High–density lipoprotein cholesterol (HDL–C) has cardio–protective effects. However, results from clinical trials showed that improving HDL–C levels alone did not reduce the cardiovascular disease (CVD) events and different HDL particles (HDL–P) subfractions may relate to different CVD risk. In this meta–analysis, we reviewed prospective studies reported relationships of HDL–P subfractions with CVD risk.

Data sources: MEDLINE, Cochrane Library and China National Knowledge Infrastructure (CNKI) were searched up to July 1st, 2013. Study selection: Prospective studies that reported an association of HDL–P subfractions with the incidence of CVD were included and studies did not assess the hazard ratio, relative risk, or odds ratio of HDL–P and studies did not adjust for any other risk factors were excluded. Data extraction and synthesis: All studies were extracted by 1 researcher and verified by another researcher. Full data were extracted from the studies meanwhile the quality was evaluated. Heterogeneity was analyzed. Pooled relative risk (RR) and 95% confidence interval were calculated.

Six studies were enrolled in this meta–analysis. HDL–P can be grouped into three subfractions: large HDL–P, medium HDL–P and small HDL–P. Only higher large HDL–P concentration was associated with decreased risk for CVD and pooled RR was 0.65 (95%CI: 0.55–0.76). Medium HDL–P and small HDL–P were not associated with the incidence of CVD events.

Higher large HDL–P concentration is associated with lower CVD risk. Assessment of HDL–P subfractions may thus be of great clinical importance for evaluating the CVD risk.

Lipoproteins HDL; Cardiovascular diseases; Meta–analysis