High-density Lipoprotein Cholesterol Levels In Men Research Articles

The relation between overweight, obesity and plasma lipids in Saudi adults with type 2 diabetes

Background: Worldwide, epidemic exists with respect to diabetes mellitus, primarily because of increased rates of obesity. Lipoprotein abnormalities are common in overweight and obese patients with diabetes and contribute significantly to its complications. Methods: A cross-sectional study was conducted at the Primary Health Care Clinics at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. A total of 2519 Saudi diabetic and non-diabetic patients were randomly selected to assess the association of dyslipidaemia and overweight and obesity in type 2 diabetic patients and non-diabetic controls. Patients were subjected to investigations of glycosylated haemoglobin (HbA1c) and fasting serum lipids. Results: A total of 2519 patients attending the Primary Health Care Clinics were included in this study (45.9% men, 54.1% women). The diabetic group comprised 50.8% (1280) and non-diabetic group comprised 49.2% (1239) of the sample. The mean ± standard deviation age of diabetic and non-diabetic patients was 37.1 ± 7.7 and 32.1 ± 8.1, respectively. The diabetic patients were older, had higher body mass index, serum triglyceride and HbA1c values were significantly higher when compared to non-diabetic subjects. Whereas, total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) were significantly lower in diabetics. Nineteen percentage of men and 27% of women with diabetes mellitus had increased total plasma cholesterol levels that did not differ significantly (P = 0.2) from the rates in non-diabetic men and women (21% of men and 34% of women). The prevalence of high LDL cholesterol levels in men and women with diabetes mellitus (23% and 31%, respectively) did not differ significantly (P = 0.4) from the rates in non-diabetic men and women (18% and 28%, respectively). The prevalence of high HDL cholesterol levels in men and women with diabetes mellitus (25% and 27%, respectively) did not differ significantly (P = 0.7) from the rates in non-diabetic men and women (23% and 25%, respectively). In contrast, the prevalence of high plasma triglyceride levels in individuals with diabetes mellitus (30% in men and 32% in women) was significantly higher than in those without diabetes mellitus (21% of men and 16% of women), P = 0.02. Conclusion: The study has documented several lipid abnormalities in type 2 diabetic patients and has pointed the significance of diabetic management in the control of lipid abnormalities where the control over overweight and obesity conditions is of importance. The study revealed that obesity and dyslipidaemia were high among diabetic patients and required special attention. This can be done through health education at the primary care level and at the diabetic clinics.

Abstract 13783: Paradigms to Predict Cardiometabolic Disease in African Descent Populations Should Focus on HDL-Cholesterol Rather than Triglyceride

Paradigms for the early detection of cardiometabolic disease usually incorporate both elevated triglyceride (TG) and low high density lipoprotein -cholesterol (HDL-C). However, African-Americans with cardiometabolic disease usually have normal TG levels. The HDL-C pattern of African-Americans with cardiometabolic disease is uncertain. The TG and HDL-C pattern in Africans with cardiometabolic disease is unknown. To clarify the TG and HDL-C pattern in African descent populations with cardiometabolic disease, 377 blacks (167 African-Americans, 210 African immigrants, 59% male, age 36±9y, mean±SD, range 20-64y, BMI 29.0±6.3 kg/m2, range 18.5-54.7) had glucose tolerance status determined by OGTT, lipid profiles and insulin resistance determined by the insulin sensitivity index (SI). Insulin resistance was defined as the lowest quartile of SI (<2.18 L/mU - 1min- 1). Metabolic triad was defined as hyperinsulinemia (fasting insulin≥3.7 μU/mL), hyperapolipoproteinB (≥64 mg/dL) and sdLDL(≥21.5 nm) based on the median values of the group with normal BMI. Cardiometabolic disease was defined as one or more of the following: pre-diabetes, diabetes, insulin resistance or metabolic triad. The frequency with which hypertriglyceridemia (TG≥150 mg/dL) or low HDL-C (<40 mg/dL in men or <50 mg/dL in women) occurred in the presence of cardiometabolic disease was determined. The prevalence of cardiometabolic disease did not differ in African-Americans and African immigrants (63% vs. 60%, P=0.51). TG and HDL-C levels in blacks with cardiometabolic disease did not differ by African ancestry. In the presence of cardiometabolic disease, TG levels were 80±40 vs. 87±43, P=0.24, resp. while HDL-C levels in men were: 45±11 vs. 44±12, P=0.63, and in women: 48±10 vs. 49±10, P=0.86). Less than 10% of people with cardiometabolic disease had TG≥150 mg/dL. However, 42% of people with cardiometabolic disease had low HDL-C. If HDL-C levels were low, the odds of having cardiometabolic disease was 2.84 (95% CI 1.76, 4.59. P<0.001). Overall, more than 40% of people with cardiometabolic disease had low HDL while <10% had elevated TG levels. Therefore, paradigms to detect cardiometabolic disease in African descent populations should focus on HDL-C rather than TG.

Increased Prevalence of low High-density Lipoprotein Cholesterol (HDL-C) Levels in Korean Adults: Analysis of the Three Korean National Health and Nutrition Examination Surveys (KNHANES 1998–2005)

ObjectivesHigh-density lipoprotein cholesterol (HDL-C) is an independent risk factor for cardiovascular diseases that has shown a remarkable increase, but little is known about the prevalence of low HDL-C in Korea. This study aimed to evaluate changing trends of low HDL-C prevalence, and indicate other risk factors associated with low HDL-C. MethodsWe selected subjects aged ≥20 years from the Korean National Health and Nutrition Examination Survey (KNHANES) 1998, 2001, and 2005 (n = 7962, 6436, and 6412). The mean level of HDL-C and the prevalence of low HDL-C was calculated, and cardiovascular risk factors associated with low HDL-C, as well as demographic, anthropometric, lifestyle, and nutrition factors, were assessed using the KNHANES 2005 data. ResultsMean HDL-C levels in men and women between KNHANES 1998 and 2005 decreased significantly, from 48.1 to 42.3 and from 51.6 to 47.1 mg/dL, respectively (both p < 0.001). The decrease was slightly less for women compared with men for the same period, and women had higher HDL-C levels at all periods. Covariate-adjusted OR revealed that body mass index, waist circumference, and non-alcohol drinker in both men and women were associated with low HDL-C levels by KNHANES 2005, as were employed and light physical activity in men and low fat intake in women. ConclusionThe prevalence of low HDL-C increased significantly from KNHANES 1998 to 2001 and 2005 (p < 0.001) in both men and women. body mass index, waist circumference, and non-alcohol drinker were identified as associated with low HDL-C in Korean adults.

Associations Between Television Viewing Time and Overall Sitting Time with the Metabolic Syndrome in Older Men and Women: The Australian Diabetes Obesity and Lifestyle Study

To examine associations between self-reported television (TV) viewing time and overall sitting time with the metabolic syndrome and its components. Cross-sectional. Population-based sample of older men and women living in Australia. One thousand nine hundred fifty-eight participants from the Australian Diabetes, Obesity and Lifestyle (AusDiab) study (aged ≥ 60, mean age 69, 54% women). Self-reported television viewing time and overall sitting time were collected using an interviewer-administered questionnaire. The metabolic syndrome was defined according to the revised International Diabetes Federation criteria. Compared with those in the lowest quartile, the odds ratios (ORs) of the metabolic syndrome in the highest quartile of television viewing time were 1.42 (95% confidence interval (CI)=0.93-2.15) for men and 1.42 (95% CI=1.01-2.01) for women and in the highest quartile of overall sitting time were 1.57 (95% CI=1.02-2.41) for men and 1.56 (95% CI=1.09-2.24) for women. Television viewing time was associated with lower high-density lipoprotein cholesterol (HDL-C) levels and glucose intolerance in women. Overall sitting time was detrimentally associated with greater risk of high triglyceride levels in men and women, abdominal obesity in women, and low HDL-C levels in men. All models were adjusted for age, education, physical activity, self-rated health, employment, diet, smoking, and alcohol intake and for hormone replacement therapy and estrogen use in women. For older adults, high levels of sedentary behavior were associated with greater prevalence of the metabolic syndrome; reducing prolonged overall sitting time may be a feasible way to improve metabolic health.

Hypothesis Testing

In most biomedical research, investigators hypothesize about the relationships of various factors, collect data to test those relationships, and try to draw conclusions about those relationships from the data collected. In many cases, investigators test relationships by comparing the average level of a factor between 2 groups or between 1 group and a standard reference. This framework is as true for understanding the basic role of cardiac myosin binding protein-C phosphorylation in cardiac physiology1 as it is for evaluating non–high-density lipoprotein cholesterol (HDL-C) as a predictor of myocardial infarction in large groups of individuals.2 In this article we describe hypothesis testing, which is the process of drawing conclusions on the basis of statistical testing of collected data, and the specific approach used to test means (or average levels of a collected data element). These concepts are covered in detail in many statistical textbooks at various levels, including Pagano and Gauvreau,3 Zar,4 and Kleinbaum et al.5 The purpose of statistical inference is to draw conclusions about a population on the basis of data obtained from a sample of that population. Hypothesis testing is the process used to evaluate the strength of evidence from the sample and provides a framework for making determinations related to the population, ie, it provides a method for understanding how reliably one can extrapolate observed findings in a sample under study to the larger population from which the sample was drawn. The investigator formulates a specific hypothesis, evaluates data from the sample, and uses these data to decide whether they support the specific hypothesis. The first step in testing hypotheses is the transformation of the research question into a null hypothesis, H, and an alternative hypothesis, HA.6 The null and alternative hypotheses are concise statements, usually in …

The association between high-density lipoprotein cholesterol level and cholesteryl ester transfer protein TaqIB gene polymorphism is influenced by alcohol drinking in a population-based sample

Cholesteryl ester transfer protein (CETP) is a key enzyme in high-density lipoprotein (HDL) cholesterol metabolism. We studied the association between CETP TaqIB polymorphism and the HDL cholesterol levels considering environmental factors in a population-based sample consisting of 1729 participants who did not use lipid-lowering agents (659 men and 1070 women). The CETP TaqIB genotypes were determined by PCR-RFLP analysis. The serum HDL cholesterol levels of female participants with the B2B2 genotype were significantly higher than those with other genotypes ( p < 0.001). Multiple regression analysis with covariates such as age, waist to hip (W/H) ratio, alcohol drinking, current smoking, non-HDL cholesterol, and logarithm of triglyceride revealed that the CETP TaqIB genotype was an independent determinant of HDL cholesterol levels in men ( p = 0.049) and women ( p < 0.001). Subgroup analysis revealed that an interaction was observed between the CETP TaqIB polymorphism and alcohol consumption in the regulation of HDL cholesterol levels in men ( p = 0.049) and women ( p = 0.022). No interactions were observed between the CETP TaqIB polymorphism and current smoking status, body mass index, or W/H ratio in the regulation of HDL cholesterol levels. The association between the CETP TaqIB polymorphism and HDL cholesterol levels was more evident in alcohol consumers than in non-drinkers.

Modulation of High-Density Lipoproteins in a Population in Istanbul, Turkey, With Low Levels of High-Density Lipoproteins

The extent to which high-density lipoprotein (HDL) cholesterol levels can be increased in patients with low HDL cholesterol is important because low HDL cholesterol levels increase the risk of coronary heart disease (CHD). During the past 14 years, we have assessed risk factors in Turks, a population in which extremely low HDL cholesterol levels (mean 36 mg/dl in men, 42 mg/dl in women) are a prime CHD risk factor. Although genetically determined to a significant extent, these low HDL cholesterol levels can be modulated by lifestyle factors, as in other populations. We measured the HDL cholesterol levels in men and women residing in Istanbul at 3 time points: 1990 to 1993, 1996 to 2000, and 2003. The mean HDL cholesterol levels increased from 45.3 +/- 9.5 mg/dl in 1990 to 1993 to 49.7 +/- 12 mg/dl in 2003 (p <0.0001) in women, but were virtually unchanged in men (38 +/- 8 vs 39 +/- 10 mg/dl). In contrast to previous years, the HDL cholesterol levels in women in 2003 were markedly affected by education level and socioeconomic status, averaging 56 +/- 9 mg/dl in those with a university education and 48 +/- 12 mg/dl in those with a primary school education. Part of this difference could be explained by less smoking and more exercise and lower body mass index (average 25.6 +/- 4.9 vs 29.7 +/- 5.1 kg/m(2)) of the highly educated women. It is important to note the increase in the prevalence of obesity between the 1990 to 1993 interval and 2003 in men and women, including a remarkable change from 9.4% to 45.2% among women with a primary school education. None of these factors affected the HDL cholesterol levels of men by >2 mg/dl at any of the 3 points. In conclusion, because CHD risk changes by as much as 2% to 4% per 1 mg/dl difference in HDL cholesterol level, the 8 mg/dl difference may reflect as much as a 20% to 30% reduction in CHD risk associated with the benefit of higher education in women. Why education failed to affect the HDL cholesterol levels in Turkish men remains unclear.

Common polymorphisms of ATP binding cassette transporter A1, including a functional promoter polymorphism, associated with plasma high density lipoprotein cholesterol levels in Turks

The role of high levels of high density lipoprotein cholesterol (HDL-C) in protection against development of atherosclerosis is generally attributed to its role in reverse cholesterol transport, and the ATP binding cassette transporter A1 (ABCA1) is a key element of this process. We examined polymorphisms in ABCA1 in Turks, a population characterized by very low HDL-C levels. We discovered 36 variations in ABCA1 and genotyped informative polymorphisms in over 2300 subjects. The rare alleles of C–14T and V771M polymorphisms were associated with higher HDL-C levels in men and, in combination with the rare alleles of R219K and I883M, respectively, with higher HDL-C in both sexes. Rare alleles of the C–14T and V771M polymorphisms were more frequent in the high HDL-C (≥40 mg/dl) than in the low HDL-C group (≤30 mg/dl) in men ( P < 0.05). Moreover, the T allele of C–14T had more in vitro transcriptional activity than the C allele (20–88%), depending on the cell line ( P < 0.05), suggesting its functionality. Haplotype construction and haplotype association with phenotype were performed in the promoter and coding region of ABCA1 separately. Analysis of the promoter haplotype block supported the association with the C–14T polymorphism. The C–14T and R219K polymorphisms were on different haplotype blocks. Analysis of the coding region structure revealed that the rare M allele of V771M was distributed predominantly among three common haplotypes, but the sum of their frequencies comprise only two-thirds of the frequency of the M allele. The rare alleles of the V771M and the I883M polymorphisms do not exist together on any of the common haplotypes. In conclusion, we describe a functional promoter polymorphism (C–14T) and a coding sequence variant (V771M) of ABCA1 and their interactions with two other variants (R219K and I883M) on plasma HDL-C levels in Turks.

Relationship between DRD4 Polymorphism and Lipid Metabolism: What Is the Role of Novelty Seeking?

Objective: This study examined the association of the dopamine receptor D₄ (DRD4) gene polymorphism with the temperament dimension of novelty seeking (NS) on cardiovascular heart disease risk factors [the levels of high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides]. Method: From the ongoing population-based study of ‘Cardiovascular Risk in Young Finns’, 125 participants were DRD4 genotyped in 1997 and responded to the NS scale of the Temperament and Character Inventory in 2001. Their cholesterol and triglyceride concentrations were assessed in 2001. Results: Having a 2- or 5-allele DRD4 polymorphism was related to high HDL cholesterol levels in men, but to low HDL cholesterol levels in women. NS was related to triglycerides in men and to LDL in women, but this was mediated by behavioral, age, and weight factors, and NS was not the underlying factor for the association between the polymorphism and lipids. Conclusion: Our preliminary findings suggest that there is a link between the dopaminergic receptor gene DRD4 and lipid metabolism, but this link is dependent on gender.

Lipoprotein levels in elderly patients with asthma

Lipoprotein levels in elderly patients with asthma

Life-style factors do not explain racial differences in high-density lipoprotein cholesterol: the Minnesota Heart Survey.

We analyzed data from a population-based survey to determine whether serum high-density lipoprotein cholesterol (HDL-C) concentrations are different in blacks and whites after controlling for life-style characteristics. We studied a total of 741 white men, 453 black men, 786 white women, and 572 black women age 35-74 years. Age-adjusted HDL-C concentrations were higher in black than white men (48.6 vs 40.8 mg/dl) and in black than white women (56.1 vs 54.0 mg/dl). Life-style characteristics associated with HDL-C in women were exogenous hormone use, average number of cigarettes smoked per day, average ounces of alcohol consumed per week, body mass index, and use of beta-blockers. Life-style characteristics associated with HDL-C levels in men included age, average number of cigarettes smoked per day, average ounces of alcohol consumed per week, body mass index, and a self-reported history of diabetes. After adjustment for life-style characteristics, black men and women had HDL-C levels 7.0 and 5.3 mg/dl higher, respectively, than whites. Body mass index was a negative confounder in women; after adjusting for body mass and age, black women had HDL-C levels 4.6 mg/dl higher than white women. These data indicate that the measured life-style factors cannot fully explain the observed differences in HDL-C between blacks and whites. These findings, which are consistent with other reports, may reflect an inability to assess life-style factors accurately and/or genetic or cultural factors yet to be determined.

Effects of Chromium Supplementation on Serum High-Density Lipoprotein Cholesterol Levels in Men Taking Beta-Blockers

To determine the efficacy of glucose tolerance factor (GTF)-chromium for increasing serum levels of high-density lipoprotein (HDL) cholesterol in patients taking beta-blockers. Randomized, double-blind, placebo-controlled trial. Mixed primary and referral-based outpatient clinic at a university-affiliated VA Medical Center. Referred sample of 72 men receiving beta-blockers, mainly for hypertension. Sixty-three patients (88%) completed the study. Current medications, including beta-blockers, were continued. During the 8-week treatment phase, patients in the chromium group received a total daily dose of 600 micrograms of biologically active chromium divided into three equal doses; control patients received a placebo of identical appearance and taste. Serum levels of total cholesterol and HDL cholesterol were measured. Mean baseline levels of HDL and total cholesterol (+/- SD) were 0.93 +/- 0.28 mmol/L and 6.0 +/- 1.0 mmol/L (36 +/- 11.1 mg/dL and 232 +/- 38.5 mg/dL), respectively. The difference between groups in adjusted mean change in HDL cholesterol levels, accounting for baseline HDL cholesterol levels, age, weight change, and baseline total cholesterol levels, was 0.15 mmol/L (5.8 mg/dL) (P = 0.01) with a 95% Cl showing that the treatment effect was greater than +0.04 mmol/L (+1.4 mg/dL). Mean total cholesterol, triglycerides and body weight did not change significantly during treatment for either group. Compliance as measured by pill count was 85%, and few side effects were reported. Two months after the end of treatment, the between-group difference in adjusted mean change from baseline to end of post-treatment follow-up was -0.003 mmol/L (-0.1 mg/dL). Two months of chromium supplementation resulted in a clinically useful increase in HDL cholesterol levels in men taking beta-blockers.

Lipid and apolipoprotein levels in an Australian community

Serum levels of total and high density lipoprotein (HDL) cholesterol and apolipoproteins A1 and B were measured in over 600 men and women aged 30-69 years who were selected at random from an Australian community. Total cholesterol and apolipoprotein A1 and B levels increased with age, with this effect being most pronounced for total cholesterol and apolipoprotein B in women. Body mass index and waist-to-hip ratio were positively correlated with apolipoprotein B and total cholesterol levels, and negatively correlated with apolipoprotein A1 and HDL cholesterol levels. All lipid and apolipoprotein A1 levels increased with the quantity of alcohol consumed. After adjusting for age, body mass index and smoking, the association with alcohol was strongest for apolipoprotein A1 and HDL cholesterol levels in men (P = 0.0001), and for apolipoprotein A1 levels in women (P = 0.01). Levels of apolipoprotein A1 and HDL cholesterol were lower, and of apolipoprotein B and total cholesterol were higher, in current cigarette smokers than non-smokers, with significant associations for apolipoprotein B (P = 0.004) and HDL cholesterol levels (P = 0.04) in men. In general, the associations between apolipoprotein A1 levels and the other variables were weaker than those for HDL cholesterol levels, whereas the associations with apolipoprotein B levels were stronger than those for total cholesterol levels (except for alcohol consumption). Thus, obesity, alcohol consumption and cigarette smoking should be considered when interpreting apolipoprotein levels.