Diabetes Care, Vol 19, Issue 6 629-637, Copyright © 1996 by American Diabetes Association

ARTICLES

The dense LDL phenotype. Association with plasma lipoprotein levels, visceral obesity, and hyperinsulinemia in men

A Tchernof, B Lamarche, D Prud'Homme, A Nadeau, S Moorjani, F Labrie, PJ Lupien and JP Despres
Lipid Research Center, Laval University Medical (Research Center), Ste-Foy, Canada.

OBJECTIVE: To investigate the potential relationship between the cluster of metabolic abnormalities found in visceral obesity and the small dense LDL phenotype. RESEARCH DESIGN AND METHODS: We have estimated LDL peak particle size by nondenaturing 2-16% gradient gel electrophoresis in a sample of 79 men. Glucose tolerance and fasting plasma insulin and lipoprotein levels were also measured. RESULTS: The LDL particle score, calculated from migration, distances and relative band intensities and reflecting the proportion of small dense LDL particles, was positively correlated with plasma triglyceride (TG) (r = 0.60, P < 0.0001) and negatively correlated with HDL cholesterol (r = -0.56, P < 0.0001) levels. Although the LDL particle score was not associated with variations in plasma LDL cholesterol or LDL apolipoprotein (apo) B concentrations, it was significantly correlated with the LDL apo B-to-LDL cholesterol ratio (r = 0.60, P < 0.0001). Fasting plasma insulin and visceral adipose tissue (AT) areas measured by computed tomography were weakly but significantly correlated with the LDL particle score (r = 0.23 and 0.29, respectively, P < 0.05). LDL peak particle size showed similar but inverse correlations with anthropometric and metabolic variables. Subjects classified as having small dense LDL particles (by comparing subjects in the highest tertile versus those in the lowest tertile of the LDL particle score distribution) were characterized by increased plasma TG, reduced HDL cholesterol, higher fasting insulin levels, and elevated visceral AT accumulation. However, multiple regression analyses revealed that visceral AT accumulation was not an independent predictor of the dense LDL phenotype after inclusion of TG and HDL cholesterol levels and lipoprotein ratios in the model. CONCLUSIONS: It thus appears that the high TG-low HDL cholesterol dyslipidemia frequently found in visceral obesity and in a hyperinsulinemic state is a strong correlate of the small dense LDL phenotype. Although associated with the dense LDL phenotype, visceral obesity and hyperinsulinemia were not independent predictors of an increased proportion of small dense LDL particles after controlling for TG and HDL cholesterol levels.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J.-P. Despres, I. Lemieux, J. Bergeron, P. Pibarot, P. Mathieu, E. Larose, J. Rodes-Cabau, O. F. Bertrand, and P. Poirier Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk Arterioscler. Thromb. Vasc. Biol., June 1, 2008; 28(6): 1039 - 1049. [Abstract] [Full Text] [PDF]

				J.-P. Despres and H. B. Brewer Metabolic syndrome: the dysmetabolic state of dysfunctional adipose tissue and insulin resistance Eur. Heart J. Suppl., March 1, 2008; 10(suppl_B): B1 - B3. [Full Text] [PDF]

				J.-P. Despres, P. Poirier, J. Bergeron, A. Tremblay, I. Lemieux, and N. Almeras From individual risk factors and the metabolic syndrome to global cardiometabolic risk Eur. Heart J. Suppl., March 1, 2008; 10(suppl_B): B24 - B33. [Abstract] [Full Text] [PDF]

				P. Blackburn, I. Lemieux, B. Lamarche, J. Bergeron, P. Perron, G. Tremblay, D. Gaudet, and J.-P. Despres Type 2 Diabetes Without the Atherogenic Metabolic Triad Does Not Predict Angiographically Assessed Coronary Artery Disease in Women Diabetes Care, January 1, 2008; 31(1): 170 - 172. [Full Text] [PDF]

				B. J. Arsenault, I. Lemieux, J.-P. Despres, N. J. Wareham, R. Luben, J. J.P. Kastelein, K.-T. Khaw, and S. M. Boekholdt Cholesterol levels in small LDL particles predict the risk of coronary heart disease in the EPIC-Norfolk prospective population study Eur. Heart J., November 2, 2007; 28(22): 2770 - 2777. [Abstract] [Full Text] [PDF]

				C. Schindler Review: The metabolic syndrome as an endocrine disease: is there an effective pharmacotherapeutic strategy optimally targeting the pathogenesis? Therapeutic Advances in Cardiovascular Disease, October 1, 2007; 1(1): 7 - 26. [Abstract] [PDF]

				S. A. Lear, K. H. Humphries, S. Kohli, J. J. Frohlich, C. L. Birmingham, and G. B. J. Mancini Visceral Adipose Tissue, a Potential Risk Factor for Carotid Atherosclerosis: Results of the Multicultural Community Health Assessment Trial (M-CHAT) Stroke, September 1, 2007; 38(9): 2422 - 2429. [Abstract] [Full Text] [PDF]

				L. de Koning, A. T. Merchant, J. Pogue, and S. S. Anand Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies Eur. Heart J., April 2, 2007; (2007) ehm026v1. [Abstract] [Full Text] [PDF]

				A. D Sniderman, R. Bhopal, D. Prabhakaran, N. Sarrafzadegan, and A. Tchernof Why might South Asians be so susceptible to central obesity and its atherogenic consequences? The adipose tissue overflow hypothesis Int. J. Epidemiol., February 1, 2007; 36(1): 220 - 225. [Abstract] [Full Text] [PDF]

				J.-P. Despres, A. Golay, L. Sjostrom, and the Rimonabant in Obesity-Lipids Study Group Effects of Rimonabant on Metabolic Risk Factors in Overweight Patients with Dyslipidemia N. Engl. J. Med., November 17, 2005; 353(20): 2121 - 2134. [Abstract] [Full Text] [PDF]

				Y. Jang, J. H. Lee, J. S. Chae, O. Y. Kim, S. J. Koh, J. Y. Kim, H. Cho, J. E. Lee, and J. M Ordovas Association of the 276G->T polymorphism of the adiponectin gene with cardiovascular disease risk factors in nondiabetic Koreans Am. J. Clinical Nutrition, October 1, 2005; 82(4): 760 - 767. [Abstract] [Full Text] [PDF]

				S. Stan, E. Levy, E. E. Delvin, J. A. Hanley, B. Lamarche, J. O'Loughlin, G. Paradis, and M. Lambert Distribution of LDL Particle Size in a Population-Based Sample of Children and Adolescents and Relationship with Other Cardiovascular Risk Factors Clin. Chem., July 1, 2005; 51(7): 1192 - 1200. [Abstract] [Full Text] [PDF]

				G. Ferretti, T. Bacchetti, C. Moroni, S. Savino, A. Liuzzi, F. Balzola, and V. Bicchiega Paraoxonase Activity in High-Density Lipoproteins: A Comparison between Healthy and Obese Females J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1728 - 1733. [Abstract] [Full Text] [PDF]

				M. Okazaki, S. Usui, M. Ishigami, N. Sakai, T. Nakamura, Y. Matsuzawa, and S. Yamashita Identification of Unique Lipoprotein Subclasses for Visceral Obesity by Component Analysis of Cholesterol Profile in High-Performance Liquid Chromatography Arterioscler. Thromb. Vasc. Biol., March 1, 2005; 25(3): 578 - 584. [Abstract] [Full Text] [PDF]

				M.-T. Berthier, A. Houde, M. Cote, A.-M. Paradis, P. Mauriege, J. Bergeron, D. Gaudet, J.-P. Despres, and M.-C. Vohl Impact of adiponectin gene polymorphisms on plasma lipoprotein and adiponectin concentrations of viscerally obese men J. Lipid Res., February 1, 2005; 46(2): 237 - 244. [Abstract] [Full Text] [PDF]

				K. K. Miller, B. M. K. Biller, J. G. Lipman, G. Bradwin, N. Rifai, and A. Klibanski Truncal Adiposity, Relative Growth Hormone Deficiency, and Cardiovascular Risk J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 768 - 774. [Abstract] [Full Text] [PDF]

				A. Sekikawa, H. Ueshima, W. R. Zaky, T. Kadowaki, D. Edmundowicz, T. Okamura, K. Sutton-Tyrrell, Y. Nakamura, K. Egawa, H. Kanda, et al. Much lower prevalence of coronary calcium detected by electron-beam computed tomography among men aged 40-49 in Japan than in the US, despite a less favorable profile of major risk factors Int. J. Epidemiol., February 1, 2005; 34(1): 173 - 179. [Abstract] [Full Text] [PDF]

				Y. Jang, J. Y. Kim, O. Y. Kim, J. E. Lee, H. Cho, J. M Ordovas, and J. H. Lee The -1131T->C polymorphism in the apolipoprotein A5 gene is associated with postprandial hypertriacylglycerolemia; elevated small, dense LDL concentrations; and oxidative stress in nonobese Korean men Am. J. Clinical Nutrition, October 1, 2004; 80(4): 832 - 840. [Abstract] [Full Text] [PDF]

				M.-E. Piche, J.-F. Arcand-Bosse, J.-P. Despres, L. Perusse, S. Lemieux, and S. J. Weisnagel What is a Normal Glucose Value?: Differences in indexes of plasma glucose homeostasis in subjects with normal fasting glucose Diabetes Care, October 1, 2004; 27(10): 2470 - 2477. [Abstract] [Full Text] [PDF]

				J.-C. Hogue, B. Lamarche, D. Gaudet, M. Lariviere, A. J. Tremblay, J. Bergeron, I. Lemieux, J.-P. Despres, C. Gagne, and P. Couture Relationship between cholesteryl ester transfer protein and LDL heterogeneity in familial hypercholesterolemia J. Lipid Res., June 1, 2004; 45(6): 1077 - 1083. [Abstract] [Full Text] [PDF]

				Y. Bosse, L. Perusse, and M.-C. Vohl Genetics of LDL particle heterogeneity: from genetic epidemiology to DNA-based variations J. Lipid Res., June 1, 2004; 45(6): 1008 - 1026. [Abstract] [Full Text] [PDF]

				S. Desroches, J.-F. Mauger, L. M. Ausman, A. H. Lichtenstein, and B. Lamarche Soy Protein Favorably Affects LDL Size Independently of Isoflavones in Hypercholesterolemic Men and Women J. Nutr., March 1, 2004; 134(3): 574 - 579. [Abstract] [Full Text] [PDF]

				A. Wakatsuki, Y. Okatani, N. Ikenoue, K. Shinohara, K. Watanabe, and T. Fukaya Effect of Lower Dose of Oral Conjugated Equine Estrogen on Size and Oxidative Susceptibility of Low-Density Lipoprotein Particles in Postmenopausal Women Circulation, August 19, 2003; 108(7): 808 - 813. [Abstract] [Full Text] [PDF]

				M.-P. St-Onge, B. Lamarche, J.-F. Mauger, and P. J. H. Jones Consumption of a Functional Oil Rich in Phytosterols and Medium-Chain Triglyceride Oil Improves Plasma Lipid Profiles in Men J. Nutr., June 1, 2003; 133(6): 1815 - 1820. [Abstract] [Full Text] [PDF]

				C. Couillard, M.-C. Vohl, J. C. Engert, I. Lemieux, A. Houde, N. Almeras, D. Prud'homme, A. Nadeau, J.-P. Despres, and J. Bergeron Effect of apoC-III gene polymorphisms on the lipoprotein-lipid profile of viscerally obese men J. Lipid Res., May 1, 2003; 44(5): 986 - 993. [Abstract] [Full Text] [PDF]

				D. J. Nieves, M. Cnop, B. Retzlaff, C. E. Walden, J. D. Brunzell, R. H. Knopp, and S. E. Kahn The Atherogenic Lipoprotein Profile Associated With Obesity and Insulin Resistance Is Largely Attributable to Intra-Abdominal Fat Diabetes, January 1, 2003; 52(1): 172 - 179. [Abstract] [Full Text] [PDF]

				A. Wakatsuki, Y. Okatani, N. Ikenoue, and T. Fukaya Different Effects of Oral Conjugated Equine Estrogen and Transdermal Estrogen Replacement Therapy on Size and Oxidative Susceptibility of Low-Density Lipoprotein Particles in Postmenopausal Women Circulation, October 1, 2002; 106(14): 1771 - 1776. [Abstract] [Full Text] [PDF]

				C. Couillard, N. Bergeron, A. Pascot, N. Almeras, J. Bergeron, A. Tremblay, D. Prud'homme, and J.-P. Despres Evidence for impaired lipolysis in abdominally obese men: postprandial study of apolipoprotein B-48- and B-100-containing lipoproteins Am. J. Clinical Nutrition, August 1, 2002; 76(2): 311 - 318. [Abstract] [Full Text] [PDF]

				A. Wakatsuki, Y. Ogawa, T. Saibara, Y. Okatani, and T. Fukaya Size and Oxidative Susceptibility of Low-Density Lipoprotein Particles in Breast Cancer Patients with Tamoxifen-Induced Fatty Liver J. Clin. Endocrinol. Metab., August 1, 2002; 87(8): 3676 - 3681. [Abstract] [Full Text] [PDF]

				I. L. Ruel, D. Gaudet, P. Perron, J. Bergeron, P. Julien, and B. Lamarche Characterization of LDL Particle Size Among Carriers of a Defective or a Null Mutation in the Lipoprotein Lipase Gene: The Quebec LIPD Study Arterioscler. Thromb. Vasc. Biol., July 1, 2002; 22(7): 1181 - 1186. [Abstract] [Full Text] [PDF]

				M. J. Franz, J. P. Bantle, C. A. Beebe, J. D. Brunzell, J.-L. Chiasson, A. Garg, L. A. Holzmeister, B. Hoogwerf, E. Mayer-Davis, A. D. Mooradian, et al. Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications Diabetes Care, January 1, 2002; 25(1): 148 - 198. [Full Text] [PDF]

				I. Lemieux, B. Lamarche, C. Couillard, A. Pascot, B. Cantin, J. Bergeron, G. R. Dagenais, and J.-P. Despres Total Cholesterol/HDL Cholesterol Ratio vs LDL Cholesterol/HDL Cholesterol Ratio as Indices of Ischemic Heart Disease Risk in Men: The Quebec Cardiovascular Study Arch Intern Med, December 10, 2001; 161(22): 2685 - 2692. [Abstract] [Full Text] [PDF]

				A. Pascot, I. Lemieux, D. Prud'homme, A. Tremblay, A. Nadeau, C. Couillard, J. Bergeron, B. Lamarche, and J.-P. Despres Reduced HDL particle size as an additional feature of the atherogenic dyslipidemia of abdominal obesity J. Lipid Res., December 1, 2001; 42(12): 2007 - 2014. [Abstract] [Full Text] [PDF]

				A. C. St-Pierre, I. L. Ruel, B. Cantin, G. R. Dagenais, P.-M. Bernard, J.-P. Despres, and B. Lamarche Comparison of Various Electrophoretic Characteristics of LDL Particles and Their Relationship to the Risk of Ischemic Heart Disease Circulation, November 6, 2001; 104(19): 2295 - 2299. [Abstract] [Full Text] [PDF]

				J.-P. Despres Drug treatment for obesity BMJ, June 9, 2001; 322(7299): 1379 - 1380. [Full Text] [PDF]

				A. Pascot, J.-P. Després, I. Lemieux, N. Alméras, J. Bergeron, A. Nadeau, D. Prud’homme, A. Tremblay, and S. Lemieux Deterioration of the Metabolic Risk Profile in Women: Respective contributions of impaired glucose tolerance and visceral fat accumulation Diabetes Care, May 1, 2001; 24(5): 902 - 908. [Abstract] [Full Text]

				D. E. Kelley and B. H. Goodpaster Skeletal Muscle Triglyceride: An aspect of regional adiposity and insulin resistance Diabetes Care, May 1, 2001; 24(5): 933 - 941. [Abstract] [Full Text]

				J. Q. Purnell, S. E. Kahn, R. S. Schwartz, and J. D. Brunzell Relationship of Insulin Sensitivity and ApoB Levels to Intra-abdominal Fat in Subjects With Familial Combined Hyperlipidemia Arterioscler. Thromb. Vasc. Biol., April 1, 2001; 21(4): 567 - 572. [Abstract] [Full Text] [PDF]

				P. Little and C. D Byrne Abdominal obesity and the "hypertriglyceridaemic waist" phenotype BMJ, March 24, 2001; 322(7288): 687 - 689. [Full Text]

				J.-P. Després, I. Lemieux, and D. Prud'homme Treatment of obesity: need to focus on high risk abdominally obese patients BMJ, March 24, 2001; 322(7288): 716 - 720. [Full Text]

				S. I. McFarlane, M. Banerji, and J. R. Sowers Insulin Resistance and Cardiovascular Disease J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 713 - 718. [Full Text]

				B. L. Wajchenberg Subcutaneous and Visceral Adipose Tissue: Their Relation to the Metabolic Syndrome Endocr. Rev., December 1, 2000; 21(6): 697 - 738. [Abstract] [Full Text]

				I. Lemieux, A. Pascot, C. Couillard, B. Lamarche, A. Tchernof, N. Almeras, J. Bergeron, D. Gaudet, G. Tremblay, D. Prud'homme, et al. Hypertriglyceridemic Waist : A Marker of the Atherogenic Metabolic Triad (Hyperinsulinemia; Hyperapolipoprotein B; Small, Dense LDL) in Men? Circulation, July 11, 2000; 102(2): 179 - 184. [Abstract] [Full Text] [PDF]

				J. Q. Purnell, S. E. Kahn, J. J. Albers, D. N. Nevin, J. D. Brunzell, and R. S. Schwartz Effect of Weight Loss with Reduction of Intra-Abdominal Fat on Lipid Metabolism in Older Men J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 977 - 982. [Abstract] [Full Text]

				S. M. Grundy, R. Pasternak, P. Greenland, S. Smith Jr, and V. Fuster Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1348 - 1359. [Full Text] [PDF]

				S. M. Grundy, R. Pasternak, P. Greenland, S. Smith Jr, and V. Fuster Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations : A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology Circulation, September 28, 1999; 100(13): 1481 - 1492. [Full Text] [PDF]

				E. A. Enas, B. Lamarche, G. R. Dagenais, and J.-P. Despres Triglycerides and Small, Dense Low-Density Lipoprotein JAMA, December 16, 1998; 280(23): 1990 - 1991. [Full Text] [PDF]

				J. R. Sowers Obesity and cardiovascular disease Clin. Chem., August 1, 1998; 44(8): 1821 - 1825. [Abstract] [Full Text] [PDF]

				J. Q. Purnell, J. E. Hokanson, S. M. Marcovina, M. W. Steffes, P. A. Cleary, and J. D. Brunzell Effect of Excessive Weight Gain With Intensive Therapy of Type 1 Diabetes on Lipid Levels and Blood Pressure: Results From the DCCT JAMA, July 8, 1998; 280(2): 140 - 146. [Abstract] [Full Text] [PDF]

				B. Lamarche, A. Tchernof, P. Mauriege, B. Cantin, G. R. Dagenais, P. J. Lupien, and J.-P. Despres Fasting Insulin and Apolipoprotein B Levels and Low-Density Lipoprotein Particle Size as Risk Factors for Ischemic Heart Disease JAMA, June 24, 1998; 279(24): 1955 - 1961. [Abstract] [Full Text] [PDF]

				M. Halle, A. Berg, J. Keul, B. Lamarche, A. Tchernof, J.-P. Despres, and G. R. Dagenais Small, Dense LDL Particles and Coagulation • Response Circulation, March 10, 1998; 97(9): 936 - 937. [Full Text] [PDF]

				B. Lamarche, A. Tchernof, S. Moorjani, B. Cantin, G. R. Dagenais, P. J. Lupien, and J.-P. Despres Small, Dense Low-Density Lipoprotein Particles as a Predictor of the Risk of Ischemic Heart Disease in Men: Prospective Results From the Quebec Cardiovascular Study Circulation, January 7, 1997; 95(1): 69 - 75. [Abstract] [Full Text]