High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus

Objective Patients with systemic lupus erythematosus (SLE) have increased risk of premature atherosclerosis but the exact mechanisms remains unclear. Flow-mediated dilatation (FMD) is an established non-invasive assessment of vascular endothelial function. Lipoprotein subfractions may be better pred...

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Main Authors: Tze Ping Loh, Lieng Hsi Ling, Anselm Mak, Lingli Gong, Nien Yee Kow, Chun En Yau, Sen Hee Tay, Ainsley Ryan Yan Bin Lee, Cheryl Kai Ting Chua, Wan Ling Cheng, Avery Joy Li Chia, Shi Yin Wong, Bernett Teck Kwong Lee
Format: Article
Language:English
Published: BMJ Publishing Group 2024-05-01
Series:Lupus Science and Medicine
Online Access:https://lupus.bmj.com/content/11/1/e001030.full
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author Tze Ping Loh
Lieng Hsi Ling
Anselm Mak
Lingli Gong
Nien Yee Kow
Chun En Yau
Sen Hee Tay
Ainsley Ryan Yan Bin Lee
Cheryl Kai Ting Chua
Wan Ling Cheng
Avery Joy Li Chia
Shi Yin Wong
Bernett Teck Kwong Lee
author_facet Tze Ping Loh
Lieng Hsi Ling
Anselm Mak
Lingli Gong
Nien Yee Kow
Chun En Yau
Sen Hee Tay
Ainsley Ryan Yan Bin Lee
Cheryl Kai Ting Chua
Wan Ling Cheng
Avery Joy Li Chia
Shi Yin Wong
Bernett Teck Kwong Lee
author_sort Tze Ping Loh
collection DOAJ
description Objective Patients with systemic lupus erythematosus (SLE) have increased risk of premature atherosclerosis but the exact mechanisms remains unclear. Flow-mediated dilatation (FMD) is an established non-invasive assessment of vascular endothelial function. Lipoprotein subfractions may be better predictors of FMD than conventional cholesterol measurements. We tested the hypothesis that lipoprotein subfractions are independently associated with FMD.Methods Forty-one consecutive adult patients with SLE without known cardiovascular risk factors or disease were recruited in this cross-sectional study. Endothelial function and early atherosclerosis were assessed by brachial FMD and common carotid artery (CCA) intima-media thickness (IMT). High-density lipoprotein (HDL)/low-density lipoprotein (LDL) subfractions were measured. Machine learning models were also constructed to predict FMD and CCA IMT.Results Median FMD was 4.48% (IQR 5.00%) while median IMT was 0.54 mm (IQR 0.12 mm). Univariate analysis showed lower LDL1 (r=−0.313, p<0.05) and higher HDL2 subfractions (r=0.313, p<0.05) were significantly associated with higher log-transformed FMD. In a multiple linear regression model, HDL2 (β=0.024, SE=0.012, p<0.05) remained an independent predictor of higher FMD after adjusting for age, body mass index, LDL1 and systolic blood pressure. The machine learning model included parameters such as HDL2 (positive association), prednisolone dose, LDL cholesterol and LDL1 for prediction of FMD (r=0.433, p<0.01). Age, LDL cholesterol and systolic blood pressure were independently associated with higher CCA IMT after adjusting for body mass index and HDL2.Conclusions HDL 2, a large HDL particle, was independently associated with greater FMD and may be a biomarker of vascular health in SLE.
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spelling doaj-art-f11759081c1e4b2a8e0ebe55d19d45462024-11-10T09:10:09ZengBMJ Publishing GroupLupus Science and Medicine2053-87902024-05-0111110.1136/lupus-2023-001030High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosusTze Ping Loh0Lieng Hsi Ling1Anselm Mak2Lingli Gong3Nien Yee Kow4Chun En Yau5Sen Hee Tay6Ainsley Ryan Yan Bin Lee7Cheryl Kai Ting Chua8Wan Ling Cheng9Avery Joy Li Chia10Shi Yin Wong11Bernett Teck Kwong Lee12Department of Laboratory Medicine, National University Hospital, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeDivision of Rheumatology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeDivision of Rheumatology, Department of Medicine, National University Hospital, SingaporeDepartment of Laboratory Medicine, National University Hospital, SingaporeRoyal College of Surgeons in Ireland, Dublin, IrelandYong Loo Lin School of Medicine, National University of Singapore, SingaporeCentre for Biomedical Informatics, Lee Kong Chian School of Medicine, Nanyang Technological University, SingaporeObjective Patients with systemic lupus erythematosus (SLE) have increased risk of premature atherosclerosis but the exact mechanisms remains unclear. Flow-mediated dilatation (FMD) is an established non-invasive assessment of vascular endothelial function. Lipoprotein subfractions may be better predictors of FMD than conventional cholesterol measurements. We tested the hypothesis that lipoprotein subfractions are independently associated with FMD.Methods Forty-one consecutive adult patients with SLE without known cardiovascular risk factors or disease were recruited in this cross-sectional study. Endothelial function and early atherosclerosis were assessed by brachial FMD and common carotid artery (CCA) intima-media thickness (IMT). High-density lipoprotein (HDL)/low-density lipoprotein (LDL) subfractions were measured. Machine learning models were also constructed to predict FMD and CCA IMT.Results Median FMD was 4.48% (IQR 5.00%) while median IMT was 0.54 mm (IQR 0.12 mm). Univariate analysis showed lower LDL1 (r=−0.313, p<0.05) and higher HDL2 subfractions (r=0.313, p<0.05) were significantly associated with higher log-transformed FMD. In a multiple linear regression model, HDL2 (β=0.024, SE=0.012, p<0.05) remained an independent predictor of higher FMD after adjusting for age, body mass index, LDL1 and systolic blood pressure. The machine learning model included parameters such as HDL2 (positive association), prednisolone dose, LDL cholesterol and LDL1 for prediction of FMD (r=0.433, p<0.01). Age, LDL cholesterol and systolic blood pressure were independently associated with higher CCA IMT after adjusting for body mass index and HDL2.Conclusions HDL 2, a large HDL particle, was independently associated with greater FMD and may be a biomarker of vascular health in SLE.https://lupus.bmj.com/content/11/1/e001030.full
spellingShingle Tze Ping Loh
Lieng Hsi Ling
Anselm Mak
Lingli Gong
Nien Yee Kow
Chun En Yau
Sen Hee Tay
Ainsley Ryan Yan Bin Lee
Cheryl Kai Ting Chua
Wan Ling Cheng
Avery Joy Li Chia
Shi Yin Wong
Bernett Teck Kwong Lee
High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus
Lupus Science and Medicine
title High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus
title_full High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus
title_fullStr High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus
title_full_unstemmed High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus
title_short High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus
title_sort high density lipoprotein cholesterol subfraction hdl2 is associated with improved endothelial function in systemic lupus erythematosus
url https://lupus.bmj.com/content/11/1/e001030.full
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