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Obesity and lipids

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Abstract

Obesity increases cardiovascular risk through multiple mechanisms. Abdominal (visceral) adiposity is metabolically active and is largely responsible for the atherogenic dyslipidemia, hyperinsulinemia, hypertension, chronic inflammatory state, and prothrombotic state that constitute the metabolic syndrome, and the subsequent increased risk for cardiovascular disease and acute coronary events. Cholesterol guidelines for assessing cardiovascular risk have traditionally focused on low-density lipoprotein (LDL) levels, and reduction of plasma LDL has been shown to reduce cardiovascular events and total mortality. However, the cardiovascular risks associated with the dyslipidemia of obesity—characterized by low levels of high-density lipoprotein; increased triglycerides; increased subfractions of small, dense LDL; and increased levels of apolipoprotein B-100—are also now well recognized.

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References and Recommended Reading

  1. CDC National Center for Health Statistics: Overweight prevalence. http://www.cdc.gov/nchs/data/hus/hus04trend.pdf#069

  2. Enzi G, Gasparo M, Bindetti PR, et al.: Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography. Am J Clin Nutr 1986, 44:739–746.

    PubMed  CAS  Google Scholar 

  3. Howard BV: Insulin actions in vivo: insulin and lipoprotein metabolism. In International Textbook of Diabetes Mellitus, edn 2. Edited by Alberti KGMM, DeFronzo RA, Keen H. West Sussex, UK: John Wiley & Sons; 1995:531–539.

    Google Scholar 

  4. Howard BV, Ruotolo G, Robbins DC: Obesity and dyslipidemia. Endocrinol Metab Clin N Am 2003, 31:855–867. Review of the pathogenesis of dyslipidemia in obesity.

    Article  Google Scholar 

  5. Miyashita Y, Shirai K, Itoh Y, et al.: Low lipoprotein lipase mass in preheparin serum of type 2 diabetes mellitus patients and its recovery with insulin therapy. Diabetes Res Clin Pract 2002, 56:181–187.

    Article  PubMed  CAS  Google Scholar 

  6. Santamarina-Fojo S, Haudenschild C, Amar M: The role of hepatic lipase in lipoprotein metabolism and atherosclerosis. Curr Opin Lipidol 1998, 9:211–219.

    Article  PubMed  CAS  Google Scholar 

  7. Carr MC, Brunzell JD: Abdominal obesity and dyslipidemia in the metabolic syndrome: importance of type 2 diabetes and familial combined hyperlipidemia in coronary artery disease risk. J Clin Endocrinol Metab 2004, 89:2601–2607.

    Article  PubMed  CAS  Google Scholar 

  8. Anderson JW, Allgood LD, Turner J, et al.: Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999, 70:466–473.

    PubMed  CAS  Google Scholar 

  9. Roberts CK, Barnard RJ, Liang KG, Vaziri ND: Effect of diet on adipose tissue and skeletal muscle VLDL receptor and LPL: implications for obesity and hyperlipidemia. Atherosclerosis 2002, 161:133–141.

    Article  PubMed  CAS  Google Scholar 

  10. Wolever TM, Jenkins DJ, Jenkins AL, Josse RG: The glycemic index: methodology and clinical implications. Am J Clin Nutr 1991, 54:846–854.

    PubMed  CAS  Google Scholar 

  11. Simin L, Manson JE, Stampfer MJ, et al.: Dietary glycemic load assessed by food-frequency questionnaire in relation to plasma high-density-lipoprotein cholesterol and fasting plasma triacylglycerols in postmenopausal women. Am J Clin Nutr 2001, 73:560–566.

    Google Scholar 

  12. Frost G, Leeds AA, Doré CJ, et al.: Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 1999, 353:1269–1276.

    Article  Google Scholar 

  13. Turly ML, Skeaff CM, Mann JI, et al.: The effect of a low-fat, high-carbohydrate diet on serum high density lipoprotein cholesterol and triglyceride. Eur J Clin Nutr 1998, 52:728–732.

    Article  Google Scholar 

  14. Garg A: High-monounsaturated-fat diets for patients with diabetes mellitus: a meta-analysis. Am J Clin Nutr 1998, 67:577S-582S.

    PubMed  CAS  Google Scholar 

  15. Blackburn P, Lamarche B, Couillard C, et al.: Postprandial hyperlipidemia: another correlate of the “hypertriglyceridemic waist” phenotype in men. Atherosclerosis 2003, 171:327–336.

    Article  PubMed  CAS  Google Scholar 

  16. Austin MA: Plasma triglyceride and coronary heart disease. Arterioscler Thromb 1991, 11:2–14.

    PubMed  CAS  Google Scholar 

  17. Castelli WP: Epidemiology of triglycerides: a view from Framingham. Am J Cardiol 1992, 70:3H-9H.

    Article  PubMed  CAS  Google Scholar 

  18. Jeppesen J, Hein HO, Suadicani P, Gyntelberg F: Triglyceride concentration and ischemic heart disease: an eight-year follow-up in the Copenhagen Male Study. Circulation 1998, 97:1029–1036.

    PubMed  CAS  Google Scholar 

  19. Assmann G, Schulte H, von Eckardstein A: Hypertiglyceridemia and elevated lipoprotein(a) are risk factors for major coronary events in middle-aged men. Am J Cardiol 1996, 77:1179–1184.

    Article  PubMed  CAS  Google Scholar 

  20. Cullen P: Evidence that triglycerides are an independent coronary heart disease risk factor. Am J Cardiol 2000, 86:943–949.

    Article  PubMed  CAS  Google Scholar 

  21. Castelli WP: The triglyceride issue: a view from Framingham. Am Heart J 1986, 112:432–437.

    Article  PubMed  CAS  Google Scholar 

  22. Rosenson RS, Shott S, Lu L, et al.: Hypertriglyceridemia and other factors associated with plasma viscosity. Am J Med 2001, 110:488–492.

    Article  PubMed  CAS  Google Scholar 

  23. Castelli WP: Cholesterol and lipids in the risk of coronary artery disease — the Framingham Study. Can J Cardiol 1988, 4(Suppl A):5A-10A.

    PubMed  Google Scholar 

  24. Mackness MI, Arrol S, Abbott C, et al.: Protection of low-density lipoprotein against oxidative modification by high-density lipoprotein associated paraoxonase. Atherosclerosis 1993, 104:129–135.

    Article  PubMed  CAS  Google Scholar 

  25. Barter PJ, Baker PW, Rye KA: Effect of high-density lipoproteins on the expression of adhesion molecules in endothelial cells. Curr Opin Lipidol 2002, 12:285–288.

    Article  Google Scholar 

  26. Glomset JA: The plasma lecithins: cholesterol acyltransferase reaction. J Lipid Res 1968, 9:155–167.

    PubMed  CAS  Google Scholar 

  27. Whitney EJ, Krasuski RA, Personius BE, et al.: A randomized trial of a strategy for increasing high-density lipoprotein cholesterol levels: effects on progression of coronary heart disease and clinical events. Ann Intern Med 2005, 142:95–104. Recent evaluation of treatment targeting HDL-C on CHD outcomes.

    PubMed  Google Scholar 

  28. Walldius G, Jungner I, Holme I, et al.: High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. Lancet 2001, 358:2026–2033. Prospective data on apoB as a predictor of MI.

    Article  PubMed  CAS  Google Scholar 

  29. Sniderman AD, Scantlebury T, Cianflone K: Hypertriglyceridemic hyperapob: the unappreciated atherogenic dyslipoproteinemia in type 2 diabetes mellitus. Ann Intern Med 2001, 135:447–459. Review of the atherogenesis of dyslipidemia.

    PubMed  CAS  Google Scholar 

  30. Tribble DL, Rizzo M, Chait A, et al.: Enhanced oxidative susceptibility and reduced antioxidant content of metabolic precursors of small, dense low-density lipoproteins. Am J Med 2001, 110:103–110.

    Article  PubMed  CAS  Google Scholar 

  31. Bjornheden T, Babyi A, Bondjers G, Wiklund O: Accumulation of lipoprotein fractions and subfractions in the arterial wall, determined in an in vitro perfusion system. Atherosclerosis 1996, 123:43–56.

    Article  PubMed  CAS  Google Scholar 

  32. Brewer HB Jr, Santamarina-Fojo S: New insights into the role of the adenosine triphosphate-binding cassette transporters in high-density lipoprotein metabolism and reverse cholesterol transport. Am J Cardiol 2003, 91:3–11E.

    Article  Google Scholar 

  33. Eckel RH, Krauss RM, for the AHA Nutrition Committee: American Heart Association call to action: obesity as a major risk factor for coronary heart disease. Circulation 1998, 97:2099–2100.

    PubMed  CAS  Google Scholar 

  34. Franz MJ, Bantle JP, Beebe CA, et al.: Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002, 25:148–198.

    Article  PubMed  Google Scholar 

  35. Goldstein DJ: Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord 1992, 16:397–415.

    PubMed  CAS  Google Scholar 

  36. Leenen R, van der Kooy K, Meyboom S, et al. Relative effects of weight loss and dietary fat modification on serum lipid levels in the dietary treatment of obesity. J Lipid Res 1993, 34:2183–2191.

    PubMed  CAS  Google Scholar 

  37. Dattilo AM, Kris-Etherton PM: Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr 1992, 56:320–328.

    PubMed  CAS  Google Scholar 

  38. Meckling KA, Gauthier M, Grubb R, Sanford J: Effects of a hypocaloric, low-carbohydrate diet on weight loss, blood lipids, blood pressure, glucose tolerance, and body composition in free-living overweight women. Can J Physiol Pharmacol 2002, 80:1095–1105.

    Article  PubMed  CAS  Google Scholar 

  39. Spivak H, Hewitt MF, Onn A, Half E: Weight loss and improvement of obesity-related illness in 500 U.S. patients following laparoscopic adjustable gastric banding procedure. Am J Surg 2005, 189:27–32.

    Article  PubMed  Google Scholar 

  40. Ibañez J, Izquierdo M, Argüelles I, et al. Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes. Diabetes Care 2005, 28:662–667. One of recent trials reporting improvement in insulin sensitivity with resistance training.

    Article  PubMed  Google Scholar 

  41. Grandjean PW, Couse SF, O’Brian BC, et al. The effects of menopausal status and exercise training on serum lipids and the activities of intravascular enzymes related to lipid transport. Metabolism 1998, 47:377–383.

    Article  PubMed  CAS  Google Scholar 

  42. Kokkinos PF, Holland JC, Narayan P, et al. Miles run per week and high-density lipoprotein cholesterol levels in healthy, middle-aged men. Arch Intern Med 1995, 155:415–420.

    Article  PubMed  CAS  Google Scholar 

  43. Kokkinos PF, Narayan P, Colleran J: Effects of moderate intensity exercises on serum lipids in African-American men with sever systemic hypertension. Am J Cardiol 1998, 81:732–735.

    Article  PubMed  CAS  Google Scholar 

  44. Gyntelberg F, Brennan R, Holloszy J, et al. Plasma triglyceride lowering by exercise despite increased food intake in patients with type-IV hyperlipoproteinemia. Am J Clin Nutr 1977, 30:716–720.

    PubMed  CAS  Google Scholar 

  45. Thompson PD, Yurgalevitch SM, Flynn MM, et al. Effect of prolonged exercise training without weight loss on high-density lipoprotein metabolism in overweight men. Metabolism 1997, 46:217–223.

    Article  PubMed  CAS  Google Scholar 

  46. Marti B, Suter E, Riesen WF, et al.:Effects of long-term, selfmonitored exercise on the serum lipoprotein and apolipoprotein profile in middle-aged men. Atherosclerosis 1990, 81:19–31.

    Article  PubMed  CAS  Google Scholar 

  47. Wood PD, Haskell WL, Blair SN, et al.: Increased exercise level and plasma lipoprotein concentrations: a one-year randomized, controlled study in sedentary middle-aged men. Metabolism 1983, 32:31–39.

    Article  PubMed  CAS  Google Scholar 

  48. Kelley GA, Kelley KS, Tran ZV: Aerobic exercise, lipids and lipoproteins in overweight and obese adults: a meta-analysis of randomized controlled trials. Int J Obes 2005, 29:881–893.

    Article  CAS  Google Scholar 

  49. Durstine JL, Haskell WL: Effects of exercise training on plasma lipids and lipoproteins. Exerc Sport Sci Rev 1994, 22:447–521.

    Google Scholar 

  50. Williams PT: Relationship of distance run per week to coronary heart disease risk factors in 8283 male runners: the National Runner’s Health Study. Arch Intern Med 1997, 157:191–198.

    Article  PubMed  CAS  Google Scholar 

  51. Stein RA, Michielli DW, Giantz MD, et al.: Effects of different exercise training intensities on lipoprotein cholesterol fractions in healthy middle-aged men. Am Heart J 1990, 119:277–283.

    Article  PubMed  CAS  Google Scholar 

  52. Tran ZV, Weltman A, Glass GV, et al.: The effects of exercise on blood lipids and lipoproteins: a meta-analysis of studies. Med Sci Sports Exerc 1983, 15:393–402.

    PubMed  CAS  Google Scholar 

  53. Williams PT, Stefanick ML, Vranizan KM, et al.: Effects of weight loss by exercise or by dieting on plasma high-density lipoprotein (HDL) levels in men with low, intermediate, and normal-to-high HDL at baseline. Metabolism 1994, 43:917–924.

    Article  PubMed  CAS  Google Scholar 

  54. Kraus WE, Houmard JA, Duscha BD, et al.: Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med 2002, 347:1483–1492.

    Article  PubMed  CAS  Google Scholar 

  55. NCEP Expert Panel: Third report of the NCEP expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002, 106:3143–3421.

    Google Scholar 

  56. Taylor AJ, Sullenberger LE, Lee HJ, et al.: Arterial biology for the investigation of the treatment effects of reducing cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins. Circulation 2004, 110:3512–3517.

    Article  PubMed  CAS  Google Scholar 

  57. Friedberg CE, Jannsen MJ, Hiene RJ, et al.: Fish oil and glycemic control in diabetes. A meta-analysis. Diabetes Care 1998, 21:494–500.

    Article  PubMed  CAS  Google Scholar 

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Miller, W.M., Nori-Janosz, K.E., Lillystone, M. et al. Obesity and lipids. Curr Cardiol Rep 7, 465–470 (2005). https://doi.org/10.1007/s11886-005-0065-8

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