Association between Very Low-Density Lipoprotein Cholesterol (VLDL-C) and Carotid Intima-Media Thickness in Postmenopausal Women Without Overt Cardiovascular Disease and on LDL-C Target Levels

• Main Authors: Marco Gentile, Arcangelo Iannuzzi, Francesco Giallauria, Antonello D’Andrea, Elio Venturini, Mario Pacileo, Giuseppe Covetti, Camilla Panico, Amalia Mattiello, Giuseppe Vitale, Filippo Maria Sarullo, Paolo Rubba, Carlo Vigorito, Salvatore Panico, Gabriella Iannuzzo
• Format: Article
• Language: English
• Published: MDPI AG 2020-05-01
• Series: Journal of Clinical Medicine
• Subjects: VLDL; atherosclerosis; carotid intima-media thickness; women; menopause
• Online Access: https://www.mdpi.com/2077-0383/9/5/1422

Background: atherosclerotic process inexorably advances in patients reaching low-density lipoprotein cholesterol (LDL-C) targets. An attractive hypothesis is that lipoprotein particles (very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL)), could contribute to residual risk. The present study aims to investigate the relationship between carotid intima-media thickness (IMT) and different lipoprotein subfractions in a cohort of healthy postmenopausal women. Methods: 75 postmenopausal women, at LDL-C target levels without overt cardiovascular disease, underwent biochemical analyses (including subfraction assay of plasma lipoproteins) and carotid ultrasound examination. Results: a statistically significant correlation between VLDL and carotid IMT (<i>p</i> < 0.001) was found. No significant correlation was found between carotid IMT and LDL-C (<i>p</i> = 0.179), IDL-C (<i>p</i> = 0.815), high-density lipoprotein (HDL) (<i>p</i> = 0.855), and LDL score (<i>p</i> = 0.240). Moreover, IMT is significantly correlated to LDL particle diameter (<i>p</i> = 0.044). After adjusting for age, systolic blood pressure, body mass index, smoking habits, glucose plasma concentration, and Lipoprotein(a) (Lpa) levels, multivariate analysis showed that women in the third tertile of VLDL-C, compared with those in the first tertile, were significantly associated to the highest IMT (<i>p</i> = 0.04). Conclusions: in this cohort of postmenopausal women, VLDL-C was significantly associated to carotid IMT, independent of main cardiovascular risk factors. These findings pave the way for targeting circulating concentrations of VLDL-C to reduce cardiovascular events in patients with target LDL-C levels.