Associations of indices of adiposity with atherogenic lipoprotein subfractions

OBJECTIVE: To investigate the associations of indices of adiposity with cardiovascular risk factors. SUBJECTS: 93 men and 98 women aged 18-69 y. OUTCOME MEASURES: Body mass index (BMI), waist to hip ratio (WHR), waist circumference, waist to height ratio, blood pressure, fasting concentrations of blood glucose, insulin, plasma lipids and lipoprotein subfractions, apoproteins, lipoprotein(a) and post-heparin lipases. RESULTS: BMI and waist showed similar associations (P < 0.01) with a cluster of major cardiovascular risk factors including total cholesterol, low density lipoprotein-cholesterol and very low density lipoprotein-cholesterol in men, and ratio of low density lipoprotein-/high density lipoprotein-cholesterol for both genders. Large waist circumference was significantly (P (0.01) associated (controlled for age and smoking) with features of the metabolic syndrome, including raised insulin concentration (men: r = 0.37, women: r = 0.49), reduced high density lipoprotein(2) (men: r = -0.30, women: r = -0.34), increased very low density lipoprotein(1) mass (men: r = 0.31, women: r = 0.42), raised small, dense low density lipoprotein (men: r = 0.30, women: r = 0.31), elevated blood pressure (men: r = 0.27, women: r = 0.28), increased triglyceride (men: r = 0.43, women: r = 0.48) and apolipoprotein-B (men: r = 0.32, women: r = 0.35). Waist circumference also correlated with hepatic lipase/lipoprotein lipase ratio in women (r = 0.52). Height adjustment did not substantially change relationships between waist circumference and risk factors. WHR correlated with fewer risk factors. CONCLUSION: For the purpose of health promotion to prevent cardiovascular disease associated with overweight and intra-abdominal fat accumulation, the general public should be advised to be aware of the risk associated with large waist circumference.