocysteine and TC and LDL-C value[2]. Cholesterol in subfractions appears to be a more sensitive marker. Cholesterol in the atherogenic fractions like in VLDL, IDL A, B, C, and LDL 3 showed a positive correlation with homocysteine, while less atherogenic or anti-atherogenic fractions like LDL 1, 2, HDL 2, and 3 were reciprocally correlated with homocysteine. Spearman's non-parametric analysis in dyslipidemic patients showed a statistically significant positive correlation between homocysteine and the cholesterol in the large subfraction HDL 1 (Spearman's rho 0.89, p = 0.019). Spearman's non-parametric analysis in the control group individuals showed a statistically significant positive correlation between homocysteine and the cholesterol in the intermediate subfractions HDL 6 and 7 (Spearman's rho 0.89, p = 0.019 for both). The divergent regression trends between homocysteine and the large HDL sub-particles 1, 4, 6, and 7 observed in dyslipidemic and non-dyslipidemic patients suggest a modification of these particles during abnormal lipid metabolism in dyslipidemia.
The first results of this project indicate the importance of monitoring the relation of homocysteine concentration and the cholesterol level in lipoprotein subfractions in a large scale. Our results are aimed to assist in the management, whether in the diagnosis or in the treatment of dyslipidemic patients, making it more personal.
Key words: dyslipidemia, cholesterol, lipoprotein, homocysteine
This work was supported by grant no. VEGA 1/0910/16.