Predominance of small dense LDL differentiates metabolically unhealthy from metabolically healthy overweight adults in Korea

Metabolism. 2014 Mar;63(3):415-21. doi: 10.1016/j.metabol.2013.11.015. Epub 2013 Nov 28.

Abstract

Objective: The purposes of this study were (1) to determine the association between lipoprotein subfraction profiles and metabolically healthy overweight (MHO) phenotype, as defined by visceral adiposity; and (2) to identify the strongest predictor of metabolic health among the lipoprotein measurements.

Materials/methods: This cross-sectional study was comprised of 462 overweight patients, who were classified as MHO or non-MHO based on their visceral adipose tissue (VAT) area to subcutaneous adipose tissue area (SAT) ratio (VAT/SAT ratio). Serum lipoprotein subfraction analyses and other metabolic parameters were measured.

Results: Among the overweight participants, two hundred fifty-five individuals (53.7%) had the MHO phenotype. After adjusting for age, sex, medication, lifestyle factors, and confounding metabolic characteristics, the non-MHO group showed significantly higher lipid levels and a greater prevalence of unfavorable lipid profiles. LDL subclass pattern type B was the most significant predictor of the non-MHO phenotype (odds ratio 2.70; 95% CI 1.55-4.69), while serum LDL cholesterol level was not a significant predictor of the non-MHO phenotype.

Conclusions: Lipoprotein subfraction particle measurements were significantly associated with the non-MHO phenotype and a higher VAT/SAT ratio, with small dense LDL predominance being the most significant predictor of MHO phenotype. These findings will help identify MHO and non-MHO phenotypes and perhaps lead to a development of cost-effective individualized treatments.

Keywords: Lipoprotein subfraction; Overweight; Small dense low-density lipoprotein (LDL); Visceral to subcutaneous adipose tissue ratio (VAT/SAT ratio).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity / physiology
  • Adult
  • Body Mass Index
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intra-Abdominal Fat / metabolism
  • Korea
  • Lipoproteins / metabolism
  • Lipoproteins, LDL / blood*
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / metabolism*
  • Overweight / blood*
  • Overweight / metabolism*

Substances

  • Lipoproteins
  • Lipoproteins, LDL