Prospective association of hdl functions and coronary artery disease in the general population. Lifestyle interventions as a modulatory factor
- Autores: Albert Sanllorente Melenchon
- Directores de la Tesis: Álvaro Hernáez Camba (dir. tes.), Montserrat Fitó Colomer (codir. tes.)
- Lectura: En la Universitat Pompeu Fabra ( España ) en 2021
- Idioma: español
- Tribunal Calificador de la Tesis: Rosa María Lamuela Raventós (presid.), Camille Lassale (secret.), Alberto Goday Arno (voc.)
- Programa de doctorado: Programa de Doctorado en Biomedicina por la Universidad Pompeu Fabra
- Materias:
- Enlaces
- Tesis en acceso abierto en: TDX
- Resumen
Background: High-density lipoprotein (HDL) functions have arisen as alternative biomarkers to better explain HDL atheroprotective capacity rather than HDL cholesterol levels.
Aims: To study the association between HDL functions and the incidence of coronary artery disease, and assess the capacity of lifestyle interventions to improve HDL functions.
Methods: We studied several HDL functional determinations in three population-based studies. First, we analyzed the association between HDL functions and the incidence of coronary artery disease in a general population (REGICOR study). Second, we evaluated the association between changes in the consumption of key Mediterranean diet food groups and HDL functions in individuals at high cardiovascular risk (PREDIMED study). Third, we examined the effect of an intervention with an energy-restricted Mediterranean diet and physical activity on HDL functions in a population with metabolic syndrome (PREDIMED-plus study). Finally, we performed a systematic review of randomized controlled trials evaluating the effects of lifestyle modifications on HDL functions.
Results: High HDL levels of complement component 3 and low concentrations of apolipoprotein A-I and sphingosine-1-phosphate in HDL particles were associated with a greater incidence of coronary artery disease. Regular consumption of virgin olive oil, nuts, legumes, whole grains, and fish was associated with improved HDL function. In addition, the lifestyle intervention with an energy-restricted Mediterranean diet and physical activity enhanced the HDL role in triglyceride metabolism. Finally, evidence summarized in the systematic review suggested that dietary interventions with polyunsaturated fatty acids and dietary antioxidants improve HDL functions.
Conclusion: Dysfunctional HDLs are a risk factor for coronary artery disease in the general population. Several lifestyle modifications are capable of increasing HDL functionality in individuals at high cardiovascular risk.
