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Abdominal obesity with hypertriglyceridaemia, lipoprotein(a) and apolipoprotein A ‐ I determine marked cardiometabolic risk
Author(s) -
Onat Altan,
Can Günay,
Örnek Ender,
Sansoy Vedat,
Aydın Mesut,
Yüksel Hüsniye
Publication year - 2013
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12150
Subject(s) - medicine , endocrinology , abdominal obesity , apolipoprotein b , population , waist , obesity , diabetes mellitus , type 2 diabetes , lipoprotein , cholesterol , metabolic syndrome , environmental health
Abstract Background Risks for coronary heart disease ( CHD ) and diabetes ( T 2 DM ) of the ‘hypertriglyceridemic waist’ phenotype ( H tg W ) warrant further investigation. We studied this issue and whether partial proinflammatory conversion of apolipoprotein (apo) A‐I by lipoprotein(a) [ L p(a)] is a codeterminant. Materials and Methods In a population‐based prospective study, 1328 Turkish adults were analysed in four groups by the presence of abdominal obesity and elevated triglycerides ( H tg). Results LDL‐cholesterol levels, significantly elevated in isolated H tg, were lower in H tg W , yet significantly higher apo B and complement C 3 values existed in women with H tg W in whom also the lowest L p(a) values prevailed. Lp(a) was linearly associated, more strongly in H tg W than in the remaining groups, with apo B and, in women inversely, with gamma‐glutamyltransferase. Incident H tg W was predicted, not in men, but in women inversely by L p(a) ( OR 0·80 [95%CI 0·65; 0·97]), regardless of adjustment for relevant confounders. After adjustment for conventional risk factors, H tg W (OR 2·84) and high apoA‐I/ HDL ‐C ratio (OR 1·50) were significantly and additively associated with combined prevalent and incident CHD risk. High apoA‐I and low HDL ‐cholesterol levels interacted therein in women. Type‐2 diabetes was strongly predicted by H tg W , mediated in men by high apoA‐I/ HDL ‐C ratio. Conclusion HtgW is associated with excess inflammatory markers, is predicted in women paradoxically by lower circulating Lp(a) and is associated in both sexes with marked excess cardiometabolic risk to which high apoA‐I/ HDL ‐C ratio contributes additively. These findings are consistent in women with apoA‐I being oxidized via aggregation to Lp(a).