Proatherogenic or antiatherogenic high density lipoprotein type in acute coronary syndrome and healthy male person

  • Marita Kaniawati
  • Irawan Yusuf
  • Syakib Bakri
  • Anwar Santoso


Aim: To make proatherogenic/antiatherogenic HDL type criteria using Apolipoprotein A-I (ApoA-I), Paraoxonase-1 (PON-1), Neopterin and HDL-cholesterol levels, which may be useful in clinical practice.

Methods: This was a case control study recruiting 52 subjects with Acute Coronary Syndrome (ACS) and 30 control healthy subjects. HDL type was classifi ed into antiatherogenic and  proatherogenic based on the levels of ApoA-I, PON-1, Neopterin and HDL-cholesterol. Concentrations of ApoA-I was measured by immunoturbidimetry method, PON-1 was measured by colorimetric method, Neopterin was measured by ELISA, and HDL-C was determined by homogenous method. Univariate logistic regression analysis was done using ACS as a dependent variable and levels of ApoA-I, PON-1, Neopterin andHDL-cholesterol as independent variables. Proatherogenic/ antiatherogenic HDL type was determined by using ApoA-I, PON-1, Neopterin and HDL-cholesterol cut off and odd ratios.

Results: Patientâs age was 50.89 + 12.63 year, HDL-C was 39.82 + 9.84 mg/dL, Apo A-1 was 119.77 + 32.05 mg/ dL, PON-1 was 41.26 + 18.19 kU/L, Neopterin was 16.22 + 38.10 nmol/L. Cut offs of ApoA-I, PON-1 and Neopterin successively were 124.5 mg/dL, 40.8 kU/L, and 7.016 nmol/L. On univariate logistic regression analysis showed that OR of ApoA-I, PON-1 and Neopterin respectively were 29.759 (95% CI : 4.074 â 217.382), 1.647 (95% CI : 0.412 â 6.586), 4.317 (95% CI : 1.098 â 16.977). Using scoring system, we concluded that total score > 18 was proatherogenic HDL type, and total score < 18 was antiatherogenic HDL type. With this scoring we found 78.85% had proatherogenic HDL type in ACS population.

Conclusions: Dysfunctional HDL or proatherogenic/anti atherogenic  HDL type can be predicted by using ApoA-Iâ PON-1âNeopterinâHDL-cholesterol scoring system. Those with score of 18 are supposed to have antiatherogenic HDL type, and those with score of > 18 were having proatherogenic HDL type. (Med J Indones 2010; 19:228-34)

Keywords: ApoliproteinA-I (ApoA-I), HDL-cholesterol, neopterin, paraoxonase-1 (PON-1), proatherogenic/antiatherogenic HDL


Kontush A, Chapman MJ. Functionally defective high-density lipoprotein: A new therapeutic target at the crossroads of dyslipidemia, infl ammation, and atherosclerosis. harmacological Reviews 2006; 58 : 342-74.

Smith JD. Dysfunctional HDL as a diagnostic and therapeutic target. Arterioscler Thromb Vasc Biol. 2010; 30 : 151-5.

Navab M, Ananthramaiah GM, Reddy ST. Thematic Review Series : The pathogenesis of atherosclerosis. The oxidation hypothesis of atherogenesis : the role of oxidized phospholipids and HDL. Journal of Lipid Research. 2004 ; 45 : 993-1007.

Khovidhunkit W, Memon RA, Feingold KR, Grunfeld C. Infection and infl ammation-induced changes of lipoproteins. The Journal of Infectious Diseases. 2000 ; 181 (suppl 3) : S462-S72.

Zhang Y, Zanotti I, Reilly MP, Glick JM, Rothblat GH, Rader DJ. Overexpression of apoliprotein A-I promotes reverse transport of cholesterol from macrophages to feces in vitro. Circulation. 2003 ; 108 : 661-3.

Ansell BJ, Watson KE, Fogelman AM, Navab M, Fonarow GC. High - Density Lipoprotein function. J. Am coll cardiol. 2005 ; 46 : 1792-8.

Rosenblat M, Vaya J, Shih D, Aviram M. Paraoxonase 1 (PON1) enhances HDL-mediated macrophage cholesterol effl ux via the ABCA transporter in associationwith increased HDL binding to the cells : A possible role for lysophosphatidylcholine. Atherosclerosis. 2005 ; 179 : 69-77.

Tward A, Xia YR, Wang XP, Shi YS, Park C, Castellani LW. Decreased atherosclerosis lesion formation in human serum paraoxonase transgenic mice. Circulation. 2002 ; 106 : 484-90.

Assmann G, Nofer JR. Atheroprotective effects of highdensity lipoproteins. Ann Rev Med .2003 ; 54 : 321-41.

Van Lenten BJ, Navab M, Shih D, Fogelman AM, Lusis AJ. The role of high-density lipoproteins in oxidation and infl ammation. Trens Cardiovasc Med. 2001; 11 : 155-61.

Burger D, Dayer JM. High-density lipoprotein-associated apolipoprotein A-I : the missing link between infection and chronic infl ammation Autoimmun Rev 2002 ; 1 : 111-7.

Liao XL, Lou B, Ma J, Wu MP. Neutrophils activation can be diminished by apolipoprotein A-I. Life Sci 2005 ; 77 : 325-35.

Sampietro T, Bigazzi F, Dal Pino B, Fusaro S, Greco F, Tuoni M, et al. Increased plasma C-reactive protein in familial hypoalphalipoproteinemia : A proinfl ammatory condition Circulation. 2002 ; 105 : 11-4.

Pirro M, Siepi D, Lupattelli G. Plasma C-Reactive Protein in Subjects with Hypo/Hyperalphalipoproteinemias. Metabolism 2003 ; 52/4:432-6.

Kent JW, Comuzzie AG, Mahaney MC, Almasy L, Rainwataer DL, van de Berg, et al. Intercellular adhesion molecule-1 concentration is genetically correlated with insulin resistance, obesity, and HDL concentration in Mexican Americans. Diabetes. 2004 ; 53 : 2691-5.

Kaski JC, Avanzas P, Arroyo-Espliguero R. 2005. Neopterin : Still a Forgotten Biomarker. Clinical Chemistry. 2005 ; 51/10 : 1902-3. 234 Kaniawati et al. Med J Indones

Barter PJ, Calabresi L, Gotto AM, Nicholls SJ, Schaefer EJ, editors. Should HDL be a target of therapy ? An educational symposium of the XV International Symposium on therosclerosis; 2009 June 14-18; Boston, MA, USA: Fondazione Giovanni Lorenzini Medical Science Foundation; 2009.

Nicholls SJ, Hazen SL. Myeloperoxidase and Cardiovascular Disease. Arterioscler Thromb Vasc Biol 2005 ; 25 : 1102-11.

How to Cite
Kaniawati M, Yusuf I, Bakri S, Santoso A. Proatherogenic or antiatherogenic high density lipoprotein type in acute coronary syndrome and healthy male person. Med J Indones [Internet]. 2010Nov.1 [cited 2024Mar.3];19(4):228-34. Available from:
Basic Medical Research

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