Prediction of metabolic syndrome among postmenopausal Ghanaian women using obesity and atherogenic markers

ABSTRACT: BACKGROUND: Metabolic syndrome (MetS) is an important health problem which puts individuals at risk for cardiovascular diseases and type 2 diabetes as well as obesity-related cancers such as colon and renal cell in men, and endometrial and oesophageal in women. OBJECTIVE: This study was aimed at examining how obesity indicators and related determinants influence metabolic syndrome, and how the factors can be used to predict the syndrome and its cut-offs in postmenopausal Ghanaian women. METHODS: Two hundred and fifty (250) Ghanaian subjects were involved in the study with one hundred and forty-three (143) being premenopausal women and one hundred and seven (107) postmenopausal women. The influence of traditional metabolic risk factors including high blood pressure, dyslipidemia and glucose intolerance on obesity and atherogenic indices i.e. body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), Waist-to-thigh ratio (WTR), waist-to-height ratio (WHtR), high density lipoprotein cholesterol to total cholesterol ratio (HDL-C/TC), high density lipoprotein cholesterol to low density lipoprotein ratio (HDL-C/LDL-C) and triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C) were identified according to the Harmonization (H_MS) criterion. RESULTS: The most significant anthropometric marker that significantly influence metabolic risk factors among the pre- and postmenopausal women was waist-to-hip ratio (premenopausal: p- 0.004, 0.026 and 0.002 for systolic blood pressure (SBP), fasting blood glucose (FBG) and HDL-C; postmenopausal: p-0.012, 0.048, 0.007 and 0.0061 for diastolic blood pressure (DBP), FBG, triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) respectively). Using the receiver operating characteristic (ROC) analysis, the area under the curve for WC, WHR, TG/HDL-C and HDL-C/TC among postmenopausal women were estimated at 0.6, 0.6, 0.8 and 0.8 respectively. The appropriate cut-off values for WC, WHR, TG/HDL-C and HDL-C/TC that predicted the presence of metabolic syndrome were 80.5 cm, 0.84, 0.61 and 0.34 respectively. CONCLUSION: The presence of metabolic syndrome among Ghanaian postmenopausal women can be predicted using WC, WHR, TG/HDL-C and HDL-C/TC.     

Weight loss is correlated with an improved lipoprotein profile in obese postmenopausal women

BACKGROUND: Changes in plasma lipid and lipoprotein distributions that occur after menopause increase the risk of cardiovascular disease in women, especially in those who are overweight. OBJECTIVE: The purpose of this study was to evaluate the impact of a nine-month weight reduction program on plasma lipids, dietary intake and abdominal fat obesity. DESIGN: A partial crossover design was used to study a weight loss treatment consisting of Phentermine hydrochloride (Fastin, SmithKline Beecham Pharmaceuticals, Philadelphia, PA) therapy plus a low energy diet (5040 kJ/d). Forty-seven obese, postmenopausal Caucasian women (BMI of 30-38 kg/m2) were randomized into two groups, both of which received drug and diet treatment over six months. However, Group I started the intervention program three months later than Group II. Plasma total, HDL and LDL cholesterol and triacylglycerol were measured, body composition was assessed by anthropometry and dual energy x-ray absorptiometry, and food frequency records were collected at four timepoints. RESULTS: Over nine months, women in Group II reduced body weight (14.4%), lowered plasma concentrations of LDL cholesterol (14% to 26%) and triacylglycerol (15%) and raised plasma HDL cholesterol concentration (15%). These plasma lipid changes decreased the total cholesterol/HDL cholesterol ratio from 4.3 to 3.2. All subjects decreased abdominal fat measurements and energy and cholesterol intakes, as well as percentage of energy derived from total and saturated fat during the study. Most subjects also increased dietary fiber consumption. CONCLUSION: Both weight loss and diet modifications are associated with an improved plasma lipid profile in obese postmenopausal women.     

健康群体人体成分与血脂的相关性分析

目的探讨女护士群体人体成分指标与血脂的相关性,为更精准的个体化健康管理提供依据。方法选取20~59岁健康体检女护士856名,使用两种衡量标准将所有体检者各分为4组,分别讨论。第一个维度是按年龄分为4组:20~29岁组(n=335),30~39岁组(n=344),40~49岁组(n=131),50~59岁组(n=46);第二个维度是按BMI(body mass index)kg/m²和体脂肪含量%(body fat percentage,BF%)分4组:组1:BMI<24 kg/m²,BF%<25%;组2:BMI<24 kg/m²,BF%≥25%;组3:BMI≥24 kg/m²,BF%<25%;组4:BMI≥24 kg/m²,BF%≥25%。采用Inbody720人体成分分析仪生物电阻抗法检测人体组分成分和禁食12h后采静脉血检测甘油三脂,低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇。结果随着年龄的增长,BMI、体脂肪含量%、内脏脂肪面积(visceral fat area,VFA)、腰臀脂肪比(waist hip ratio,WHR)等指标相应增长,甘油三脂、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇与BMI(kg/m²)、体脂肪含量、内脏脂肪面积、腰臀脂肪比的增长程正相关;研究对象无BMI≥24 kg/m²,BF%<25%的人群,也就是说该群体没有“运动员”类型的超体质量肌肉型,从侧面说明该群体运动量不足;基础代谢(basal metabolic rate,BMR)在50岁后下降,身体水分含量、蛋白质含量、矿物质含量随年龄增长而下降。结论提示应该尽早的关注除体质量外,体脂肪含量百分比、内脏脂肪面积等指标,注意饮食结构的调整和保持运动量,减脂增肌。     

Adiponectin represents an independent risk factor for hypertension in middle aged Korean women

Adiponectin, which is secreted specifically by adipose tissue, has been shown to act as an anti-atherosclerotic protein. Several studies have shown that adiponectin levels are lower in individuals with obesity, diabetes and cardiovascular disease. The present study investigated relationships between serum adiponectin levels and body mass index (BMI), waist-to-hip ratio (WHR), blood pressure (BP) and lipid profiles in 300 middle-aged Korean women (mean age 50.6 +/- 6.2; BMI 25.78 +/- 3.68 kg/m(2)). The serum adiponectin level was positively associated with high density lipoprotein (HDL)-cholesterol (r = 0.29) and negatively associated with BMI, WHR, percent body fat, triglyceride (TG), systolic BP, and diastolic BP. Multivariate logistic regression analysis revealed that increasing concentrations of adiponectin were associated with lower risk of hypertension. In overall odds ratios (95% CIs) for hypertension, those in the second, third, and fourth (versus the first) quartile of adiponectin after adjustment for age were 0.59 (0.297-1.185), 0.47 (0.236 - 0.938), and 0.32 (0.16 - 0.648), respectively. Regardless of BMI, WHR and percent body fat, higher adiponectin was independently associated with a lower risk of hypertension. These findings suggest that the serum adiponectin level is decreased with atherogenic lipid phenotype including hypertriglyceridemia and low HDL-cholesterol. Furthermore, low serum adiponectin concentration may be an independent risk factor for hypertension in middle-aged Korean women.     

Weight Loss is Correlated with an Improved Lipoprotein Profile in Obese Postmenopausal Women

Background: Changes in plasma lipid and lipoprotein distributions that occur after menopause increase the risk of cardiovascular disease in women, especially in those who are overweight.

Objective: The purpose of this study was to evaluate the impact of a nine-month weight reduction program on plasma lipids, dietary intake and abdominal fat obesity.

Design: A partial crossover design was used to study a weight loss treatment consisting of Phentermine hydrochloride (Fastin®, SmithKline Beecham Pharmaceuticals, Philadelphia, PA) therapy plus a low energy diet (5040 kJ/d). Forty-seven obese, postmenopausal Caucasian women (BMI of 30–38 kg/m²) were randomized into two groups, both of which received drug and diet treatment over six months. However, Group I started the intervention program three months later than Group II. Plasma total, HDL and LDL cholesterol and triacylglycerol were measured, body composition was assessed by anthropometry and dual energy x-ray absorptiometry, and food frequency records were collected at four timepoints.

Results: Over nine months, women in Group II reduced body weight (14.4%), lowered plasma concentrations of LDL cholesterol (14% to 26%) and triacylglycerol (15%) and raised plasma HDL cholesterol concentration (15%). These plasma lipid changes decreased the total cholesterol/HDL cholesterol ratio from 4.3 to 3.2. All subjects decreased abdominal fat measurements and energy and cholesterol intakes, as well as percentage of energy derived from total and saturated fat during the study. Most subjects also increased dietary fiber consumption.

Conclusion: Both weight loss and diet modifications are associated with an improved plasma lipid profile in obese postmenopausal women.     

Skinfold and body circumferences as measures of body fat patterning in a French female active population: relationships with the metabolic risk profile

Body mass index (BMI), various anthropometric indices of abdominal fat distribution and some metabolic variables (blood lipids, fasting glucose, blood pressure) were measured in 408 French-born women from an occupational population who volunteered for the study. The aim of the study was to determine the best index for describing the relationships between the body fat pattern and the metabolic risk profile. The four age-adjusted circumference ratios (waist/hip, waist/thigh, xiphoid/hip, xiphoid/thigh) showed similar associations with the metabolic variables whereas the three age-adjusted skinfold ratios (epigastric/thigh, mesogastric/thigh, hypogastric/thigh) tended to be more weakly associated with the metabolic variables, particularly with apolipoprotein (Apo) B and fasting glucose. Multiple regression analyses showed that age-adjusted BMI was significantly related to high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, Apo A and Apo B, and blood pressure, independently of abdominal fat distribution. After controlling for the effects of BMI, the waist/thigh ratio remained significantly associated to triglyceride, Apo B, fasting glucose, and systolic blood pressure, whereas the waist/hip ratio and the mesogastric/thigh skinfold ratio were significantly related only to triglyceride and systolic blood pressure independently of BMI. With the exception of triglyceride and fasting glucose, the degree of association between the metabolic variables and the abdominal fat distribution tended to be weaker than that observed with the BMI. These results emphasize the importance of the global corpulence in the levels of metabolic variables. However, all indices of abdominal fat distribution were, to varying degrees, independently associated with an unfavorable metabolic profile. Among them, the waist/thigh circumference ratio seems to be a useful indicator of the body fat pattern in women.     

体脂分布特征与血脂关系及其预测血脂异常的观察

目的 研究体脂分布特征与血脂关系及其预测血脂异常的价值.方法 采用整群抽样方法抽取北京市郊区居民有效样本784名,测量其身高、体重、腰围(WC)、臀围、身体成分与高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG),并计算体重指数(BMI)与腰臀比(WHR).结果 年龄调整偏相关分析显示WC与HDL-C(r=-0.310)、LDL-C(r =0.204),WHR与TC (r=0.151)、TG (r=0.271)的相关性最好.BMI、WC、WHR、躯干脂肪质量(TFM)分组分析显示WC、WHR、TFM能敏感地反应人体血脂水平的变化;BMI、WC、WHR、TFM能敏感地反应低HDL、高TG及血脂异常的风险.ROC曲线分析显示WC、WHR、BMI、TFM预测血脂异常风险的ROC曲线皆在参考线上方,且男女受试者WHR (0.684、0.630)、WC (0.667、0.616)、TFM(0.661、0.604)的ROC曲线下面积有大于BMI (0.629、0.597)的趋势,但差异均无统计学意义(P＞0.05).结论 体脂分布特征指标如WHR、WC、TFM与BMI相比,在预测血脂异常风险中的应用价值更高;以Youden指数最大值为判定依据预测血脂异常风险,男性理想界值点BMI为24 kg/m2,WHR为0.91,WC为85 cm,TFM为7.5 kg;女性BMI为25 kg/m2,WHR为0.91,WC为87 cm,TFM为9.Skg.由于样本量较少,有待进一步扩大范围的研究.     

Prior hrt use, ethnicity and mammographic density

PURPOSE: Mammographic density has been strongly associated with breast cancer risk in several studies. To clarify possible pathogenic mechanisms underlying this relationship, we assessed factors affecting mammographic density in postmenopausal women.METHODS: Percent density (PD) was measured on pre-randomization mammograms from 425 participants in the Women's Health Initiative clinical trial; no women were currently using HRT. Trained observers used a previously validated computer-assisted thresholding technique to measure PD (ratio of dense areas to breast area) on craniocaudal films. Univariate relationships were assessed between PD and age, parity, education, history of HRT use, age at first birth, abortion history, alcohol use, serum cholesterol, physical activity, smoking, dietary fat intake, body-mass index (BMI), and waist-to-hip ratio (WHR). Multivariable regression was used to identify predictors of PD (log transformed), controlling for confounders.RESULTS: PD ranged from 0-60% with mean 8%. Age, gravidity, BMI, and WHR were negatively associated with PD. Mean PD in the highest tertiles of BMI and WHR was nearly half that in the lowest. Ethnicity (50% white, 28% black, and 19% Hispanic) and hysterectomy status (50% had intact uterus) were unassociated with PD. Controlling for age, BMI, WHR, smoking, hysterectomy status, prior HRT, and nulliparity, mean PD differed significantly by ethnicity, with black women having highest PD. However, the effect of prior HRT use differed by uterine status. In women with uteri intact, ethnicity, but not prior HRT use, was related to PD after controlling for age, BMI, and WHR. In hysterectomized women, ethnicity was unrelated to PD, while previous HRT was associated with lower PD.CONCLUSIONS: Gravidity, ethnicity and body shape and size are associated with mammographic density in postmenopausal women. Previous hormone use predicts lower PD, but only among hysterectomized women. This may be due to the higher frequency of oophorectomies in this group, which may lower PD and increase likelihood of HRT use. Planned analyses of entire sample of 1050 women will clarify the effect of these and other factors on density, and on density change in followup mammograms.     

Exercise mitigates the association of abdominal obesity with high-density lipoprotein cholesterol in premenopausal women: results from the third National Health and Nutrition Examination Survey

OBJECTIVE: To examine the relationship between abdominal obesity, as measured by waist-to-hip ratio (WHR) and high-density lipoprotein cholesterol (HDL-C) level within the context of age, body fatness, exercise, saturated fat intake, and other plasma lipids. DESIGN/SUBJECTS: Subjects were premenopausal, white, non-Hispanic women from the third National Health and Nutrition Examination Survey. Smokers, heavy drinkers, and women who took lipid-altering drugs were excluded. Of 1,188 subjects who met the inclusion criteria, complete data were available for 435 women. STATISTICAL ANALYSES: Means were calculated using all subjects for each variable, then F-protected t tests and linear contrasts were performed to test differences in means between subgroups. A P < .05 was considered significant. RESULTS: Age was not significantly associated with HDL-C level. Comparisons of HDL-C by WHR, percentage body fat (%BF), and exercise level revealed that HDL-C level was significantly lower at the higher levels of WHR and %BF and higher at the highest levels of exercise. Higher levels of HDL-C were generally accompanied by lower levels of triacylglycerol. When HDL-C was compared by exercise level within each WHR tertile and %BF tertile, the association of exercise with HDL-C diminished. Saturated fat intake was not associated with HDL-C. CONCLUSIONS/APPLICATIONS: Increased exercise is associated with a lower WHR and subsequently a higher HDL-C level. This association between WHR and HDL-C appears to be mediated through %BF. Women exercisers with the highest WHR had consistently more favorable plasma lipid profiles and lower mean body mass index and %BF than nonexercisers. Thus, for women who exhibit abdominal obesity, exercise mitigates the association of WHR with HDL-C level. Vigorous exercise in the premenopausal years may promote a more favorable lipid profile, even in the presence of increased body fat and abdominal girth.     

Coronary heart disease risk factors in male adolescents, with particular reference to smoking and blood lipids.

PURPOSE: To examine coronary heart disease (CHD) risk factors, particularly blood lipids and smoking, in adolescent boys in the Sydney Metropolitan area, and to investigate possible differences between boys from English-speaking (ESB) and non-English-speaking backgrounds (NESBs). METHODS: Male volunteers aged 15-18 years were recruited from the senior years of four secondary schools in different geographical areas of Sydney. Body mass index (BMI), waist-hip ratio (WHR), blood lipids, and percent body fat were measured. Behavioral variables were estimated by questionnaire. RESULTS: A total of 110 boys were recruited; 74% were from an ESB. Mean WHR (0.836 +/- 0.045), waist circumference (80.6 +/- 9.4 cm), and percent body fat (21.0 +/- 6.3) were similar across age groups. Atherogenicity of the lipid profile, as measured by the ratio of total cholesterol to high-density lipoprotein cholesterol (TC:HDL-C), was lower in boys aged 15 years than in any other age group (p < .05). TC:HDL-C was strongly associated with BMI (r = .57; p < .0001) and WHR (r = .35; p < .01). Smokers had higher BMI, were less active and had lower HDL-C (p < .001) and higher TC:HDL-C (p < .0001) than nonsmokers. Smoking, even of short duration, and quite moderate consumption of cigarettes (6/day) were associated with a deterioration of the lipid profile. Boys from NESBs had a higher degree of risk in all of the factors examined. CONCLUSIONS: Regular smoking of short duration has an appreciable impact on lipid and lipoprotein concentrations in this sample of Australian adolescent boys. Boys from an NESB appear to be at greater risk of developing CHD in later life.     

Relationship between adipokines and lipid profile in postmenopausal women with different apolipoprotein E genotypes

The aim of the authors of this study was to clarify the relationships among apolipoprotein E (ApoE) genotype, blood pressure, lipid profile, serum leptin, and adiponectin in healthy postmenopausal women. The study was conducted between March 2011 and December 2012 on 266 participants aged 50–65 years from the Institute of Rural Health in Lublin, Poland. Results showed that women had four combinations of genotypes: ?2/?3, ?3/?3, ?3/?4, and ?4/?4. Carriers of different genotypes did not differ in terms of age, body mass index (BMI), blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, and adiponectin levels. Mean low-density lipoprotein (LDL) cholesterol levels were higher in ε4 carriers compared to non-carriers. Fasting serum leptin concentrations were higher in homozygotes ?4/?4. Leptin correlated positively with BMI in all study groups and with LDL in ?2/?3, ?3/?3, and ?3/?4. Adiponectin correlated negatively with triglycerides in ?2/?3, ?3/?3, and ?3/?4 and positively with HDL in ?2/?3 carriers. Adipokines were not associated with blood pressure. Multiple regression analyses demonstrated associations among leptin, ApoE ?4/?4, BMI, and LDL, and among adiponectin, BMI, and triglycerides. In healthy postmenopausal women ?4/?4 genotype was associated with lower leptin levels. Homozygosity ?4/?4 was associated with a more atherogenic lipid profile and possibly dysregulation of leptin and adiponectin signaling in lipid metabolism.     

Men and women differ in lipoprotein response to dietary saturated fat and cholesterol restriction

A diet restricted in saturated fat and cholesterol is recommended for subjects with elevated LDL cholesterol concentrations before and during drug therapy. Gender differences in lipoprotein subspecies response to such diets have not been studied in detail. We examined the effects of a diet low in total fat, saturated fat and cholesterol (Therapeutic Lifestyle Changes, TLC, diet: 26% of energy as fat, 4% as saturated fat, and 45 mg cholesterol/4.2 MJ), compared with an average American diet (AAD: 35% of energy as fat, 14% as saturated fat, and 147 mg cholesterol/4.2 MJ), on plasma lipoprotein subspecies in men and women. Each diet period lasted 6 wk. Body weight was kept constant during each diet period. Men (n = 19) and postmenopausal women (n = 14) >40 y old with moderate hypercholesterolemia participated in this study. Plasma lipoprotein concentrations were assessed by standardized methodology, and lipoprotein sizes were determined by gradient gel electrophoresis and NMR spectroscopy. The TLC diet resulted in greater reductions in total cholesterol and plasma apolipoprotein B concentrations in men than in women (-19% vs. -12%, P < 0.05, and -18% vs. -9%, P < 0.05, respectively). Postprandial triacylglycerol and LpAI:AII concentrations were reduced in men, but not in women (-15% vs. 8%, P < 0.05, and -9% vs. -2%, respectively, P < 0.05). Similar decreases in LpAI concentrations and LDL and HDL particle size were observed in men and women. These data are consistent with the concept that middle aged/elderly men may have a more favorable lipoprotein response to a low fat, low cholesterol diet than postmenopausal women.     

Body fat distribution, serum lipoproteins and blood pressure in middle-aged Finnish men and women

The association of body fat distribution as measured by the ratio of waist to hip girth (WHR) to age, to serum total cholesterol and HDL-cholesterol and to blood pressure was studied in a population-based sample of 2461 men and 2768 women aged 25 to 64 years not treated with cardiovascular drugs. In men, the relationships of age with WHR and age with body mass index (BMI) were similar, an increase levelling at the age of about 50 years. In women, BMI increased linearly, but WHR exponentially with age. In both sexes, age-adjusted WHR and BMI associated positively with non-HDL cholesterol, and with systolic and diastolic blood pressure, and inversely with HDL-cholesterol and the HDL/non-HDL cholesterol ratio. WHR and BMI were independently related to several cardiovascular risk factors. HDL-cholesterol concentration was 19% lower in men, and 17% lower in women who belonged to the upper tertile of both WHR and BMI, than in the subjects in the lower tertiles of WHR and BMI. Age-adjusted WHR and BMI also predicted fasting and 2-hour post-challenge blood glucose values in women aged 45 to 64 years, but not in men. The WHR provides additional information on elevated cardiovascular risk factors in cross-sectional analysis among middle-aged men and women independently of BMI. The measurement of WHR in large-scale risk factor surveys should be recommended, in order to assess the independent contribution of WHR to the risk of cardiovascular disease, and to find out the importance of WHR for the prevention of chronic diseases.     

Dietary intake and changes in lipoprotein lipids in obese, postmenopausal women placed on an American Heart Association Step 1 diet

BACKGROUND: Dietary intake and changes in lipoprotein lipids in obese, postmenopausal women placed on an American Heart Association Step 1 diet. OBJECTIVE: The purpose of this study was to determine the specific dietary factors associated with the commonly observed decrease in HDL-C concentration in obese, postmenopausal women placed on a low-fat diet. DESIGN/SUBJECTS/INTERVENTION: Dietary intake, lipoprotein lipid concentrations, and body weight were measured before and after 10 weeks of instruction in the principles of the American Heart Association (AHA) Step 1 diet in 55 overweight and obese (body mass index=33+/-4 kg/m2), sedentary, postmenopausal women (mean age 59+/-5 years). RESULTS: The percent of energy obtained from total fat, monounsaturated, polyunsaturated, saturated fat, and dietary cholesterol decreased significantly after dietary intervention, while the polyunsaturated:saturated ratio and the percent of energy obtained from total carbohydrate, complex carbohydrate, and simple carbohydrate increased. On average, the women lost a small, but significant, amount of body weight (2%+/-3%, P<.0001). Adherence to the AHA diet reduced total cholesterol (-8%+/-8%), LDL-C (-6%+/-11%), and HDL-C (-16%+/-10%). The only dietary change that predicted decreases in HDL-C concentrations was the increase in the percent of energy from simple sugar (r=-0.32, P<.05). There were no relationships between changes in HDL-C and changes in percent of energy from fat (r=0.16), saturated fat (r=0.07), polyunsaturated fat (r=0.04), or monounsaturated fat (r=0.09). APPLICATIONS/CONCLUSIONS: In postmenopausal women, a dietary reduction in total fat, saturated fat, and cholesterol reduces body weight, total cholesterol, and LDL-C, but substitution of simple sugar for dietary fat may lead to a reduction in HDL-C. Further research is needed to determine which specific simple sugars are contributing to diet-induced reductions in HDL-C in older women placed on a low-fat diet.     

The Family Risk Score for coronary heart disease: associations with lipids, lipoproteins, and body habitus in a middle-aged bi-racial cohort: The ARIC study

PURPOSE: To examine the association between the Family Risk Score (FRS) for coronary heart disease (CHD) and body mass index (BMI), waist-to-hip ratio (WHR), high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, and lipoprotein(a) protein [Lp(a)]. METHODS: FRS was computed from observed and expected CHD events using family data collected from 11467 black and white adults of the Atherosclerosis Risk in Communities Study (ARIC). BMI, WHR, and lipids adjusted for study center, race, education, BMI (except BMI), WHR (except for BMI and WHR), cigarette smoking, alcohol, and Keys' score were compared among low (FRS < -0.5), average (-0.5 to 0.5), and high (> 0.5) FRS using analysis of covariance. The association between FRS and these risk factors was compared to that for simpler estimates of family risk. RESULTS: Adjusted means of BMI, WHR, LDL, LP(a), and triglycerides were positively associated with FRS, whereas HDL cholesterol was inversely associated with FRS. Of demographic and behavioral factors, cigarette smoking was most strongly associated with FRS. Based on additional comparisons of adjusted means, high vs. low levels of FRS appear to correlate better with CHD risk factors than do the simpler family history assessments. CONCLUSIONS: In situations were genetic or clinical information is not available, FRS may be a favorable measure of familial burden for CHD.     

Menopause-related changes in lipoproteins and some other cardiovascular risk factors

Changes in lipids, lipoproteins and other cardiovascular risk factors associated with the occurrence of menopause have been examined in a cross-sectional study of 435 healthy white women, aged 45-54 years not using sex hormones. Univariate analysis showed that total cholesterol, low density lipoprotein (LDL) cholesterol, apolipoprotein A1, apolipoprotein B, triglycerides, systolic blood pressure and fibrinogen were significantly higher in post menopausal women than in premenopausal women. High density lipoprotein (HDL) cholesterol, diastolic blood pressure and blood glucose did not change with menopausal status. After controlling for the effects of confounding variables (age, body mass index and smoking status), total cholesterol, LDL cholesterol, triglycerides, apolipoprotein B and systolic blood pressure remained significantly increased in postmenopausal women as compared with premenopausal women. Our findings add to epidemiological evidence that menopause adversely affects the lipid and lipoprotein metabolism and thus, may increase the risk of coronary heart disease.     

Relationships between 3-y longitudinal changes in body mass index, waist-to-hip ratio, and metabolic variables in an active French female population.

Three-year longitudinal changes in body mass index (BMI), waist-to-hip ratio (WHR), and metabolic variables were examined in 209 active French women. For the entire group, a weak but significant positive association was found between change in BMI and change in WHR. However, analysis of covariance according to the degree of abdominal fat distribution showed a heterogeneity of this association that was confined to women with abdominal fat distribution. Changes in BMI were positively associated with changes in total cholesterol (P less than 0.05), triglycerides (P less than 0.10), and blood pressure (P less than 0.001), whereas changes in WHR were associated with changes in triglycerides (P less than 0.05) and diastolic blood pressure (P less than 0.10). These longitudinal results suggest that a more favorable body-fat pattern and metabolic profile might be achieved by reducing weight, or at least by preventing weight gain, particularly in women with high abdominal-fat distribution.     

Altered lipoprotein metabolism in spontaneous vitamin E deficiency of owl monkeys

Certain owl monkeys (AOT) develop spontaneous hemolytic anemia that responds to vitamin E. The anemia is associated with red blood cell lipid peroxidation and altered red blood cell membrane lipid composition. To investigate these changes, plasma lipid and lipoprotein profiles were characterized in anemic, anemia-susceptible, and anemia-resistant AOT. The plasma vitamin E and vitamin A concentrations were assessed as an index of fat absorption and the effect of corn oil supplementation and vitamin E-selenium injection were measured. Anemia-susceptible AOT had depressed plasma levels of vitamin E and A and an altered lipoprotein metabolism characterized by elevated ratios of low/high density lipoprotein cholesterol and free to esterified cholesterol in these lipoproteins. Vitamin E-selenium injection in anemia-susceptible AOT increased the plasma vitamin E, and vitamin E and corn oil supplements reduced the high density lipoprotein free to esterified cholesterol ratio. The data suggest that the AOT suffer from fat malabsorption and that the consequences (including tocopherol deficiency) result in altered cholesterol metabolism.     

Lipoprotein profile and prevalence of cardiovascular risk factors in urban Moroccan women

OBJECTIVE: The study aimed to characterize the lipid and apolipoprotein profile and the prevalence of cardiovascular risk factors in a population of urban adult women of Morocco. DESIGN: A total of 213 women 25-55 y old were sampled from an agricultural province of Morocco: El Jadida. The following parameters of lipid and apolipoprotein profile were measured: plasma triglycerides (TG), plasma cholesterol (TC), triglyceride-rich lipoprotein triglycerides (TRL-TG), TRL-cholesterol (TRL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoproteins A1, B, B48, CIII and E. Waist circumference (WC), body mass index (BMI) and blood pressure (BP) were also determined. RESULTS: The women studied showed the following pattern: elevated TC, LDL-C levels and TC/HDL-C in 10, 19.4 and in 43.8%, respectively; low HDL-C levels in 45.3% (<0.9 mmol/l) or in 95% (when the cutoff <1.3 mmol/l is used), elevated TG levels in 11.8%. Elevated TRL-C (>0.6 mmol/l) and TRL-TG (>0.8 mmol/l) were observed in 13.4%. Obesity and hypertension were highly prevalent in 23.9 and 16.5%, respectively. Plasma triglyceride concentrations were closely correlated with plasma concentrations of TRL-TG (R = 0.86, P = 0.0001), apoB (R = 0.50, P = 0.0001) and apoCIII (R = 0.52, P = 0.0001) and moderately correlated with HDL-C levels (R = -0.3, P = 0.0001) and BMI (R = 0.4, P = 0.0001). The association between BMI and systolic blood pressure was statistically significant (R = 0.3, P = 0.0001). Obesity, BP, TRL-C, TRL-TG, TG, apoB and apoCIII increased with age. CONCLUSION: There is a high prevalence of some risk factors for cardiovascular disease including altered lipid and lipoprotein profiles in the Moroccan urban women studied, some of these risk factors are associated with age.     

Soy isoflavones improve plasma lipids in normocholesterolemic and mildly hypercholesterolemic postmenopausal women

BACKGROUND: Soy-protein consumption is known to reduce plasma total and LDL cholesterol concentrations. However, the responsible soy component or components and the magnitude of effects in normocholesterolemic and mildly hypercholesterolemic subjects are unclear. OBJECTIVE: The present study examined the effects of soy isoflavone consumption on plasma concentrations of triacylglycerol, apolipoprotein (apo) A-I, apo B, lipoprotein(a), and total, LDL, and HDL cholesterol and on LDL peak particle diameter in normocholesterolemic and mildly hypercholesterolemic postmenopausal women. DESIGN: In a randomized crossover trial, fasting plasma samples were obtained from 18 postmenopausal women throughout three 93-d periods of daily isolated soy protein (ISP) consumption providing an average of 7.1 +/- 1.1 (control), 65 +/- 11 (low isoflavone), or 132 +/- 22 (high isoflavone) mg isoflavones/d. RESULTS: Compared with values measured during the control diet, the plasma LDL cholesterol concentration was 6.5% lower (P < 0.02) during the high-isoflavone diet and the ratio of LDL to HDL cholesterol was 8.5% and 7.7% lower during the low- and high-isoflavone diets, respectively (P < 0.02). Isoflavone consumption did not significantly affect plasma concentrations of total or HDL cholesterol, triacylglycerol, apo A-I, apo B, or lipoprotein(a) or the LDL peak particle diameter. CONCLUSIONS: Consumption of isoflavones as a constituent of ISP resulted in small but significant improvements in the lipid profile in normocholesterolemic and mildly hypercholesterolemic postmenopausal women. Although the effects were small, it is possible that isoflavones may contribute to a lower risk of coronary heart disease if consumed over many years in conjunction with other lipid-lowering strategies.