Gemfibrozil reduces plasma C-reactive protein levels in abdominally obese men with the atherogenic dyslipidemia of the metabolic syndrome.
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Adult↗
Biomedical subjects
Jean Bergeron
Publications and source records attributed to Jean Bergeron.
Effect of plasma C-reactive protein levels in modulating the risk of coronary heart disease associated with small, dense, low-density lipoproteins in men (The Quebec Cardiovascular Study).
This purpose of this study was to investigate how plasma C-reactive protein (CRP), a nonspecific acute-phase reactant, modulates the risk of coronary heart disease (CHD) associated with the small, dense, low-density lipoprotein (LDL) phenotype. LDL particle size and plasma CRP were measured in the Quebec Cardiovascular Study cohort of 2,025 men free of CHD at baseline, among whom 103 had a first CHD event during a 5-year follow-up period. Plasma CRP levels were measured using the Behring Latex-Enhanced (highly sensitive) CRP assay. LDL particle size phenotype was characterized using 2% to 16% polyacrylamide gradient gel electrophoresis. There were weak but significant associations between plasma CRP levels and features of LDL size, such as the proportion of LDL with a diameter <255 A (r = 0.09, p <0.001) and LDL peak particle size (r = -0.09, p <0.001). Variations in plasma CRP levels modulated the risk of CHD associated with small LDL peak particle size (relative risk 4.3 vs 2.5 in men with high vs low plasma CRP levels, respectively) and with an elevated proportion of LDL <255 A (relative risk 6.6 vs 3.0). Thus, increased plasma CRP levels further elevate the risk of CHD associated with having small, dense LDL particles.
Age Distribution↗
Effect of apoC-III gene polymorphisms on the lipoprotein-lipid profile of viscerally obese men.
Abdominal visceral adipose tissue (AT) accumulation is associated with an atherogenic metabolic profile that includes increased plasma triglyceride (TG), low HDL cholesterol levels, and an insulin-resistant hyperinsulinemic state. Whereas the apolipoprotein (apo) C-III C3238G gene variant, often referred to as the SstI polymorphism, has been related to variations in plasma TG concentrations, another variation within the insulin responsive element (C-482T) of the apoC-III gene has been associated with greater glucose and insulin responses to an oral glucose tolerance test (OGTT); however, these results were obtained in nonobese individuals. We therefore investigated the effects of three apoC-III gene polymorphisms, namely SstI, C-482T, and T-455C, on fasting plasma lipoprotein-lipid levels and response to a 75 g OGTT in a sample of 122 viscerally obese men (abdominal visceral AT area >or=130 cm(2)). Among the three gene variants that were examined, the SstI variation was the only one found to be associated with hypertriglyceridemia. Indeed, S1/S2 heterozygotes (n = 24) were characterized by increased fasting plasma TG concentrations compared with S1/S1 homozygotes (n = 98) (mean +/- SD: 3.03 +/- 1.58 vs. 2.34 +/- 0.95 mmol/l respectively, P < 0.05). The higher TG concentrations in S1/S2 were associated with the presence of smaller, denser LDL particles compared with S1/S1 subjects (LDL peak particle diameter: 24.8 +/- 0.5 nm vs. 25.1 +/- 0.5 nm respectively, P < 0.05). Furthermore, there was no association between the response to the OGTT and any of the apoC-III gene variants (SstI, T-455C, or C-482T) examined. Results of the present study support the notion of a hypertriglyceridemic effect associated with the apoC-III SstI polymorphism that could modulate the magnitude of the dyslipidemic state in abdominally obese patients.
Adipose Tissue↗
The interleukin 6-174G/C polymorphism is associated with indices of obesity in men.
Obesity represents an expansion of adipose tissue (AT) mass and is closely related to insulin resistance and cardiovascular disease. Several hormonal signals have been shown to originate from AT, one of them being interleukin 6 (IL6), for which one third of circulating levels is accounted for by AT. To study the impact of the IL6 -174G/C polymorphism on obesity-related phenotypes, we genotyped a cohort of 270 French-Canadian men from the greater Quebec City area selected to cover a wide range of body fatness values. The IL6 -174G allele was more commonly observed among lean subjects (body mass index <25 kg/m(2), chi(2) = 7.27, P = 0.007 or waist-line <100 cm, chi(2) = 6.63, P = 0.01). When men were subdivided according to insulin and glucose levels at 180 min following the glucose load, using 160 pmol/l and 4.6 mmol/l, respectively, as cutoff points, the -174G allele was more frequently observed in groups with low concentrations of either insulin or glucose, P = 0.03 and P = 0.01, respectively. When comparisons between genotype groups were performed, -174G/G homozygotes presented the lowest waist circumference ( P < 0.05). In summary, this study showed that, in men, the IL6 -174G/C polymorphism is associated with some indices of body composition and parameters of glucose and insulin homeostasis.
Blood Glucose↗
Postprandial hyperlipidemia: another correlate of the "hypertriglyceridemic waist" phenotype in men.
Fasting hypertriglyceridemia has been reported to be predictive of an exaggerated triglyceride (TG) response to an oral fat load. Abdominal obesity has also been associated with postprandial hyperlipidemia. The objective of the present study was to quantify the contribution of abdominal obesity and fasting hypertriglyceridemia to the magnitude of postprandial lipemia. For that purpose, potential differences in postprandial TG-rich lipoprotein (TRL) levels were examined among men characterized by the absence/presence of the "hypertriglyceridemic waist" phenotype following a standardized breakfast with a high fat content (64% calories as fat). Sixty-nine men (mean age +/- S.D.: 45.1 +/- 10.5 years) were classified according to waist girth (< 90 or >/ or = 90 cm) and fasting TG concentrations (< 2.0 or > or = 2.0 mmol/l). Subjects characterized by "hypertriglyceridemic waist" (waist > or = 90 cm and fasting TG > or = 2.0 mmol/l) showed the highest TRL-TG concentrations (P < 0.0001) throughout the entire postprandial period (8 h) as well as elevated concentrations of apolipoprotein (apo) B-48 and apo B-100 in all TRL fractions (large, medium and small) compared to subjects with low fasting TG levels who had waist girth values either above or below 90 cm. These higher postprandial TRL-TG levels among carriers of the "hypertriglyceridemic waist" phenotype also led to significantly greater postprandial TG-total area under the curve (AUC) in total TRLs resulting mainly from the increased concentrations of large- and medium-sized TRLs. Furthermore, subjects characterized by the "hypertriglyceridemic waist" phenotype displayed higher fasting insulin concentrations and postprandial insulin AUC compared to men with low fasting plasma TG levels and low waist girth values. In conclusion, results of the present study indicate that postprandial hyperlipidemia is associated with the simultaneous presence of abdominal obesity and elevated fasting TG concentrations: a condition that we have described as the "hypertriglyceridemic waist" phenotype.
Adipose Tissue↗
Apolipoprotein AI- and AI:AII-containing lipoproteins in white men and women of the HERITAGE Family study: Associations with metabolic risk profile variables.
It is now well established that an increased high-density lipoprotein (HDL) cholesterol level, especially in the HDL(2) subfraction, is associated with a reduced risk of coronary heart disease (CHD). However, little is known about the associations between the apolipoprotein (apo) composition of HDL and CHD metabolic risk factors. In the present study, we examined the gender differences in plasma concentration of HDL containing apo AI only (LpAI) versus both apoAI and apoAII (LpAI/AII), and also compared their associations with body composition, adipose tissue (AT) distribution, and metabolic risk profile variables. For that purpose, we measured fasting plasma lipoprotein-lipid levels including LpAI and LpAI/AII concentrations in a sample of 215 men and 174 women, all Caucasians, of the HERITAGE Family Study. All subjects underwent anthropometric, body fatness (underwater weighing) and abdominal AT accumulation (computed tomography) measurements. We found that, women had higher LpAI and lower LpAI/AII concentrations compared with men. Whereas in women, LpAI levels were correlated to body fat mass and waist circumference, no association between body composition, fat distribution, and LpAI concentrations was noted in men. Increased LpAI concentrations were associated with higher HDL(2) cholesterol levels in both men and women. Overall, elevated LpAI and LpAI/AII concentrations showed contrasting associations with metabolic risk profile variables as high LpAI, but not LpAI/AII concentrations were associated with a more favorable metabolic risk profile. We also found that high HDL cholesterol appeared to be more closely related to a better metabolic risk profile than high LpAI in both genders. Our results suggest that LpAI and HDL cholesterol levels are good correlates of the metabolic profile, but that HDL cholesterol concentrations could still represent a better index in CHD risk assessment.
Adipose Tissue↗
Triglycerides and small dense LDL: the twin Achilles heels of the Friedewald formula.
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Apolipoproteins B↗
Effects of atorvastatin on electrophoretic characteristics of LDL particles among subjects with heterozygous familial hypercholesterolemia.
The effects of the HMG CoA reductase inhibitor atorvastatin on electrophoretic characteristics of LDL particles were evaluated in 46 patients (28 males and 18 females) with heterozygous familial hypercholesterolemia (FH) aged 20-61 carrying either a negative or a defective LDL receptor gene mutation. Following a 6 week drug-free baseline period, FH heterozygotes were treated with atorvastatin (median dose: 20 mg/day, range 10-80 mg/day)) for 6 months to maintain their plasma LDL-cholesterol concentrations between 4.0 and 5.0 mmol/l. Atorvastatin treatment significantly reduced plasma total cholesterol, LDL-cholesterol and triglyceride levels and increased plasma HDL-cholesterol. Furthermore, atorvastatin treatment significantly increased LDL peak particle diameter (LDL-PPD) by 0.5% (from 255.0+/-6.2 to 256.4+/-5.5 A, P=0.004) and reduced the absolute concentration of cholesterol among small (<255 A) and large (>260 A) LDL particles by 35% (P<0.001). Changes in LDL-PPD and plasma triglyceride levels were inversely correlated (R=-0.34; P=0.02). Stepwise multiple linear regression analyses showed that 41.6% of the variation in the LDL-PPD response to atorvastatin was attributable to the initial LDL-PPD (14.4%, P=0.003), the apo E polymorphism (12.4%, P=0.02), the nature of the LDL receptor gene mutation (9.6%, P=0.01) and change in triglyceride levels (5.2%, P=0.04). Moreover, the reduction in the cholesterol content of LDL <255 A was directly correlated with the daily dosage of atorvastatin (P=0.05). Results of the present study showed that atorvastatin alters significantly LDL heterogeneity in patients at high risk of coronary heart disease (CHD) such as FH heterozygotes. These results also suggest that genetic and metabolic factors may be important determinants of atorvastatin-induced changes of LDL particle size and distribution among FH heterozygotes.
Adult↗
Influences of apolipoprotein E polymorphism on the response of plasma lipids to the ad libitum consumption of a high-carbohydrate diet compared with a high-monounsaturated fatty acid diet.
The purpose of this study was to assess the contribution of the apolipoprotein E (apoE) polymorphism and factors, such as age and waist circumference, to variations in plasma low-density lipoprotein-cholesterol (LDL-C) response following ad libitum consumption of a diet rich in complex carbohydrates (high-CHO: 58% of energy as CHO) versus a diet rich in fat and monounsaturated fatty acids (high-MUFA: fat, 40% of energy and 22% as MUFA). Sixty-five men participated in this parallel 6- to 7-week study involving either a high-CHO or a high-MUFA diet. Fasting plasma lipid profile and anthropometry were determined at the beginning and at the end of the dietary period. The high-CHO and high-MUFA diets both induced significant (P<.01) and comparable reductions in body weight and waist circumference. These changes were associated with a significant (P<.01) and comparable decrease in LDL-C (-19% and -16%, respectively). Stepwise multiple regression analyses showed that 32% of the variation in the LDL-C response to the high-CHO diet was attributable to the apoE polymorphism (18.5%, P=.04) and waist circumference (13.5%, P=.03) indicating that men with a waist circumference greater than 100 cm and the E2 allele had the greatest reduction in plasma LDL-C after the high-CHO diet. On the other hand, in the high-MUFA group, waist circumference was the only significant contributing factor to the LDL-C response and accounted for 44.5% of its variance. In conclusion, the plasma LDL-C response to ad libitum comsumption of a high-CHO and a high-MUFA diets are not modulated to the same extent by the apoE polymorphism and waist circumference.
Adult↗
Impact of postprandial variation in triglyceridemia on low-density lipoprotein particle size.
The fasting atherogenic dyslipidemia of visceral obesity, which includes the presence of small, dense low-density lipoprotein (LDL) particles, is predictive of an increased risk of coronary heart disease (CHD). It has also been suggested that progression of atherosclerosis may be accelerated in the presence of postprandial hyperlipidemia independently from the fasting dyslipidemic state. Studies have shown that the best predictor of postprandial hyperlipidemia and of the small, dense LDL phenotype is fasting triglyceride (TG) concentration. In the present study, we evaluated the impact of postprandial hypertriglyceridemia on the variation in LDL particle size. Fasting (0 hour) and postprandial changes (2, 4, 6, and 8 hours) in LDL particle size were measured by nondenaturing 2% to 16% polyacrylamide gel electrophoresis in a sample of 49 men (mean age +/- SD: 46.6 +/- 9.2 years) who underwent a standardized breakfast with a high-fat (64% calories as fat) content. The postprandial increase in TG levels was associated with a transient reduction in LDL particle size, the most substantial reduction being observed 4 hours (-1.0 +/- 2.4 A) after the oral fat load. Although there were strong correlations between TG-rich lipoprotein (TRL)-TG levels and LDL particle size in the fasting state (r=-0.71, P<.0001) as well as 4 hours after the oral fat load (r=-0.70, P<.0001), changes in TRL-TG concentrations during the postprandial state (from time 0 to 4 hours) were not associated with changes in LDL particle size during this period (r=-0.04, not significant [NS]). However, among subgroups of men matched for similar fasting TRL-TG levels (n=12), subjects with the highest total area under the curve (AUC) of TRL-TG after the fat load were characterized by smaller LDL particle size at 6 and 8 hours compared with men with the lowest AUC TRL-TG (P<.02). Men displaying the highest postprandial AUC TRL-TG were also characterized by the greatest accumulation of visceral adipose tissue (AT) (P<.05). These results indicate that the hypertriglyceridemic (hyperTG) state induced by a high-fat meal is associated with a transient reduction in LDL peak particle diameter, which is not proportionate, however, to the level of TG achieved in the postprandial state. Furthermore, despite similar TG levels at baseline, viscerally obese men with an impaired postprandial lipemia had smaller LDL particles at the end of the oral fat load than obese men with a lower accumulation of visceral AT.
Adult↗
Visceral obesity attenuates the effect of the hepatic lipase -514C>T polymorphism on plasma HDL-cholesterol levels in French-Canadian men.
UNLABELLED: The dyslipidemic state of visceral obesity is characterized by increased plasma triglyceride (TG) levels, low HDL-cholesterol concentrations and alterations in LDL composition and concentration. A functional, non-coding -514C>T single nucleotide polymorphism (SNP) of the hepatic lipase gene (LIPC) has been related to variation in HDL-cholesterol concentrations. OBJECTIVES: To investigate the hypotheses that the LIPC -514C>T polymorphism may be associated with a deteriorated lipoprotein-lipid profile and that environmental factor, such as abdominal obesity, alters this association. METHODS: A total of 235 French-Canadian men from the greater Quebec City area were assigned into three groups on the basis of their LIPC -514C>T SNP, including 149 CC homozygotes, 75 CT heterozygotes, and 11 TT homozygotes. RESULTS: In the present study, the highest values of BMI, waist circumference, and accumulation of visceral adipose tissue (VAT) were observed among TT homozygotes (p<0.05). After adjustment for age and BMI, TT homozygotes still showed higher plasma apolipoprotein (apo) AI and HDL-TG concentrations than the two other groups (p<0.05). When the two genotype groups (CC vs CT/TT) were further divided on the basis of VAT accumulation using a cut-off point of 130 cm(2) (high vs low) it appears that irrespective of the genotype subjects with low VAT had higher HDL(2)-cholesterol concentrations (p<0.0001). However, lean carriers of the T allele had higher plasma HDL(2)-cholesterol levels than lean CC homozygotes. The beneficial effect of the T allele on plasma HDL(2)-cholesterol levels was abolished in the presence of visceral obesity (VAT>130 cm(2)). CONCLUSION: In summary, the presence of visceral obesity attenuates the impact of the LIPC -514C>T polymorphism on plasma HDL(2)-cholesterol levels.
Adult↗
Variations in body composition and plasma lipids in response to a high-carbohydrate diet.
OBJECTIVE: To examine the extent to which variations in body composition modulate changes in the lipid profile in response to the ad libitum consumption of a diet rich in carbohydrates (CHOs) (high-CHO diet: 58% of energy as CHOs) or high in fat and in monounsaturated fatty acids (MUFAs) (high-MUFA diet: 40% of energy as fat, 23% as MUFAs). RESEARCH METHODS AND PROCEDURES: Sixty-three men were randomly assigned to one of the two diets that they consumed for 6 to 7 weeks. Body composition and fasting plasma lipid levels were measured at the beginning and the end of the dietary intervention. RESULTS: The high-CHO and high-MUFA diets induced significant and comparable reductions in body weight and waist circumference. These changes were accompanied by significant and comparable (p < 0.01) reductions in total plasma cholesterol and low-density lipoprotein cholesterol levels. However, the high-MUFA diet had more beneficial effects on plasma triglyceride concentrations (p < 0.01) and on plasma high-density lipoprotein cholesterol levels (p = 0.02) compared with the high-CHO diet. Diet-induced changes in waist circumference were significantly associated with changes in low-density lipoprotein cholesterol levels in the high-CHO group (r = 0.39, p = 0.03) but not in the high-MUFA group (r = 0.16, p = 0.38). DISCUSSION: Improvements in plasma lipids induced by the ad libitum consumption of a high-CHO diet seem to be partly mediated by changes in body weight, whereas lipid changes induced by the high-MUFA diet seem to be independent of changes in body weight.
Adipose Tissue↗
Impact of abdominal visceral fat, growth hormone, fitness, and insulin on lipids and lipoproteins in older adults.
We examined the relationship between abdominal visceral fat (AVF) and plasma concentrations of lipids and lipoproteins in 19 females (F) (not on estrogen) and 31 males (M) over the age of 60 (age = 66.8 years). In addition, the effects of growth hormone (GH) release, fitness (Vo(2) peak), insulin, and glucose concentrations (both fasting and in response to an oral glucose tolerance test) on lipids were examined. Subjects were categorized by low (L) and high (H) AVF (L < 130 cm(2), H > 130 cm(2)), fat mass (FM) (above or below median value), and AVF corrected for fat mass. Factorial analysis of variance (ANOVA) showed that when subjects were divided by AVF and FM, similar results were observed with H > L (P <.05) for very-low-density lipoprotein-cholesterol (VLDL-C), triglycerides (TG), VLDL-TG, apolipoprotein (apo)-B, apo-B VLDL, cholesterol (Chol)/high-density lipoprotein (HDL), LDL/HDL, apoB/A1 and L > H for HDL, HDL(2), HDL(3), apo A1, and LDL/apo-B LDL. Gender differences were also observed with F > M for Chol, LDL, HDL, and HDL(2). When AVF was corrected for FM, these gender differences were still present. After correcting for FM, differences remained between H and L AVF groups for VLDL, TG, VLDL-TG, apo-B, apo-B LDL, apo-B VLDL, apoB/A1 (P <.05). Twenty-four hour integrated GH concentration (IGHC) was inversely related to VLDL, TG, VLDL TG, LDL TG, apoB, apoB VLDL, apoB LDL, Chol/HDL, LDL/HDL, and apoB/A1 in F, but not M (P <.05). Vo(2) peak was directly related to Chol, LDL, HDL(3), and apoB LDL with stronger relationships observed in F. Fasting insulin was related to lipids and lipoproteins in both men and women. These data suggest that, in older adults, elevated levels of AVF, FM, and AVF corrected for FM are associated with unfavorable lipid-lipoprotein profiles and extend similar findings reported in younger males and females with elevated AVF. These data also support previous findings indicating that AVF is a primary determinant of GH release.
Abdomen↗
Whole-body fat oxidation rate and plasma triacylglycerol concentrations in men consuming an ad libitum high-carbohydrate or low-carbohydrate diet.
BACKGROUND: High-carbohydrate diets may increase plasma triacylglycerol concentrations either by increasing production of triacylglycerols or by reducing their clearance. OBJECTIVE: We assessed whether the changes in plasma triacylglycerol concentrations induced by dietary interventions were associated with the changes in whole-body fat oxidation rates. DESIGN: In a parallel study, 37 healthy male subjects [body mass index (in kg/m(2)): 28 +/- 5, age: 34 +/- 11 y (x +/- SD)] consumed an ad libitum high-carbohydrate (60% of energy; n = 19) or low-carbohydrate (46% of energy), high-fat (41% of energy, 23% as monounsaturated fatty acids; n = 18) diet for 7 wk. The following variables were measured before and after the dietary interventions: 1) plasma triacylglycerols before and 2, 4, 6, and 8 h after a meal (containing 40% of daily energy needs and 41% fat); 2) indirect calorimetry throughout the 8-h test; and 3) postheparin plasma lipoprotein lipase (phLPL) activity at time 8 h of the test. RESULTS: The diets induced changes in 1) body weight: -2.5 +/- 2.8 kg (P < 0.01) and -1.7 +/- 3.1 kg (P < 0.05) and 2) fasting plasma triacylglycerols: 0.0 +/- 0.4 mmol/L (NS) and -0.3 +/- 0.3 mmol/L (P < 0.05) for the high-carbohydrate and the low-carbohydrate diets, respectively. In normoinsulinemic subjects (fasting insulin < 100 pmol/L), dietary changes in postprandial triacylglycerols were significantly predicted by changes in phLPL, body weight, respiratory quotient (or fat oxidation), and the type of diet (stepwise multiple linear regression). CONCLUSION: Postprandial plasma triacylglycerol concentrations may depend at least partly on fat oxidation, body weight, and LPL activity.
Adult↗
Plasma lipids and lipoproteins in hypercholesterolemic men fed a lipid-lowering diet containing lean beef, lean fish, or poultry.
BACKGROUND: To reach desirable lipid and lipoprotein concentrations, patients with hypercholesterolemia are often told to replace the consumption of beef with that of fish and poultry. OBJECTIVE: The objective of this study was to compare the effects on lipoprotein profiles in hypercholesterolemic men of the incorporation of lean beef, poultry (without skin), and lean fish into an American Heart Association diet with a high polyunsaturated-to-saturated fatty acid ratio and a high fiber content. DESIGN: Three groups of subjects each rotated in a crossover design through 3 experimental periods that lasted 26 d each. The diets were planned to provide 11 713 kJ/d, of which 18% came from protein, 53% from carbohydrate, and 30% from lipids (polyunsaturated-to-monounsaturated-to-saturated fatty acid ratio: 1.0:1.1:1.0); 268 mg cholesterol/d; and 29 g fiber/d. RESULTS: The lean beef, lean fish, and poultry diets reduced plasma total and LDL cholesterol by 5-9%, LDL apolipoprotein B by 16-19%, VLDL triacylglycerols by 22-31%, and the ratio of total cholesterol to HDL cholesterol by 6-11%; they also increased the ratio of LDL cholesterol to apolipoprotein B by 18-28%. No significant difference was found in these lipid variables between the 3 experimental diets. However, the lean fish diet increased HDL(2) cholesterol significantly more (P < 0.05) than did the lean beef diet and the ratio of HDL(2) to HDL(3) cholesterol significantly more (P < 0.05) than did the lean beef and poultry diets. CONCLUSION: The results indicate that an American Heart Association diet with a high polyunsaturated-to-saturated fatty acid ratio and high fiber content induced numerous favorable changes in coronary artery disease risk factors in hypercholesterolemic men, regardless of the protein source.
Adult↗
High carbohydrate and high monounsaturated fatty acid diets similarly affect LDL electrophoretic characteristics in men who are losing weight.
We compared the effects of ad libitum consumption of a defined high complex carbohydrate (CHO) diet (% of energy: CHO, 58.3; fat, 25.8) vs. a defined high monounsaturated fatty acid (MUFA) diet (% of energy: CHO, 44.7; fat, 40.1; MUFA, 22.5) on LDL electrophoretic characteristics. Healthy men [n = 65; age, 37.5 +/- 11.2 (mean +/- SD) y; BMI, 29.2 +/- 4.9 kg/m2] were randomly assigned to one of the two diets that they consumed for 6-7 wk. The high CHO diet significantly reduced body weight (-2%). The diet-induced reduction in plasma LDL cholesterol (C) levels in the high-CHO diet group was due mainly to concurrent reductions in the cholesterol content of small (<25.5 nm, P < 0.01) and medium-sized LDL (25.5-26.0 nm, P = 0.01). The high MUFA diet also reduced body weight, and LDL-C and LDL-apolipoprotein (apo)B levels, which were comparable to those in the high CHO group. The cholesterol levels of small LDL particles tended to be reduced (P = 0.24) in the high MUFA group (-12%), similar to changes in the high CHO group. These results suggest that, when associated with weight loss, ad libitum consumption of high CHO and high MUFA diets may be considered to be equally beneficial for the management of LDL-related atherogenic dyslipidemia. However, the high MUFA diet more favorably affected triglyceride levels, suggesting that it may be preferable to a high CHO diet in cardiovascular disease prevention.
Adult↗
Contribution of visceral adiposity to the exaggerated postprandial lipemia of men with impaired glucose tolerance.
OBJECTIVE: Impaired glucose tolerance (IGT) has been associated with alterations in numerous coronary heart disease risk factors, including postprandial hyperlipidemia. An excess visceral adipose tissue accumulation is also predictive of IGT and of an exaggerated postprandial lipemia. The objective of the present study was therefore to compare the respective contributions of visceral adipose tissue accumulation versus IGT with the variation in postprandial lipemia. RESEARCH DESIGN AND METHODS: Potential differences in postprandial triglyceride (TG)-rich lipoprotein (TRL) levels following a standardized breakfast with a high fat content were examined among men characterized by normal glucose tolerance (NGT) or IGT. Sixty-seven men were classified according to their glucose tolerance status (<7.8 mmol/l [NGT] or between 7.8 and 11.1 mmol/l [IGT] 2 h after a 75-g oral glucose test). RESULTS: Men with IGT showed the highest TRL-TG concentrations (P < 0.05) at the 4-, 6-, and 8-h time points compared with men with NGT. These higher postprandial TRL-TG levels among men with IGT were also accompanied by a greater postprandial TG total area under the incremental curve in all TRL fractions (large, medium, and small) (P < 0.05). Furthermore, subjects characterized by IGT had also the highest visceral adipose tissue accumulation (P < 0.009). When subgroups of IGT and NGT men were individually matched (n = 11) for similar visceral adipose tissue accumulation, no significant difference was found in postprandial responses of all TRL-TG fractions between the two groups. CONCLUSIONS: These results provide evidence that visceral adipose tissue accumulation is an important factor involved in the deterioration of postprandial lipemia noted among men with IGT.
Adipose Tissue↗
Prevalence of metabolic alterations predictive of cardiovascular disease risk in the Québec population.
BACKGROUND: It is well established that cardiovascular diseases (CVD) are the most important cause of morbidity and mortality in North America and in industrialized countries. Furthermore, the presence of CVD risk factors is widespread in Canada, and two-thirds of adult Canadians present at least one traditional risk factor for CVD. OBJECTIVE: To quantify the prevalence of metabolic alterations predictive of an increased risk of CVD in a representative sample of the Québec population. METHODS: A representative sample of the Québec population was obtained through the Québec Health Survey 1990. The cohort of 1844 subjects (907 men and 937 women), aged from 18 to 74 years, completed the evaluation, which consisted of interviews, validated questionnaires for personal and family history of CVD risk factors, and a physical examination. Anthropometric measurements, blood pressure, fasting plasma lipoprotein-lipid levels as well as fasting glucose and insulin concentrations were obtained. RESULTS: Thirty one per cent of the Québec population had a normal body weight defined by body mass index (BMI) less than 25 kg/m2 with a healthy metabolic profile (glycemia less than 6.1 mmol/L, total cholesterol less than 5.2 mmol/L, low density lipoprotein-cholesterol less than 3.4 mmol/L, triglycerides less than 2.3 mmol/L and high density lipoprotein-cholesterol greater than 0.90 mmol/L). On the other hand, 28% of the population was treated for known metabolic chronic diseases (CVD, diabetes, dyslipidemias and hypertension), whereas the remaining 33% of the Québec population (BMI greater than 25 kg/m2) were characterized by an altered metabolic profile predictive of an increased CVD risk. Furthermore, 75% of men and 70% of women with an altered metabolic profile presented at least two CVD risk factors. Overall, women tended to display a significantly healthier metabolic risk profile than men (P<0.05). CONCLUSIONS: According to our results, only 31% of the Québec population is nonobese without major alterations in their metabolic risk profile. Indeed, 61% of Quebecers are either characterized by chronic diseases or by an altered metabolic profile increasing their risk for the development of CVD and type 2 diabetes. Such a high prevalence should be a source of concern justifying the development of simple screening tools for early identification of the asymptomatic carriers of this cluster of metabolic abnormalities.
Adolescent↗