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Are HDL Enzyme Activities Better Indices of Cardio-Metabolic Risk than HDL-C Levels?
Metabolic Syndrome (MS) is a combination of physiological factors that result in increased risk for developing Cardio Vascular Diseases (CVD). One factor that has traditionally been accepted as being athero-protective is High Density Lipoprotein (HDL). However increasing reports suggest that plasma levels of HDL-C do not reflect its functionality, which is mainly attributed to its cargo of antioxidant enzymes. The study was aimed at assessing key HDL-associated enzymes as potentially better biomarkers in evaluating risk of MS and thus CVD than merely HDL-C levels in an urban South Indian population. The study consisted of patients with MS (n=41) and age matched controls (n=65). Anthropometry, routine blood biochemistry and HDL associated enzyme activities were measured. Of the HDL enzymes, paraoxonase-1 (PON-1) activity was seen to be lower whereas Lecithin Cholesterol Acyl Transferase (LCAT) was higher in subjects with MS (p<0.01). Multiple logistic regression showed that low PON-1 activity and high LCAT activity had an increased AOR for MS (RR=3.8, 95% CI-1.1, 13.3, p=0.035, and RR=17.5, 95% CI-3.9, 77.5, p<0.001 respectively), independent of HDL-C levels. This study demonstrates the prevalence of impaired function of HDL enzymes in patients with MS, which might promote inflammation, oxidative stress and atherogenesis. It also suggests that estimating the activities of key HDL enzymes such as PON-1 and LCAT could improve the accuracy of MS and CVD risk prediction than mere measurement of HDL-C levels.
CVD, HDL-C, Inflammation, LCAT, Metabolic Syndrome, PON-1.
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