Proatherogenic or antiatherogenic high density lipoprotein type in acute coronary syndrome and healthy male person

Aim: to make proatherogenic/antiatherogenic hdl type criteria using apolipoprotein a-i (apoa-i), paraoxonase-1 (pon-1), neopterin and hdl-cholesterol levels, which may be useful in clinical practice. methods: this was a case control study recruiting 52 subjects with acute coronary syndrome (acs) and 30 control healthy subjects. hdl type was classified into antiatherogenic and proatherogenic based on the levels of apoa-i, pon-1, neopterin and hdl-cholesterol. concentrations of apoa-i was measured by immunoturbidimetry method, pon-1 was measured by colorimetric method, neopterin was measured by elisa, and hdl-c was determined by homogenous method. univariate logistic regression analysis was done using acs as a dependent variable and levels of apoa-i, pon-1, neopterin and hdl-cholesterol as independent variables. proatherogenic/antiatherogenic hdl type was determined by using apoa-i, pon-1, neopterin and hdl-cholesterol cut off and odd ratios. results: patient's age was 50.89 ± 12.63 year, hdl-c was 39.82 ± 9.84 mg/dl, apo a-1 was 119.77 ± 32.05 mg/ dl, pon-1 was 41.26 ± 18.19 ku/l, neopterin was 16.22 ± 38.10 nmol/l. cut offs of apoa-i, pon-1 and neopterin successively were 124.5 mg/dl, 40.8 ku/l, and 7.016 nmol/l. on univariate logistic regression analysis showed that or of apoa-i, pon-1 and neopterin respectively were 29.759 (95% ci : 4.074 - 217.382), 1.647 (95% ci : 0.412 - 6.586), 4.317 (95% ci : 1.098 - 16.977). using scoring system, we concluded that total score > 18 was proatherogenic hdl type, and total score < 18 was antiatherogenic hdl type. with this scoring we found 78.85% had proatherogenic hdl type in acs population. conclusions: dysfunctional hdl or proatherogenic/antiatherogenic hdl type can be predicted by using apoa-i - pon-1 - neopterin - hdl-cholesterol scoring system. those with score of 18 are supposed to have antiatherogenic hdl type, and those with score of > 18 were having proatherogenic hdl type. (med j indones 2010; 19:228-34)