HDL levels predict abdominal aortic aneurysm risk
MedWire News: Serum levels of high-density lipoprotein (HDL) are the most important lipid-derived predictor of the risk for abdominal aortic aneurysm (AAA), Australian researchers have found.
In a cohort of elderly men, lower HDL levels were consistently associated with small AAAs, leading the authors to propose HDL as a potential therapeutic target.
Jonathan Golledge (James Cook University, Townsville) and co-workers assessed associations between fasting serum lipids and AAAs among 3327 participants in the Health In Men study. This was a cross-sectional screening study involving men aged 65–83 years.
In all, 7.4% of men had an AAA at screening. One-third of the participants had a history of dyslipidemia and 31% were receiving lipid-lowering medication.
Serum HDL levels were significantly lower in men with AAAs than in those without (1.3 vs 1.4 mmol/l [50.3 vs 54.1 mg/dl]), report Golledge et al in the American Journal of Cardiology. This was the case irrespective of the use or nonuse of lipid-lowering therapy.
After adjusting for known AAA risk factors, serum HDL levels were independently and inversely associated with a reduced risk for AAA, with an adjusted odds ratio (OR) of 0.72 per 0.4 mmol/l (15.5 mg/dl) increase.
After further adjustment for use of lipid-lowering therapy and other risk factors, the OR was attenuated only slightly, to 0.76 per 0.4 mmol/l increase.
Other serum lipid measures were unrelated to the risk for AAA, whereas current use of lipid-lowering therapy was associated with a two-fold increased risk for AAA (OR=2.07).
Noting that HDL has been demonstrated to have anti-inflammatory and antioxidant effects that might be relevant to a protective role against AAA, the researchers conclude: “HDL appeared to be the most important lipid in predicting the risk for AAA development, with potential value as a therapeutic target.”
They add: “Current cardiovascular strategies aimed at lowering low-density lipoprotein might not have any effect on the prevention of AAAs.”
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By Joanna Lyford