Bruna S B S Teles, Sergio H R Ramalho, Márcio S Bittencourt, Isabela M Benseñor, Michael J Blaha, Peter P Toth, Steven R Jones, Raul D Santos, Paulo A Lotufo, Luiz Sérgio F Carvalho
{"title":"Plasma levels of small HDL particles are associated with coronary atherosclerosis progression in adults with diabetes.","authors":"Bruna S B S Teles, Sergio H R Ramalho, Márcio S Bittencourt, Isabela M Benseñor, Michael J Blaha, Peter P Toth, Steven R Jones, Raul D Santos, Paulo A Lotufo, Luiz Sérgio F Carvalho","doi":"10.1210/clinem/dgaf215","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a major driver of coronary atherosclerosis progression, yet its impact is highly heterogeneous. Insulin resistance contributes to a complex interplay of metabolic disturbances that accelerate atherogenesis to varying degrees. Identifying biomarkers that refine cardiovascular risk prediction in this population remains a clinical priority.</p><p><strong>Objective: </strong>To evaluate the association between small HDL particle concentration and the incidence/progression of coronary artery calcium (CAC) in individuals with T2DM.</p><p><strong>Methods: </strong>We analyzed 4,331 participants from the ELSA-Brasil cohort. CAC incidence/progression was compared between individuals with and without T2DM. A subgroup of 461 non-statin users with T2DM and no baseline atherosclerotic cardiovascular disease (ASCVD) was further assessed for associations between small HDL particles (<8nm, HDLp1) and CAC outcomes.</p><p><strong>Results: </strong>Individuals with T2DM showed increased CAC incidence/progression rates compared to non-diabetic participants. Among 461 non-statin users with T2DM, 143 (31.0%) experienced CAC incidence/progression. Higher plasma concentrations of HDLp1 (3rd tertile) were associated with a 140% (95%CI 32-341%, p<0.001) greater likelihood of CAC incidence/progression compared to the 1st tertile. The inclusion of HDLp1 significantly improved CAC risk classification, with a net reclassification improvement (NRI) of 13.6% (95%CI 2.8-18.8%, p=0.004).</p><p><strong>Conclusion: </strong>HDLp1 concentration is significantly associated with CAC incidence/progression in individuals with T2DM and may improve risk discrimination for coronary atherosclerosis progression in this population.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Endocrinology & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1210/clinem/dgaf215","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Plasma levels of small HDL particles are associated with coronary atherosclerosis progression in adults with diabetes.
Background: Type 2 diabetes mellitus (T2DM) is a major driver of coronary atherosclerosis progression, yet its impact is highly heterogeneous. Insulin resistance contributes to a complex interplay of metabolic disturbances that accelerate atherogenesis to varying degrees. Identifying biomarkers that refine cardiovascular risk prediction in this population remains a clinical priority.
Objective: To evaluate the association between small HDL particle concentration and the incidence/progression of coronary artery calcium (CAC) in individuals with T2DM.
Methods: We analyzed 4,331 participants from the ELSA-Brasil cohort. CAC incidence/progression was compared between individuals with and without T2DM. A subgroup of 461 non-statin users with T2DM and no baseline atherosclerotic cardiovascular disease (ASCVD) was further assessed for associations between small HDL particles (<8nm, HDLp1) and CAC outcomes.
Results: Individuals with T2DM showed increased CAC incidence/progression rates compared to non-diabetic participants. Among 461 non-statin users with T2DM, 143 (31.0%) experienced CAC incidence/progression. Higher plasma concentrations of HDLp1 (3rd tertile) were associated with a 140% (95%CI 32-341%, p<0.001) greater likelihood of CAC incidence/progression compared to the 1st tertile. The inclusion of HDLp1 significantly improved CAC risk classification, with a net reclassification improvement (NRI) of 13.6% (95%CI 2.8-18.8%, p=0.004).
Conclusion: HDLp1 concentration is significantly associated with CAC incidence/progression in individuals with T2DM and may improve risk discrimination for coronary atherosclerosis progression in this population.
期刊介绍：
The Journal of Clinical Endocrinology & Metabolism is the world"s leading peer-reviewed journal for endocrine clinical research and cutting edge clinical practice reviews. Each issue provides the latest in-depth coverage of new developments enhancing our understanding, diagnosis and treatment of endocrine and metabolic disorders. Regular features of special interest to endocrine consultants include clinical trials, clinical reviews, clinical practice guidelines, case seminars, and controversies in clinical endocrinology, as well as original reports of the most important advances in patient-oriented endocrine and metabolic research. According to the latest Thomson Reuters Journal Citation Report, JCE&M articles were cited 64,185 times in 2008.
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