The emerging anti-inflammatory role of HDL-cholesterol, illustrated in cardiovascular disease free population; the ATTICA study

Objective: In this work we assessed the relationship between HDL- cholesterol levels and various inflammation markers status in a sample of cardiovascular disease free adult men and women from Greece. Methods: The ATTICA study is a population- based cohort that has randomly enrolled 1128 men and 1154 women (aged >18 years old), stratified by age - gender, from the greater area of Athens, during 2001 - 2002. Adherence to Mediterranean diet was assessed through a diet-score that was based on a validated food- frequency questionnaire. In this study we assessed the relationship between HDL- cholesterol levels and inflammation markers ( high sensitivity C- reactive protein, interleukin- 6, homocysteine and amyloid- a), after taking into account the effect of several confounders. Results: 46% of men and 40% of women had total serum cholesterol levels >200 mg/ dl, while 21% of men and 7% of women had HDL-cholesterol levels <35 mg/ dl. The mean value for HDL- cholesterol was 53 +/- 14 mg/ dl in females and 44 +/- 14 mg/ dl in males. HDL- cholesterol levels were inversely correlated to the hs- CRP levels ( b=- 0.028, P= 0.001) and homocysteine levels ( b=- 0.039, P= 0.036), after adjustment for sex, age, body mass index, physical activity status, smoking, total cholesterol levels, lipid lower agents, ethanol intake and diabetes mellitus; while no statistical significance was found between HDL- cholesterol levels and interleukin- 6 and serum amyloid- a. Conclusions: In this work we evaluated the inverse relationship between HDL- cholesterol levels and inflammatory markers in a sample adult cardiovascular disease free population. This study among others illustrates the anti- inflammatory emerging role of HDL- cholesterol in reducing cardiovascular risk. (C) 2006 Elsevier Ireland Ltd. All rights reserved.