Effects of weight change on HDL-cholesterol and its subfractions in over 28,000 men and women

Abstract

Changes in body mass index (ΔBMI) have well-established relationships to changes in high-density lipoprotein (ΔHDL)-cholesterol concentrations; however, their relationships to ΔHDL subfractions are less well understood. Assess the associations between ΔHDL and ΔBMI in a very large cohort. Age and sex-adjusted Δapo A1 concentrations were measured within 10 HDL subfractions in 14,121 women and 13,969 men using two-dimensional HDL-mapping. Significance was identified at .01<P≤.05 (*), .001<P≤.01 (†), .0001<P≤.001 (‡), and P≤.0001 (§). ΔBMI was significantly associated with Δα-1 (very large HDL, slope ± SE, females: -0.39±0.07§; males: -0.51±0.05§), Δα-3 (medium HDL, females: 0.18±0.04§; males: 0.19±0.04§), and Δα-4 (small HDL, females: 0.14±0.03§; males: 0.15±0.04§ mg/dL per kg/m2). As a percent of baseline, the changes in α-1 per ΔBMI were nearly twice as great as the changes in HDL-cholesterol per ΔBMI in both males (-1.53% vs -0.77%) and females (-0.79% vs -0.42%). HDL-cholesterol decreased significantly in healthy-weight patients who became overweight, overweight patients who became class I or class II obese, class I obese patients who became class II obese, and class II obese patients who became class III. In contrast, HDL-cholesterol increased in class III obese patients who became class II or class I, class II obese patients who became class I or overweight, class I patients who became overweight or healthy weight, overweight patients who became healthy weight, and healthy weight patients who became underweight. Weight change significantly affects HDL-cholesterol concentrations throughout the obesity spectrum. ΔBMI's effect on Δα-1 was nearly twice as great as its effect on HDL-cholesterol.