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Original Research| Volume 17, ISSUE 2, P261-271, March 2023

The association between triglyceride-rich lipoproteins, circulating leukocytes, and low-grade inflammation: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Published:February 07, 2023DOI:https://doi.org/10.1016/j.jacl.2023.01.007

      Highlights

      • Triglyceride-rich lipoproteins (TRLs) were independently associated with GlycA.
      • Medium and large TRLs were the main TRL subclasses related to GlycA.
      • Medium, large, and very large TRLs were associated with circulating leukocytes.
      • TRLs were more strongly related to neutrophils and lymphocytes than monocytes.
      • The total number of TRLs was not associated with C-reactive protein.

      Background

      Experimental studies have linked triglyceride-rich lipoproteins (TRLs) to inflammation, but the extent of this phenomenon in vivo has not been completely elucidated.

      Objective

      We investigated the association between TRL subparticles and inflammatory markers (circulating leukocytes, plasma high-sensitivity C-reactive protein [hs-CRP], and GlycA) in the general population.

      Methods

      This was a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TRLs (number of particles per unit volume) and GlycA were measured by nuclear magnetic resonance spectroscopy. The association between TRLs and inflammatory markers was determined by multiple linear regression models adjusted for demographic data, metabolic conditions, and lifestyle factors. Standardized regression coefficients (beta) with 95% confidence intervals are reported.

      Results

      The study population comprised 4,001 individuals (54% females, age 50 ± 9 years). TRLs, especially medium and large subparticles, were associated with GlycA (beta 0.202 [0.168, 0.235], p<0.001 for total TRLs). There was no association between TRLs and hs-CRP (beta 0.022 [-0.011, 0.056], p = 0.190). Medium, large, and very large TRLs were associated with leukocytes, with stronger connections with neutrophils and lymphocytes than monocytes. When TRL subclasses were analyzed as the proportion of the total pool of TRL particles, medium and large TRLs were positively related to leukocytes and GlycA, whereas smaller particles were inversely associated.

      Conclusions

      There are different patterns of association between TRL subparticles and inflammatory markers. The findings support the hypothesis that TRLs (especially medium and larger subparticles) may induce a low-grade inflammatory environment that involves leukocyte activation and is captured by GlycA, but not hs-CRP.

      Graphical abstract

      Keywords

      Abbreviations:

      ASCVD (Atherosclerotic cardiovascular disease), BMI (Body mass index), CAC (Coronary artery calcification), ELSA-Brasil (Brazilian Longitudinal Study of Adult Health), HDL (High-density lipoprotein), hs-CRP (High-sensitivity C-reactive protein), LDL (Low-density lipoprotein), NMR (Nuclear magnetic resonance), TRL (Triglyceride-rich lipoprotein)
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