Lipoprotein distribution and composition in obesity: their association with central adiposity

OBJECTIVE: To examine the relationships between the distribution and composition of subfractions of very low density (VLDL), low density (IDL) and high density (HDL) lipoproteins and central fat deposition as measured by the waist-to-hip ratio (WHR). DESIGN: Participants (n=62, 44 women and 18 men; body mass index (BMI)greater than or equal to 25.0) were recruited from those consecutively attending the outpatient obesity clinic at the University Hospital. Geneva. MEASUREMENTS: Lipoprotein subfractions were isolated from fasting blood samples by cumulative flotation or density gradient ultracentrifugation. Concentration and composition were analysed as a function of obesity indices. RESULTS: There were significant correlations between the WHR and the profiles of the three major lipoprotein subclasses. Central obesity was associated with larger VLDL, small, dense LDL and lower levels of HDL-2 independently of other indices of obesity and plasma triglycerides. Central obesity was also significantly and independently associated with compositional anomalies, specifically an increased free cholesterol content of VLDL and LDL. CONCLUSIONS: Central body fat was associated with modifications of an atherogenic nature to lipoprotein distribution and composition. The data are consistent with an impact of body fat distribution on cardiovascular disease (CVD) via the agency of modified lipoprotein metabolism independently of raised triglycerides.