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Low-Density Lipoprotein Subclass Distribution Pattern and Adiposity-Associated Dyslipidemia in Postmenopausal Women

Chicago Center for Clinical Research, Chicago, Illinois

Address reprint requests to: Kevin C. Maki, PhD, Chicago Center for Clinical Research, 515 North State Street, 27^th Floor, Chicago, Illinois 60610

Objective: A predominance of small, dense low-density lipoprotein (LDL) particles (subclass pattern B) is associated with increased risk for coronary heart disease and is characterized by elevated triglycerides and depressed high-density lipoprotein (HDL) cholesterol concentrations. The present analysis was undertaken to assess the impact of LDL subclass distribution pattern and adiposity on serum lipids in postmenopausal women.

Methods: Anthropometric measurements and fasting lipid data were obtained from 254 postmenopausal women 70 years of age or younger, not receiving sex hormone replacement, who were participating in a clinical trial designed to assess the influence of hormone replacement regimens on coronary heart disease risk markers.

Results: The prevalence of LDL subclass pattern B was 32%. Triglyceride levels were higher and HDL cholesterol lower (both p<0.001) in women with pattern B vs. pattern A, but total and LDL cholesterol levels did not differ. LDL subclass pattern contributed independently to the variance in HDL cholesterol (p<0.001) and log_e triglyceride (p<0.001) concentrations explained by anthropometric variables (waist circumference or body mass index). Compared to women with LDL subclass pattern A and waist circumference below the median value of 83.0 centimeters, those with pattern B and waist 83.0 centimeters had markedly lower HDL cholesterol levels [44.0 (41.6–47.4) vs. 57.2 (54.1–60.3) mg/dL, mean (95% CI)] and increased triglyceride concentrations [geometric mean 147.8 (131.6–165.7) vs. 95.4 (88.2–102.5) mg/dL].

Conclusions: These data suggest that adiposity and LDL subclass distribution pattern are independent determinants of plasma triglyceride and HDL cholesterol concentrations in postmenopausal women.

Key words: lipoproteins, hyperlipidemia, obesity, body fat distribution

Abbreviations: BMI=body mass index • EPAT=Eating Pattern Assessment Tool • HDL=high-density lipoprotein • LDL=low-density lipoprotein • Log_e=natural logarithm • MET=metabolic equivalents

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