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Background: The clinical value and the interrelationship of HDL and the metabolic syndrome were studied using plasma levels of TNF-α, IL 6, IL 10, IL 8, IL 1beta, IL 2R in patients with cardiovascular stenosis. Methods: On the basis of exclusion criteria, we recruited 198 male and female patients aged 45 to 75 years with CVD and 43 patients with MS. Patients were subdivided into %stenosis according to the CASS guidelines. Lipids were measured on an Olympus AU640 analyzer. Ox-LDL was measured by the immunosorbent assay and MDA by HPLC. Cytokines were analysed with DPC Immulite 1000. Statistical tests were performed using SPSS for Windows, 14.0 & Medcalc. Results: Ox-LDL and apoB were significantly higher in the MS(+) patient group (88.7 U/L) compared to the MS(-) group (77.5 U/L). Ox-LDL showed a positive correlation (P=0.001) with LDL-C, apoB and MDA. There was a higher concentration of HDL in the patient group MS(-), which was confirmed by a non-significant (P=0.849) change of apoA(I) from 1.267 g/L in the MS(+) to 1.275 g/L in the MS(-) group. A light significant increase of IL 10 (P=0.05) in MS(+) patients was observed, and the other analysed inflammation markers were mostly unchanged. MS has no direct association with the cytokine production. Conclusions: Ox-LDL and apoB were significantly higher in the MS(+) patient group. In a multiple regression analysis for ox-LDL, apoB (P=0.003) emerged as a strong predictor of the ox-LDL concentration, independent of age, gender, BMI and smoking.

Abstract: Background: Inflammation processes are considered important links between classical lipid risk factors and the progression of atherosclerosis. The interrelationship of high density lipoproteins (HDL) and apolipoprotein apoA-1 with acute phase proteins and cytokines was examined in a clinical setting of patients with angina pectoris. Methods: On exclusion criteria (myocardial infarction, heart failure, CHD>2years, anticoagulant therapy), 198 patients were recruited and were subdivided according to angiographically documented stenosis, no stenosis vs. =50% stenosis, in accordance with CASS guidelines. Lipids, apoA-1 and apoB, C-reactive protein (hs-CRP), fibrinogen, serum amyloid A (SAA) and cytokines (IL-6, IL-8, IL-10, IL2R, TNFα) were measured. Results: Low HDL-C (and apoA-I) is associated with advanced coronary stenosis (=50%) and with the number of diseased vessels, independent of age, gender, diabetes, smoking and lipid-lowering therapy. In contrast to hs-CRP and fibrinogen, SAA as well as cytokine levels were not significantly associated with stenosis. SAA (P=0.0003) and diabetes (P=0.0002) were strong predictors of apoA-I concentration independent of age, gender, BMI, smoking, CRP, as well as IL-6 in a multiple regression model. High SAA (P=0.0067) and TG (P=0.0123) were significant predictors of apoA-I/HDL-C ratio. However, SAA was not independently related to HDL-C. Conclusions: SAA is independently and inversely related to apoA-I but not to HDL-C in patients with angina pectoris, reflecting the effect of SAA on the quality of HDL particles. However, HDL-c but not SAA is inversely related to the degree of coronary artery stenosis. [Copyright &y& Elsevier]