Martin Laclaustra1,2, Esther Lopez-Garcia2,3, Fernando Civeira4, Esther Garcia-Esquinas2, Auxiliadora Graciani2, Pilar Guallar-Castillon2,3, Jose R Banegas2, Fernando Rodriguez-Artalejo2,3. 1. Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Translational Research Unit, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain martin.laclaustra@unizar.es. 2. Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/Instituto de Investigación del Hospital La Paz (IDIPAZ), Madrid, Spain. 3. Instituto Madrileño de Estudios Avanzados-Alimentación (IMDEA-Food), Centro de Excelencia International UAM+CSIC, Madrid, Spain. 4. Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Translational Research Unit, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.
Abstract
OBJECTIVE: Elevated LDL cholesterol (LDLc) is not strongly associated with obesity or metabolic syndrome (MS), but this relationship repeatedly has been examined assuming a linear association. This study aimed to assess the dose-response relationship between body mass index (BMI) or waist circumference (WC) and LDLc and to evaluate its link to metabolic impairment. RESEARCH DESIGN AND METHODS: Participants in the continuous National Health and Nutrition Examination Survey (NHANES, 1999-2010) (n = 12,383) and the Study on Nutrition and Cardiovascular Risk (ENRICA, 2008-2010) (n = 11,765), representative samples of U.S. and Spanish noninstitutionalized populations, were cross-sectionally investigated. LDLc was modeled with age- and sex-adjusted regressions, with BMI and/or WC as explanatory variables included in models as two-segment linear and natural cubic splines. RESULTS: In NHANES and ENRICA, slopes of the BMI-LDLc association changed (P < 0.001) at BMI 27.1 and 26.5 kg/m2, respectively, forming an inverted U shape. Below these BMI inflection points, LDLc rose 2.30 and 2.41 mg/dL per kg/m2 (both P < 0.001). However, above said points, LDLc declined -0.37 and -0.38 mg/dL per kg/m2 (both P < 0.001). The WC-LDLc relationship was similar to the BMI-LDLc relationship. Accumulation of MS traits was associated with a weakening of the positive BMI-LDLc association among lean participants (below the BMI inflection point). Aging shifted the inflection point of the BMI-LDLc relationship to lower BMI values. CONCLUSIONS: The BMI- and WC-LDLc relationships have inverted U shapes. Diminishing associations between BMI and LDLc might indicate metabolic impairment as a result of aging or other metabolic diseases. In lean individuals, small weight losses might help to lower LDLc for cardiovascular prevention.
OBJECTIVE: Elevated LDL cholesterol (LDLc) is not strongly associated with obesity or metabolic syndrome (MS), but this relationship repeatedly has been examined assuming a linear association. This study aimed to assess the dose-response relationship between body mass index (BMI) or waist circumference (WC) and LDLc and to evaluate its link to metabolic impairment. RESEARCH DESIGN AND METHODS: Participants in the continuous National Health and Nutrition Examination Survey (NHANES, 1999-2010) (n = 12,383) and the Study on Nutrition and Cardiovascular Risk (ENRICA, 2008-2010) (n = 11,765), representative samples of U.S. and Spanish noninstitutionalized populations, were cross-sectionally investigated. LDLc was modeled with age- and sex-adjusted regressions, with BMI and/or WC as explanatory variables included in models as two-segment linear and natural cubic splines. RESULTS: In NHANES and ENRICA, slopes of the BMI-LDLc association changed (P < 0.001) at BMI 27.1 and 26.5 kg/m2, respectively, forming an inverted U shape. Below these BMI inflection points, LDLc rose 2.30 and 2.41 mg/dL per kg/m2 (both P < 0.001). However, above said points, LDLc declined -0.37 and -0.38 mg/dL per kg/m2 (both P < 0.001). The WC-LDLc relationship was similar to the BMI-LDLc relationship. Accumulation of MS traits was associated with a weakening of the positive BMI-LDLc association among lean participants (below the BMI inflection point). Aging shifted the inflection point of the BMI-LDLc relationship to lower BMI values. CONCLUSIONS: The BMI- and WC-LDLc relationships have inverted U shapes. Diminishing associations between BMI and LDLc might indicate metabolic impairment as a result of aging or other metabolic diseases. In lean individuals, small weight losses might help to lower LDLc for cardiovascular prevention.
Authors: Bennett K Ng; Markus J Sommer; Michael C Wong; Ian Pagano; Yilin Nie; Bo Fan; Samantha Kennedy; Brianna Bourgeois; Nisa Kelly; Yong E Liu; Phoenix Hwaung; Andrea K Garber; Dominic Chow; Christian Vaisse; Brian Curless; Steven B Heymsfield; John A Shepherd Journal: Am J Clin Nutr Date: 2019-12-01 Impact factor: 7.045
Authors: Jéssica Vicky Bernardo de Oliveira; Raquel Patrícia Ataíde Lima; Rafaella Cristhine Pordeus Luna; Alcides da Silva Diniz; Aléssio Tony Cavalcanti de Almeida; Naila Francis Paulo de Oliveira; Maria da Conceição Rodrigues Gonçalves; Roberto Texeira de Lima; Flávia Emília Leite de Lima Ferreira; Sônia Cristina Pereira de Oliveira Ramalho Diniz; Alexandre Sergio Silva; Ana Hermínia Andrade E Silva; Darlene Camati Persuhn; Maria José de Carvalho Costa Journal: PLoS One Date: 2020-12-16 Impact factor: 3.240
Authors: Nikolina Kolobarić; Maja Gradinjan Centner; Petar Šušnjara; Anita Matić; Ines Drenjančević Journal: Int J Environ Res Public Health Date: 2020-12-09 Impact factor: 3.390
Authors: Pik-Fang Kho; Frederic Amant; Daniela Annibali; Katie Ashton; John Attia; Paul L Auer; Matthias W Beckmann; Amanda Black; Louise Brinton; Daniel D Buchanan; Stephen J Chanock; Chu Chen; Maxine M Chen; Timothy H T Cheng; Linda S Cook; Marta Crous-Bous; Kamila Czene; Immaculata De Vivo; Joe Dennis; Thilo Dörk; Sean C Dowdy; Alison M Dunning; Matthias Dürst; Douglas F Easton; Arif B Ekici; Peter A Fasching; Brooke L Fridley; Christine M Friedenreich; Montserrat García-Closas; Mia M Gaudet; Graham G Giles; Ellen L Goode; Maggie Gorman; Christopher A Haiman; Per Hall; Susan E Hankinson; Alexander Hein; Peter Hillemanns; Shirley Hodgson; Erling A Hoivik; Elizabeth G Holliday; David J Hunter; Angela Jones; Peter Kraft; Camilla Krakstad; Diether Lambrechts; Loic Le Marchand; Xiaolin Liang; Annika Lindblom; Jolanta Lissowska; Jirong Long; Lingeng Lu; Anthony M Magliocco; Lynn Martin; Mark McEvoy; Roger L Milne; Miriam Mints; Rami Nassir; Geoffrey Otton; Claire Palles; Loreall Pooler; Tony Proietto; Timothy R Rebbeck; Stefan P Renner; Harvey A Risch; Matthias Rübner; Ingo Runnebaum; Carlotta Sacerdote; Gloria E Sarto; Fredrick Schumacher; Rodney J Scott; V Wendy Setiawan; Mitul Shah; Xin Sheng; Xiao-Ou Shu; Melissa C Southey; Emma Tham; Ian Tomlinson; Jone Trovik; Constance Turman; Jonathan P Tyrer; David Van Den Berg; Zhaoming Wang; Nicolas Wentzensen; Lucy Xia; Yong-Bing Xiang; Hannah P Yang; Herbert Yu; Wei Zheng; Penelope M Webb; Deborah J Thompson; Amanda B Spurdle; Dylan M Glubb; Tracy A O'Mara Journal: Int J Cancer Date: 2020-08-07 Impact factor: 7.396