Relations of plasma TG and HDL-C concentrations to body composition and plasma insulin levels are altered in men with small LDL particles.

Abstract

Low-density lipoprotein (LDL) subclass pattern B is characterized by a predominance of small, dense LDL particles (LDL peak particle size ^255 A), increased plasma triglyceride (TG) levels, reduced high-density lipoprotein (HDL) cholesterol levels, and glucose intolerance. This study tested the hypothesis that there are differences in the regulation of TG and HDL metabolism by insulin in patients with LDL pattern B. The study group comprised 160 healthy older (60±8 years, mean±SD) men. Forty-nine of the men (31%) had LDL pattern B. These men had a higher waist-to-hip ratio (WHR) (0.98±0.06 versus 0.95±0.06, P<.005) and lower maximal aerobic capacity (Vo 2 max) (P<.005) than the 111 men of comparable age with a predominance of larger LDL particles (LDL peak particle size >255 A, LDL pattern A). Men with LDL pattern B also had higher TG (1.76+0.60 versus 1.03±0.41 mmol/L, P<.0001) and lower HDL cholesterol (0.83±0.13 versus 1.06±0.29 mmol/L, P<.0001) and percent HDL 2 subspecies (by gradient gel electrophoresis) (31±4 versus 43±6, P<.0001) levels than men with LDL pattern A, but the total cholesterol and LDL cholesterol levels did not differ between groups. Fasting glucose and insulin levels also did not differ between groups, but plasma glucose and insulin levels measured at 90 and 120 minutes during an oral glucose tolerance test were E levated levels of low-density lipoprotein (LDL) cholesterol (LDL-C) and reduced levels of high-density (HDL) lipoprotein cholesterol (HDL-C) are risk factors for coronary artery disease. 1 -2 Both LDL and HDL are polymorphic and consist of different subclasses of particles of varying size, density, distribution, and composition. Most individuals can be classified on the basis of their LDL particle size distribution into one of two LDL subclass patterns.3 Individuals with a predominance of small LDL particles (LDL peak particle size <, 255 A) are characterized as having LDL subclass pattern B, while those with a predominance of larger, more buoyant LDL particles (LDL peak particle size >255 A) are characterized as having LDL subclass pattern A. Individuals with LDL pattern © 1994 American Heart Association, Inc.significantly higher in men with LDL pattern B. This was associated with a higher prevalence of impaired glucose tolerance in men with LDL B compared with men with LDL A (49% versus 24%, / > <.005). The differences in lipoprotein lipid levels and glucose tolerance between groups persisted after correcting for differences (by ANCOVA) in WHR and VOjmax. Multiple linear regression analyses with interaction terms demonstrated that the regression equations delineating the relations of plasma TG and HDL to insulin levels differed significantly; men with LDL pattern B had higher plasma TG and lower HDL cholesterol levels at each plasma insulin level than men with LDL pattern A (P<.001). The relation between HDL and TG levels and body composition also differed: men with LDL pattern B had lower HDL cholesterol levels at each percent body fat (P<.005) and higher TG levels at...

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