Michael Dansinger1, Paul T Williams2, H Robert Superko2, Bela F Asztalos3, Ernst J Schaefer4. 1. Division of Endocrinology, Diabetes and Metabolism, Boston Heart Diagnostics, Framingham, MA, USA; Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA. Electronic address: MDansinger@BostonHeartDx.com. 2. Division of Endocrinology, Diabetes and Metabolism, Boston Heart Diagnostics, Framingham, MA, USA. 3. Cardiovascular Nutrition Laboratory, USDA Human Nutrition Research Center at Tufts University, Boston, MA. 4. Division of Endocrinology, Diabetes and Metabolism, Boston Heart Diagnostics, Framingham, MA, USA; Cardiovascular Nutrition Laboratory, USDA Human Nutrition Research Center at Tufts University, Boston, MA.
Abstract
BACKGROUND: Changes in body mass index (ΔBMI) have well-established relationships to changes in high-density lipoprotein (ΔHDL)-cholesterol concentrations; however, their relationships to ΔHDL subfractions are less well understood. OBJECTIVE: Assess the associations between ΔHDL and ΔBMI in a very large cohort. METHOD: Age and sex-adjusted Δapo A1 concentrations were measured within 10 HDL subfractions in 14,121 women and 13,969 men using two-dimensional HDL-mapping. Significance was identified at .01 < P ≤ .05 (*), .001 < P ≤ .01 (†), .0001 < P ≤ .001 (‡), and P ≤ .0001 (§). RESULTS: ΔBMI was significantly associated with Δα-1 (very large HDL, slope ± SE, females: -0.39 ± 0.07§; males: -0.51 ± 0.05§), Δα-3 (medium HDL, females: 0.18 ± 0.04§; males: 0.19 ± 0.04§), and Δα-4 (small HDL, females: 0.14 ± 0.03§; males: 0.15 ± 0.04§ mg/dL per kg/m2). As a percent of baseline, the changes in α-1 per ΔBMI were nearly twice as great as the changes in HDL-cholesterol per ΔBMI in both males (-1.53% vs -0.77%) and females (-0.79% vs -0.42%). HDL-cholesterol decreased significantly in healthy-weight patients who became overweight, overweight patients who became class I or class II obese, class I obese patients who became class II obese, and class II obese patients who became class III. In contrast, HDL-cholesterol increased in class III obese patients who became class II or class I, class II obese patients who became class I or overweight, class I patients who became overweight or healthy weight, overweight patients who became healthy weight, and healthy weight patients who became underweight. CONCLUSIONS: Weight change significantly affects HDL-cholesterol concentrations throughout the obesity spectrum. ΔBMI's effect on Δα-1 was nearly twice as great as its effect on HDL-cholesterol.
BACKGROUND: Changes in body mass index (ΔBMI) have well-established relationships to changes in high-density lipoprotein (ΔHDL)-cholesterol concentrations; however, their relationships to ΔHDL subfractions are less well understood. OBJECTIVE: Assess the associations between ΔHDL and ΔBMI in a very large cohort. METHOD: Age and sex-adjusted Δapo A1 concentrations were measured within 10 HDL subfractions in 14,121 women and 13,969 men using two-dimensional HDL-mapping. Significance was identified at .01 < P ≤ .05 (*), .001 < P ≤ .01 (†), .0001 < P ≤ .001 (‡), and P ≤ .0001 (§). RESULTS: ΔBMI was significantly associated with Δα-1 (very large HDL, slope ± SE, females: -0.39 ± 0.07§; males: -0.51 ± 0.05§), Δα-3 (medium HDL, females: 0.18 ± 0.04§; males: 0.19 ± 0.04§), and Δα-4 (small HDL, females: 0.14 ± 0.03§; males: 0.15 ± 0.04§ mg/dL per kg/m2). As a percent of baseline, the changes in α-1 per ΔBMI were nearly twice as great as the changes in HDL-cholesterol per ΔBMI in both males (-1.53% vs -0.77%) and females (-0.79% vs -0.42%). HDL-cholesterol decreased significantly in healthy-weight patients who became overweight, overweight patients who became class I or class II obese, class I obesepatients who became class II obese, and class II obesepatients who became class III. In contrast, HDL-cholesterol increased in class III obese patients who became class II or class I, class II obesepatients who became class I or overweight, class I patients who became overweight or healthy weight, overweight patients who became healthy weight, and healthy weight patients who became underweight. CONCLUSIONS: Weight change significantly affects HDL-cholesterol concentrations throughout the obesity spectrum. ΔBMI's effect on Δα-1 was nearly twice as great as its effect on HDL-cholesterol.