The type of
dyslipidemia in patients with
peripheral arterial disease (PAD) is still ill defined. PAD patients often show elevated
triglycerides and reduced
HDL-cholesterol, two
lipid abnormalities usually accompanied by decreased
LDL size in the "atherogenic
lipoprotein phenotype" (ALP). We investigated (1) whether PAD patients have lower
LDL size, (2) altered
LDL subclass distribution and (3) the prevalence of ALP. We measured plasma
lipids and
LDL size and subclasses by gradient gel electrophoresis in 31 adults with
intermittent claudication and 31 age-BMI-matched controls. Patients had higher prevalence of
hypertension (p=.0132), smoking (p<.0020) and diabetes (p=.0024), with lower
HDL-cholesterol (p<.0001) and increased
triglycerides (p=.0057);
LDL size was smaller (p<.0001), with decreased larger subclasses (
LDL-I, p<.0001;
LDL-IIA, p=.0068) and increased smaller particles (
LDL-IIIA, p<.0001;
LDL-IIIB, p=.0013;
LDL-IVA, p=.0029;
LDL-IVB, p<.0001). The presence of PAD was independently associated with smoking (OR 7.2, p=.0099),
hypertension (OR 6.5, p=.0362), diabetes (OR 5.5, p=.0450) and elevated small, dense
LDL (OR 6.7, p=.0497). The concomitant presence of high
triglycerides, low
HDL-cholesterol and elevated small, dense
LDL in patients was 26% (versus 0% controls, p=.0024). ALP seems to characterize PAD
dyslipidemia, but prospective studies are needed to test whether this
lipoprotein phenotype may represent a risk factor too.