Background-The crucial function of hepatic lipase (HL) in lipid metabolism has been well established, but the relationship between HL activity and coronary artery disease (CAD) is disputed. Methods and Results-We measured HL activity in the postheparin plasma of 200 consecutive men undergoing elective coronary angiography and determined the degree of CAD with the extent score, which has been shown to be better correlated with known risk factors than other measures of CAD extent. We found a

more »

... ficant inverse correlation between HL activity and the extent of CAD (rϭϪ0.19, PϽ0.01). This association was mainly due to patients with HDL levels Ͼ0.96 mmol/L (nϭ94, rϭϪ0.30, PϽ0.005). HL activity was lower in 173 patients with CAD than in 40 controls with normal angiograms (286Ϯ106 versus 338Ϯ108 nmol · mL Ϫ1 · min Ϫ1 , PϽ0.01). To correct for potential confounding factors, we performed multivariate analyses that confirmed the independent association of HL activity with CAD extent. In addition, the presence of the T allele at position Ϫ514 in the HL promoter, which leads to a reduced HL promoter activity, was associated with lower HL activity (rϭ0.30, PϽ0.001) and higher CAD extent (42.2Ϯ20.8 versus 35.3Ϯ23.6 [extent score], PϽ0.05). In patients with heterozygous familial hypercholesterolemia, calcified lesions in ECG-gated spiral computed tomography were higher in patients with low HL activity (6.3Ϯ6.8 versus 1.5Ϯ3.1, Pϭ0.01). Conclusions-Our data show that low HL activity is associated with CAD. Therefore, HL might be useful for CAD risk estimation and might be a target for pharmacological intervention. (Circulation. 2001;104:3057-3062.)