Abstract
We aimed to assess the potential relationship between dietary patterns (i.e., Mediterranean diet and healthy eating) and the advanced lipoprotein profile (ALP) in a representative cohort of the Mediterranean population. Thus, ALP data from 1142 participants, including 222 with type 1 (19.4%) and 252 type 2 diabetes (22.1%), and 668 subjects without diabetes were used to study cross-sectional associations between quantitative characteristics of lipoproteins and adherence to the Mediterranean diet. The alternate Mediterranean diet score (aMED) and the alternate healthy eating index (aHEI) were calculated. The ALP was determined by nuclear magnetic resonance (NMR) spectrometry. Bivariable and multivariable analyses were performed. Participants in the third tertile of the aMED showed higher levels of low-density lipoprotein triglycerides (LDL-TG) (mean (SD) 17.5 (5.0); p = 0.037), large high-density lipoprotein particles (HDL-P) (0.3 (0.1); p = 0.037), and medium low-density lipoprotein particles (LDL-P) (434.0 (143.0); p = 0.037). In comparison with participants in the second and first tertiles of the aHEI, participants in the third tertile had higher levels of LDL-TG (17.7 (5.0); p = 0.010), and large HDL-P (0.3 (0.1); p = 0.002), IDL-C (11.8 (5.0); p = 0.001), intermediate-density lipoprotein triglycerides (IDL-TG) (13.2 (4.2); p < 0.001), LDL-TG (17.7(5.0); p = 0.010), high-density lipoprotein triglycerides (HDL-TG) (14.5 (4.4); p = 0.029,) large HDL-P (0.3 (0.1); p = 0.002) and very–low-density lipoprotein particles (VLDL-P) size (42.1 (0.2); p = 0.011). The adjusted-multivariable analysis for potential confounding variables did not show any association between the lipoproteins and dietary patterns (i.e., aMED and aHEI). In conclusion, none of the quantitative characteristics of lipoproteins were concomitantly associated with the extent of adherence to the Mediterranean diet measured using the aMED or aHEI scores in the studied population. Our findings also revealed that people with the highest adherence were older, had a higher body mass index (BMI) and more frequently had dyslipidemia, hypertension, or diabetes than those with the lowest adherence to the Mediterranean diet (MDiet). Thus, further research may be needed to assess the potential role of the dietary pattern on the ALP.
Highlights
Total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) determined by conventional lipid analysis are commonly used to identify subjects with metabolic diseases at high cardiovascular (CV) risk [1,2]
The study population included 222 individuals diagnosed with type 1 diabetes mellitus (T1DM), 252 subjects with type 2 diabetes mellitus (T2DM) and 668 individuals without diabetes
The present study assessed the characteristics of circulating lipoproteins and their potential relationship with dietary patterns in a large cohort of Catalan adult people recruited from the northeastern region of Spain
Summary
Triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) determined by conventional lipid analysis are commonly used to identify subjects with metabolic diseases at high cardiovascular (CV) risk [1,2]. The basic determination of such serum lipid concentrations may not necessarily reflect potentially informative changes in other quantitative characteristics of lipoproteins (i.e., size, and lipoprotein subclasses that may remain hidden) In this context, the advanced lipoprotein profile (ALP) analysis by nuclear magnetic resonance (NMR) spectrometry [3] provides the concentration of the major classes of lipoprotein particles (i.e., very-low-density lipoprotein [VLDL], LDL, and HDL), and the number and size of the different subclasses [2]. CV risk in comparison with classical lipid profiles currently assessed in clinical practice [4] In this regard, elevated serum concentrations of smaller LDL-P and HDL-P appear to be more atherogenic than other particles [5]. The Mediterranean Diet (MDiet), which is rich in “healthy fats”, has been associated with lower serum LDL concentrations and a reduced risk of CV disease [6]
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