The benefits of measuring the size and number of lipoprotein particles for cardiovascular risk predictionA systematic review and meta-analysis
- Jose A. Quesada 1
- Vicente Bertomeu-González 2
- Domingo Orozco-Beltrán 1
- Alberto Cordero 3
- Vicente F. Gil-Guillén 1
- Adriana López-Pineda 1
- Rauf Nouni-García 1
- Concepción Carratalá-Munuera 1
- 1 Miguel Hernandez de Elche University, San Juan Campus, Alicante, Spain
- 2 Miguel Hernandez de Elche University, San Juan Campus, Alicante, Spain; San Juan de Alicante University Hospital, San Juan de Alicante, Alicante, Spain; Biomedical Research Center in Cardiovascular Diseases Network, Madrid, Spain
- 3 San Juan de Alicante University Hospital, San Juan de Alicante, Alicante, Spain; Biomedical Research Center in Cardiovascular Diseases Network, Madrid, Spain
ISSN: 0214-9168, 1578-1879
Year of publication: 2023
Volume: 35
Issue: 4
Pages: 165-177
Type: Article
More publications in: Clínica e investigación en arteriosclerosis
Sustainable development goals
Abstract
Objective: Cardiovascular risk (CVR) is conventionally calculated by measuring the total cholesterol content of high-density lipoproteins (HDL) and low-density lipoproteins (LDL). The purpose of this systematic review was to assess the CVR associated with LDL and HDL particle size and number as determined by nuclear magnetic resonance (NMR) spectroscopy. Material and methods: A literature search was performed using the electronic databases MEDLINE and Scopus. All cohort and case---control studies published before January 1, 2019 that met the following inclusion criteria were included: HDL-P, LDL-P, HDL-Z and/or LDL-Z measured by NMR spectroscopy; cardiovascular event as an outcome variable; risk of cardiovascular events expressed as odds ratios or hazard ratios; only adult patients. A meta-analysis was performed for each exposure variable (4 for LDL and 5 for HDL) and for each exposure measure (highest versus lowest quartile and 1-standard deviation increment). Results: This review included 24 studies. Number of LDL particles was directly associated with CVR: risk increased by 28% with each standard deviation increment. LDL particle size was inversely and significantly associated with CVR: each standard deviation increment corresponded to an 8% risk reduction. CVR increased by 12% with each standard deviation increase in number of small LDL particles. HD, particle number and size were inversely associated with CVR. Conclusion: Larger particle size provided greater protection, although this relationship was inconsistent between studies. Larger number of LDL particles and smaller LDL particle size are associated with increased CVR. Risk decreases with increasing number and size of HDL particles.