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High Plasma Concentration of Remnant Lipoprotein Cholesterol in Obese Children and Adolescents

From the Ajou University School of Medicine, Endocrinology and Metabolism, Ajou University, Suwon, South Korea

Address correspondence and reprint requests to Dae Jung Kim, Department of Endocrinology and Metabolism, Ajou University School of Medicine, San-5 Wonchon-Dong, Yongtong-Gu, Suwon 443-721, Republic of Korea. E-mail: djkim{at}ajou.ac.kr

OBJECTIVE—Remnant lipoproteins (RLPs) are the products of the lipolytic degradation of triglyceride-rich lipoproteins produced by the liver and intestine. Recent studies have demonstrated that RLPs are correlated with cardiovascular risk. We assessed the relationship between obesity and RLP and evaluated the factors related to RLP in children and adolescents.

RESEARCH DESIGN AND METHODS—We measured BMI, waist circumference, blood pressure, body fat mass, total abdominal fat, visceral and subcutaneous fat areas, fasting glucose, insulin, total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, and RLP cholesterol in 135 children and adolescents (67 boys and 68 girls). Plasma RLP fractions were isolated using an immunoaffinity gel containing specific anti–apolipoprotein (apo) B-100 and anti–apoA-I antibodies. Based on the BMI percentile, the subjects were divided into two groups: normal (<85th percentile) and overweight (85th percentile).

RESULTS—RLP cholesterol was significantly correlated with age, sex, BMI, waist circumference, systolic and diastolic blood pressures, visceral and subcutaneous fat areas, visceral-to-subcutaneous fat area ratio, total cholesterol, triglycerides, HDL cholesterol, apoB, and homeostasis model assessment of insulin resistance (HOMA-IR). According to the multivariate regression analysis, triglycerides (ß = 0.928, P < 0.001) were independently correlated with RLP cholesterol. After excluding lipid profiles as an independent variable, the multivariate regression analysis revealed that HOMA-IR (ß = 0.231, P = 0.007) and systolic blood pressure (ß = 0.169, P = 0.046) were independently associated with RLP cholesterol.

CONCLUSIONS—RLP cholesterol was significantly higher in obese children and adolescents. Triglycerides, systolic blood pressure, and insulin resistance were related to RLP cholesterol.

Abbreviations: apo, apolipoprotein • CAD, coronary artery disease • HOMA-IR, homeostasis model assessment of insulin resistance • RLP, remnant lipoprotein

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