Plasma lipoprotein subclass variation in middle-aged and older adults: Sex-stratified distributions and associations with health status and cardiometabolic risk factors

Reika Masuda; Julien Wist; Samantha Lodge; Torben Kimhofer; Michael Hunter; Jennie Hui; John P Beilby; John R Burnett; Girish Dwivedi; Markus P Schlaich; Sze-How Bong; Ruey Leng Loo; Elaine Holmes; Jeremy K Nicholson; Bu B Yeap

doi:10.1016/j.jacl.2023.06.004

Plasma lipoprotein subclass variation in middle-aged and older adults: Sex-stratified distributions and associations with health status and cardiometabolic risk factors

J Clin Lipidol. 2023 Sep-Oct;17(5):677-687. doi: 10.1016/j.jacl.2023.06.004. Epub 2023 Jul 1.

Authors

Affiliations

¹ Australian National Phenome Centre, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia.
² Australian National Phenome Centre, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia; Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia; Chemistry Department, Universidad del Valle, 76001, Cali, Colombia.
³ Australian National Phenome Centre, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia; Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia.
⁴ School of Population and Global Health, University of Western Australia, Perth, WA, 6009, Australia.
⁵ PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, WA, 6009, Australia.
⁶ School of Biomedical Sciences, University of Western Australia, Perth, WA, 6009, Australia.
⁷ Department of Clinical Biochemistry, PathWest Laboratory Medicine, Royal Perth Hospital & Fiona Stanley Hospital Network, Perth, WA, 6000, Australia; Medical School, University of Western Australia, Perth, WA, 6009, Australia.
⁸ Medical School, University of Western Australia, Perth, WA, 6009, Australia; Harry Perkins Institute of Medical Research, Perth, WA, 6150, Australia; Department of Cardiology, Fiona Stanley Hospital, Perth, WA, 6150, Australia.
⁹ Medical School, University of Western Australia, Perth, WA, 6009, Australia; Dobney Hypertension Centre, Royal Perth Hospital Medical Research Foundation, University of Western Australia, Perth, WA, 6000, Australia; Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, WA, 6000, Australia.
¹⁰ Australian National Phenome Centre, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia; Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, United Kingdom.
¹¹ Australian National Phenome Centre, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia; Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, 6150, Australia; Medical School, University of Western Australia, Perth, WA, 6009, Australia; Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, United Kingdom. Electronic address: jeremy.nicholson@murdoch.edu.au.
¹² Medical School, University of Western Australia, Perth, WA, 6009, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth WA, 6150, Australia. Electronic address: bu.yeap@uwa.edu.au.

PMID: 37442713
DOI: 10.1016/j.jacl.2023.06.004

Abstract

Background: Circulating lipids and lipoproteins mediate cardiovascular risk, however routine plasma lipid biochemistry provides limited information on pro-atherogenic remnant particles.

Objective: We analysed plasma lipoprotein subclasses including very low-density and intermediate-density lipoprotein (VLDL and IDL); and assessed their associations with health and cardiometabolic risk.

Methods: From 1,976 community-dwelling adults aged 45-67 years, 114/1071 women (10.6%) and 153/905 men (16.9%) were categorised as very healthy. Fasting plasma lipoprotein profiles comprising 112 parameters were measured using ¹H nuclear magnetic resonance (NMR) spectroscopy, and associations with health status and cardiometabolic risk factors examined.

Results: HDL cholesterol was higher, and IDL and VLDL cholesterol and triglycerides lower, in very healthy women compared to other women, and women compared to men. IDL and VLDL cholesterol and triglyceride were lower in very healthy men compared to other men. HDL cholesterol and apolipoprotein (apo) A-I were inversely, and IDL and VLDL cholesterol, apoB-100, and apoB-100/apoA-I ratio directly associated with body mass index (BMI) in women and men. In women, LDL, IDL and VLDL cholesterol increased with age. Women with diabetes and cardiovascular disease had higher cholesterol, triglycerides, phospholipids and free cholesterol across IDL and VLDL fractions, with similar trends for men with diabetes.

Conclusion: Lipoprotein subclasses and density fractions, and their lipid and apolipoprotein constituents, are differentially distributed by sex, health status and BMI. Very healthy women and men are distinguished by favorable lipoprotein profiles, particularly lower concentrations of VLDL and IDL, providing reference intervals for comparison with general populations and adults with cardiometabolic risk factors.

Keywords: Apolipoproteins; Cardiovascular disease; Cholesterol; Diabetes; Lipoproteins; Nuclear magnetic resonance spectroscopy; Triglycerides.

MeSH terms

Aged
Apolipoprotein B-100
Cardiometabolic Risk Factors*
Cholesterol
Cholesterol, HDL
Cholesterol, VLDL
Diabetes Mellitus*
Female
Health Status
Humans
Lipoproteins
Lipoproteins, VLDL
Male
Middle Aged
Triglycerides

Substances

Apolipoprotein B-100
Cholesterol, VLDL
Cholesterol, HDL
Lipoproteins
Lipoproteins, VLDL
Cholesterol
Triglycerides