Hindawi Publishing Corporation Mediators of Infammation Volume 2013, Article ID 612038, 12 pages http://dx.doi.org/10.1155/2013/612038 Research Article Implication of Low HDL-c Levels in Patients with Average LDL-c Levels: A Focus on Oxidized LDL, Large HDL Subpopulation, and Adiponectin Filipa Mascarenhas-Melo, 1 José Sereno, 1 Edite Teixeira-Lemos, 2 Daniela Marado, 3 Filipe Palavra, 1,4 Rui Pinto, 5 Petronila Rocha-Pereira, 6 Frederico Teixeira, 1 and Flávio Reis 1 1 Laboratory of Pharmacology & Experimental Terapeutics, IBILI, Faculty of Medicine, Sub-Unit 1 (P´ olo III), University of Coimbra, 3000-548 Coimbra, Portugal 2 ESAV and Educational Technologies and Health Study Center, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal 3 Internal Medicine Department, General Hospital, University and Hospital Centre of Coimbra, 3041-801 S˜ ao Martinho do Bispo, Portugal 4 Neurology Department, General Hospital, University and Hospital Centre of Coimbra, 3041-801 S˜ ao Martinho do Bispo, Portugal 5 Pharmacology and Pharmacotoxicology Unit, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal 6 Research Centre for Health Sciences, Beira Interior University, 6201-001 Covilh˜ a, Portugal Correspondence should be addressed to Fl´ avio Reis; freis@fmed.uc.pt Received 23 June 2013; Revised 26 August 2013; Accepted 30 August 2013 Academic Editor: Asım Orem Copyright © 2013 Filipa Mascarenhas-Melo et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. To evaluate the impact of low levels of high density lipoprotein cholesterol (HDL-c) on patients with LDL-c average levels, focusing on oxidative, lipidic, and infammatory profles. Patients with cardiovascular risk factors ( = 169) and control subjects ( = 73) were divided into 2 subgroups, one of normal HDL-c and the other of low HDL-c levels. Te following data was analyzed: BP, BMI, waist circumference and serum glucose Total-c, TGs, LDL-c, oxidized LDL, total HDL-c and subpopulations (small, intermediate, and large), paraoxonase-1 (PON1) activity, hsCRP, uric acid, TNF-, adiponectin, VEGF, and iCAM1. In the control subgroup with low HDL-c levels, signifcantly higher values of BP and TGs and lower values of PON1 activity and adiponectin were found, versus control normal HDL-c subgroup. However, diferences in patients’ subgroups were clearly more pronounced. Indeed, low HDL-c subgroup presented increased HbA1c, TGs, non-HDL-c, Ox-LDL, hsCRP, VEGF, and small HDL-c and reduced adiponectin and large HDL. In addition, Ox-LDL, large-HDL-c, and adiponectin presented interesting correlations with classical and nonclassical markers, mainly in the normal HDL-c patients’ subgroup. In conclusion, despite LDL-c average levels, low HDL-c concentrations seem to be associated with a poor cardiometabolic profle in a population with cardiovascular risk factors, which is better evidenced by traditional and nontraditional CV biomarkers, including Ox-LDL, large HDL-c, and adiponectin. 1. Introduction Dyslipidemia is recognized as one of the major risk factors for the development of cardiovascular disease (CVD), which is a major clinical problem worldwide. Large prospective cohort studies, such as the Framingham Heart Study and the Seven Countries Study, have been recognizing the importance of reducing major risk factors, including cholesterol levels, in particular low-density lipoprotein cholesterol (LDL-c), as a pivotal strategy to prevent the development/evolution of cardiovascular disease and related events [1–3]. However, it is now accepted that the current lipid-lowering therapies, in particular those directed to reduce LDL-c levels, such as statins, are insufcient to prevent part of the cardiovascular events; indeed, residual cardiovascular risk remains elevated even in clinical trials in which LDL-c levels have been aggressively reduced [4–6]. In fact, it has been accepted that a considerable proportion of cardiovascular events occur in