Lipoprotein subclasses are associated with Hepatic steatosis: insights from the prospective multicenter imaging study for the evaluation of chest pain (PROMISE) clinical trial

• Published in: American journal of preventive cardiology 2024-06, Vol.18, p.100680-100680, Article 100680
• Main Authors: Karady, Julia, McGarrah, Robert W, Nguyen, Maggie, Giamberardino, Stephanie N, Meyersohn, Nandini, Lu, Michael T, Staziaki, Pedro V, Puchner, Stefan B, Bittner, Daniel O, Foldyna, Borek, Mayrhofer, Thomas, Connelly, Margery A, Tchernof, Andre, White, Phillip J, Nasir, Khurram, Corey, Kathleen, Voora, Deepak, Pagidipati, Neha, Ginsburg, Geoffrey S, Kraus, William E, Hoffmann, Udo, Douglas, Pamela S, Shah, Svati H, Ferencik, Maros
• Format: Article
• Language: English
• Subjects: Cardiac CT; Hepatic steatosis; Lipoprotein; Lipoprotein particles; Lipoprotein subclasses; Original Research Contribution
• ISSN: 2666-6677; 2666-6677
• DOI: 10.1016/j.ajpc.2024.100680

•The nr1 cause of morbidity and mortality in hepatic steatosis (HS) is CV disease.•Clinically, HS is associated with dyslipidemia and coronary artery disease (CAD).•Lipoprotein particle number/size are associated with CAD and CV events.•We analyzed the association lipoprotein particle size/number and HS on CT/biopsy.•Large TRL, mean sizes of TRL-, and HDL were associated with HS on CT/biopsy.•The use of lipoprotein subclasses may improve CV risk assessment in patients with HS. To determine the relationship between lipoprotein particle size/number with hepatic steatosis (HS), given its association with traditional lipoproteins and coronary atherosclerosis. Individuals with available CT data and blood samples enrolled in the PROMISE trial were studied. HS was defined based on CT attenuation. Lipoprotein particle size/number were measured by nuclear magnetic resonance spectroscopy. Principal components analysis (PCA) was used for dimensionality reduction. The association of PCA factors and individual lipoprotein particle size/number with HS were assessed in multivariable regression models. Associations were validated in an independent cohort of 59 individuals with histopathology defined HS. Individuals with HS (n=410/1,509) vs those without (n=1,099/1,509), were younger (59±8 vs 61±8 years) and less often females (47.6 % vs 55.9 %). All PCA factors were associated with HS: factor 1 (OR:1.36, 95 %CI:1.21–1.53), factor 3 (OR:1.75, 95 %CI:1.53–2.02) and factor 4 (OR:1.49; 95 %CI:1.32–1.68) were weighted heavily with small low density lipoprotein (LDL) and triglyceride-rich (TRL) particles, while factor 2 (OR:0.86, 95 %CI:0.77–0.97) and factor 5 (OR:0.74, 95 %CI:0.65–0.84) were heavily loaded with high density lipoprotein (HDL) and larger LDL particles. These observations were confirmed with the analysis of individual lipoprotein particles in PROMISE. In the validation cohort, association between HS and large TRL (OR: 8.16, 95 %CI:1.82–61.98), and mean sizes of TRL- (OR: 2.82, 95 %CI:1.14–9.29) and HDL (OR:0.35, 95 %CI:0.13–0.72) were confirmed. Large TRL, mean sizes of TRL-, and HDL were associated with radiographic and histopathologic HS. The use of lipoprotein particle size/number could improve cardiovascular risk assessment in HS. [Display omitted]