High-density lipoprotein subclasses and noncardiovascular,noncancer chronic inflammatory-related events versus cardiovascular events: the multi-ethnic study of atherosclerosis

Background-high-density lipoprotein (hdl) particles have properties beyond reverse cholesterol transport. we hypothesized that their protection extends to inflammation-related disease. the predictive value of hdl particle subclasses and inflammatory markers was studied for noncardiovascular,noncancer chronic inflammation-related death and hospitalization,and for incident cardiovascular disease (cvd). methods and results-a multiethnic,multicenter,prospective observational study was conducted in 6475 men and women (aged 45 to 84 years) free of known cvd at baseline with median follow-up of 10.1 years. fasting venous samples were analyzed for baseline lipid profile and lipoprotein particles. we focused on the hdl family of variables (small-,medium-,and large-diameter hdl particles and hdl cholesterol). analyses identified the sum of small- plus medium-diameter hdl particles as important. small- plus medium-diameter hdl particles were inversely associated with diagnostic code-based noncardiovascular,noncancer chronic inflammation-related death and hospitalization (n=1054) independent of covariates: relative risk per sd 0.85 (95% ci: 0.79 to 0.91,p<0.0001). small- plus medium-diameter hdl particles were also associated with adjudicated fatal and nonfatal coronary heart disease events (n=423): relative risk per sd 0.88 (95% ci 0.77 to 0.98,p=0.02). conclusions-small- plus medium-diameter hdl particles are an independent predictor for noncardiovascular,noncancer chronic inflammation-related death and hospitalization and for coronary heart disease events in subjects initially free of overt cvd. these findings support the hypothesis that smaller hdl particles of diameter <9.4 nm have anti-inflammatory properties in the general population. © 2015 the authors.