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This version published online on February 1, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-1295
A more recent version of this article appeared on April 1, 2005
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Submitted on July 5, 2004
Accepted on January 24, 2005

Small, dense lipoprotein particles and reduced paraoxonase-1 in patients with the metabolic syndrome

Marie-Claude Blatter Garin, Barbara Kalix, Alfredo Morabia, and Richard W. James*

Clinical Diabetes Unit, Department of Endocrinology, Diabetes and Nutrition and Department of Clinical Epidemiology, University Hospital, Geneva, Switzerland

* To whom correspondence should be addressed. E-mail: Richard.James{at}hcuge.ch.

The presence of the metabolic syndrome (WHO definition) and its association with lipoprotein abnormalities suggestive of greater susceptibility to oxidative stress have been analyzed in patients with angiographically-defined coronary artery disease. The odds ratio for the presence of the metabolic syndrome was significantly higher in CAD positive patients (P < 0.001). The metabolic syndrome was also associated with more severe coronary disease (P < 0.01). Patients with the metabolic syndrome had significantly decreased LDL-cholesterol/apo B and HDL-cholesterol/apo AI ratios, indicative of the presence of small, dense lipoprotein particles. The syndrome was also associated with reduced concentrations and activities of the anti-oxidant enzyme, paraoxonase-1. The metabolic syndrome is characterized by smaller, denser lipoprotein particles that increase their susceptibility to oxidative modifications, and diminished serum paraoxonase-1, which is a major determinant of the anti-oxidant capacity of high density lipoproteins. These may be contributory factors to the increased presence and severity of coronary disease in such patients.
Key words: Oxidative stress • atherosclerosis • HDL • diabetes




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