Lipoprotein particle profiles by nuclear magnetic resonance compared with standard lipids and apolipoproteins in predicting incident cardiovascular disease in women.

Mora, Samia; Otvos, James D.; Rifai, Nader; Rosenson, Robert S.; Buring, Julie E.; Ridker, Paul M

doi:10.1161/circulationaha.108.816181

Cited by 490Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCholesterol and Lipid Metabolism

Lipoprotein particle profiles by nuclear magnetic resonance compared with standard lipids and apolipoproteins in predicting incident cardiovascular disease in women.

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Mora, Samia, Otvos, James D., Rifai, Nader, Rosenson, Robert S., Buring, Julie E., Ridker, Paul M·2009·Circulation

DOI 10.1161/circulationaha.108.816181PMC PMC2663974

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Abstract

BACKGROUND: Nuclear magnetic resonance (NMR) spectroscopy measures the number and size of lipoprotein particles instead of their cholesterol or triglyceride content, but its clinical utility is uncertain. METHODS AND RESULTS: Baseline lipoproteins were measured by NMR in 27 673 initially healthy women followed up for incident cardiovascular disease (n=1015) over an 11-year period. After adjustment for nonlipid risk factors, hazard ratios and 95% confidence intervals for the top versus the bottom quintile of NMR-measured lipoprotein particle concentration (measured in particles per liter) were 2.51 (1.91 to 3.30) for low-density lipoprotein (LDL(NMR)), 0.91 (0.75 to 1.12) for high-density lipoprotein (HDL(NMR)), 1.71 (1.38 to 2.12) for very low-density lipoprotein (VLDL(NMR)), and 2.25 (1.80 to 2.81) for the LDL(NMR)/HDL(NMR) ratio. Similarly adjusted results for NMR-measured lipoprotein particle size (measured in nanometers) were 0.64 (0.52 to 0.79) for LDL(NMR) size, 0.65 (0.51 to 0.81) for HDL(NMR) size, and 1.37 (1.10 to 1.70) for VLDL(NMR) size. Hazard ratios for NMR measures were comparable but not superior to standard lipids (total cholesterol 2.08 [1.63 to 2.67], LDL cholesterol 1.74 [1.40 to 2.16], HDL cholesterol 0.52 [0.42 to 0.64], triglycerides 2.58 [1.95 to 3.41], non-HDL cholesterol 2.52 [1.95 to 3.25], total/HDL cholesterol ratio 2.82 [2.23 to 3.58]) and apolipoproteins (B(100) 2.57 [1.98 to 3.33], A-1 0.63 [0.52 to 0.77], and B(100)/A-1 ratio 2.79 [2.21 to 3.54]). Essentially no reclassification improvement was found with the addition of the LDL(NMR) particle concentration or apolipoprotein B(100) to a model that already included the total/HDL cholesterol ratio and nonlipid risk factors (net reclassification index 0% and 1.9%, respectively), nor did the addition of either variable result in a statistically significant improvement in the c-index. CONCLUSIONS: In this prospective study of healthy women, cardiovascular disease risk prediction associated with lipoprotein profiles evaluated by NMR was comparable but not superior to that of standard lipids or apolipoproteins.

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Prospective multivariate studies demonstrate that large LDL predicts atherosclerosis and coronary heart disease.
“Prospective multivariate studies demonstrate that large LDL predicts atherosclerosis and coronary heart disease (35,38,39).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [38]
The Results (Association of NMR Lipoproteins, Lipids, and Apolipoproteins with CVD; page unavailable) report that large LDL particles were significantly associated with incident cardiovascular disease in women when all nine particle subclasses were included in the model. They were not associated with cardiovascular disease in the separate adjusted model. The paper does not establish that large LDL specifically predicts atherosclerosis or coronary heart disease. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Prior studies have shown that nuclear magnetic resonance spectroscopy is not superior to conventional lipid profiles.
“While such an approach can specifically measure the number and particle size of lipoprotein particles, prior studies have shown that they are not superior to conventional lipid profiles.22”
From Association of Apolipoprotein B–Containing Lipoproteins and Risk of Myocardial Infarction in Individuals With and Without Atherosclerosis (2022) · cites this paper as [22]

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Authors: Mora, S., Otvos, J. D., Rifai, N., Rosenson, R. S., Buring, J. E., & Ridker, P. M.
Affiliations: Brigham and Women's Hospital (US)
ORCID: Mora, Samia
Otvos, James D.
Rifai, Nader
Rosenson, Robert S.
Buring, Julie E.
Ridker, Paul M
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-02-24
Volume: 119
Issue: 7
Pages: 931-939
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.108.816181
PMC: PMC2663974
OpenAlex: W2026387613
Cited by: 490
References: 38
Citations by year: 2026: 15 · 2025: 19 · 2024: 22 · 2023: 25 · 2022: 27 · 2021: 39 · 2020: 21 · 2019: 17 · 2018: 31 · 2017: 37 · 2016: 32 · 2015: 35 · 2014: 29 · 2013: 28 · 2012: 30
FWCI: 38.09
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5r01hl043851-10)
National Heart, Lung, and Blood Institute (R01HL080467, R01‐HL043851, HL43851, K08HL094375, HL080467)
National Cancer Institute (CA-47988, R01CA047988)
Topics: Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
Keywords: lipoprotein particle number, cardiovascular risk prediction, women, LDL cholesterol, HDL cholesterol, triglycerides, apolipoprotein B, apolipoprotein A-I, LDL/HDL ratio, lipoprotein particle size, incident cardiovascular disease, cardiovascular risk factors, coronary artery disease, stroke, cardiovascular mortality, cardiovascular hospitalization
MeSH terms: Calibration, Cardiovascular Diseases, Female, Humans, Lipids, Lipoproteins, HDL, Lipoproteins, LDL, Magnetic Resonance Spectroscopy, Particle Size, Prospective Studies, Cohort Studies

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Lipoprotein particle profiles by nuclear magnetic resonance compared with standard lipids and apolipoproteins in predicting incident cardiovascular disease in women.

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