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High Plasma Level of Remnant-Like Particle Cholesterol in the Metabolic Syndrome

From The Third Department of Internal Medicine and The Cardiovascular Research Institute, Kurume University School of Medicine, Fukouka, Japan

Address correspondence and reprint requests to Hisashi Adachi, MD, PhD, The Third Department of Internal Medicine and The Cardiovascular Institute, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. E-mail: hadac{at}med.kurume-u.ac.jp

OBJECTIVE—The metabolic syndrome is associated with a high incidence of cardiovascular disease even when the abnormalities present in the syndrome are mild. The underlying mechanism of the metabolic syndrome has not been elucidated. We investigated whether a strong atherogenic lipoprotein, remnant-like particle (RLP) lipoprotein cholesterol, is elevated in the metabolic syndrome.

RESEARCH DESIGN AND METHODS—We performed a health examination among the residents of a rural community in Japan. Complete datasets, including fasting RLP cholesterol levels, were obtained in 1,261 subjects (509 men and 752 women) without diabetes and who were not taking lipid-lowering drugs. The subjects’ medical history, use of alcohol, and smoking habits were ascertained by a questionnaire.

RESULTS—All of the components of the metabolic syndrome were significantly related to RLP cholesterol by univariate analysis. Total cholesterol and smoking habits were also positively associated with RLP cholesterol. The subjects with the metabolic syndrome showed only mild abnormalities of each component. When RLP cholesterol levels were stratified by the number of the components of the metabolic syndrome, there was a strong association between RLP cholesterol levels and the number of components (P < 0.001 and F = 72.7).

CONCLUSIONS—RLP cholesterol levels are elevated in the metabolic syndrome, and this elevation may underlie the high incidence of cardiovascular disease in the metabolic syndrome.

Abbreviations: apo, apolipoprotein • ATP III, Adult Treatment Panel III • HOMA, homeostasis model assessment • RLP, remnant-like particle

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