{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:00:34Z","timestamp":1788908434542,"version":"build-2803163510"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,7,16]]},"abstract":"<jats:sec id=\"jah39783-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The cholesterol efflux capacity of high density lipoprotein (HDL) is negatively associated with cardiovascular risk. Small HDL particles account almost quantitatively for cholesterol efflux capacity, perhaps mediated through efflux of cholesterol and outer leaflet plasma membrane phospholipids by ABCA1 (ATP binding cassette subfamily A member 1). People with type 1 diabetes are at increased coronary artery disease (CAD) risk despite normal HDL\u2010cholesterol concentrations. We therefore tested the hypothesis that small HDL particles (HDL\u2010P)\u2014rather than HDL\u2010cholesterol\u2014predict incident CAD in type 1 diabetes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah39783-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Incident CAD (CAD death, myocardial infarction, or coronary revascularization) was determined in 550 individuals with childhood\u2010onset type 1 diabetes. HDL\u2010P was quantified by calibrated ion mobility analysis and cholesterol efflux capacity was quantified with validated assays. During a median follow\u2010up of 26\u2009years, 36.5% of the participants developed incident CAD, for an incidence density of 181.3 per 10\u2009000 person\u2010years. In multivariable Cox models, neither HDL\u2010cholesterol nor apolipoprotein A1 concentration was significantly associated with CAD risk. In contrast, higher extra\u2010small HDL\u2010P concentrations were significantly associated with decreased CAD risk (hazard ratio [HR], 0.26 [95% CI, 0.14\u20130.50]). Weaker associations were observed for total HDL\u2010P (HR, 0.88 [95% CI, 0.83\u20130.93]), small HDL (HR, 0.83 [95% CI, 0.68\u20131.02]), medium HDL (HR, 0.79 [95% CI, 0.71\u20130.89]), and large HDL (HR, 0.72 [95% CI, 0.59\u20130.89]). Although cholesterol efflux capacity was negatively associated with incident CAD, this association was no longer significant after adjustment for total HDL\u2010P.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah39783-sec-0003\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Lower concentrations of total HDL\u2010P and HDL subpopulations were positively associated with incident CAD independently of HDL\u2010cholesterol, apolipoprotein A1, and other common CVD risk factors. Extra\u2010small HDL was a much stronger predictor of risk than the other HDLs. Our data are consistent with the proposal that extra\u2010small HDL plays a critical role in cardioprotection in type 1 diabetes, mediated by macrophage cholesterol efflux by the ABCA1 pathway.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.034763","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T10:41:39Z","timestamp":1720003299000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["High\u2010Density Lipoprotein Particle Concentration and Size Predict Incident Coronary Artery Disease Events in a Cohort With Type 1 Diabetes"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9303-3810","authenticated-orcid":false,"given":"Tina","family":"Costacou","sequence":"first","affiliation":[{"name":"University of Pittsburgh","place":["Pittsburgh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7406-6606","authenticated-orcid":false,"given":"Tomas","family":"Vaisar","sequence":"additional","affiliation":[{"name":"University of Washington","place":["Seattle"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1845-8477","authenticated-orcid":false,"given":"Rachel G.","family":"Miller","sequence":"additional","affiliation":[{"name":"University of Pittsburgh","place":["Pittsburgh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2756-2989","authenticated-orcid":false,"given":"W. 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