Body fat distribution, plasma lipoproteins and the risk of coronary heart disease of male subjects.

Recent studies have related waist to hip ratio (WHR) to the incidence of coronary heart disease (CHD), but the causes underlying this relation are not fully known. The purpose of this study was to determine if waist to hip ratio is associated with the concentration of plasma lipids and apolipoproteins (apoproteins) that predispose individuals to a higher CHD risk. Plasma lipids and apoprotein concentrations were determined in 100 male volunteers, ranging in age from 19-68 yr, and WHR ranging from 0.89-1.09. Significant positive associations were found between WHR, plasma glucose (r = 0.25, P = 0.01), cholesterol (r = 0.21, P = 0.04), LDL cholesterol (r = 0.22, P = 0.03), triglycerides (r = 0.25, P = 0.01) and the ratio of total cholesterol to HDL-cholesterol (r = 0.30, P = 0.002). Negative associations were found between WHR and HDL-cholesterol (r = -0.19, P = 0.05), plasma apoprotein A-I (4 = -0.28, P = 0.005) and the ratio of plasma apoprotein A-I to apoprotein B (r = -0.26, P = 0.01). To determine the extent to which these correlations were independent of age and body fat content, a subsample of 15 pairs matched on age and percent body fat, but differing in WHR was selected from the larger sample. In the group with high WHR (1.06) HDL-cholesterol and apo A-I levels were lower and apo B higher than in the group with low WHR (0.96). Total cholesterol, triglycerides and LDL cholesterol levels in the group with high WHR were also higher but marginally significant statistically. These results show that WHR is associated with plasma lipid and apolipoprotein concentrations that are more predisposing to CHD and that males with male type obesity may be at a higher risk of CHD development than those with female type, regardless of age or degree of obesity.