Magkos F, Mohammed B S, Mittendorfer B
Center for Human Nutrition, Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, USA.
Int J Obes (Lond). 2008 Nov;32(11):1655-64. doi: 10.1038/ijo.2008.164. Epub 2008 Sep 9.
To determine the effect of obesity without the confounding effect of metabolic complications on the lipoprotein subclass profile in men and women.
Cross-sectional study.
A total of 40 lean (body mass index (BMI): 18.5-25 kg/m(2)) and 40 obese (BMI: 30-45 kg/m(2)) subjects, with blood pressure <140/90 mm Hg, fasting plasma glucose concentration <100 mg per 100 ml and total triglyceride concentration <150 mg per 100 ml; all obese subjects had normal oral glucose tolerance.
Fasting concentrations of very low-, intermediate-, low- and high-density lipoproteins (VLDL, IDL, LDL, and HDL, respectively) and average VLDL, LDL and HDL particle sizes were evaluated by using proton nuclear magnetic resonance spectroscopy.
Obese compared with lean individuals of both sexes had increased plasma concentrations of VLDL (by approximately 50%), IDL (by approximately 100%), LDL (by approximately 50%), and to some extent HDL (by approximately 10%) particles (P<0.05). The contribution of large VLDL to total VLDL concentration, small LDL to total LDL concentration, and small HDL to total HDL concentration was greater in obese than lean subjects (P<0.05), resulting in larger average VLDL size but smaller average LDL and HDL sizes (P<0.05). Women, compared with men, had reduced concentrations of total VLDL particles (by approximately 10%) due to lower concentrations of large and medium VLDL and a shift toward large at the expense of small HDL particles (P<0.05), with no difference in total HDL particle concentration. IDL and total LDL concentrations and LDL subclass distribution were not different between men and women.
Obesity is associated with pro-atherogenic alterations in the lipoprotein subclass profile, which may increase cardiovascular disease risk even in the absence of classical metabolic risk factors. On the other hand, the female cardiovascular disease risk advantage is probably largely related to differences in traditional lipid risk factors (plasma triglyceride and HDL-cholesterol concentrations) because sex differences in the plasma lipoprotein subclass profile are minimal.
确定无代谢并发症混杂效应的肥胖对男性和女性脂蛋白亚类谱的影响。
横断面研究。
共有40名瘦人（体重指数（BMI）：18.5 - 25 kg/m²）和40名肥胖者（BMI：30 - 45 kg/m²），血压<140/90 mmHg，空腹血浆葡萄糖浓度<100 mg/100 ml，总甘油三酯浓度<150 mg/100 ml；所有肥胖者口服葡萄糖耐量正常。
采用质子核磁共振波谱法评估极低密度脂蛋白（VLDL）、中间密度脂蛋白（IDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）的空腹浓度，以及平均VLDL、LDL和HDL颗粒大小。
与男女瘦人相比，肥胖者的血浆VLDL浓度（约升高50%）、IDL浓度（约升高100%）、LDL浓度（约升高50%）以及在一定程度上HDL颗粒浓度（约升高10%）均升高（P<0.05）。肥胖者中，大颗粒VLDL占总VLDL浓度的比例、小颗粒LDL占总LDL浓度的比例以及小颗粒HDL占总HDL浓度的比例均高于瘦人（P<0.05），导致平均VLDL颗粒尺寸更大，但平均LDL和HDL颗粒尺寸更小（P<0.05）。与男性相比，女性的总VLDL颗粒浓度降低（约10%），原因是大、中颗粒VLDL浓度较低，且HDL颗粒从小颗粒向大颗粒转变（P<0.05），总HDL颗粒浓度无差异。男女之间IDL和总LDL浓度以及LDL亚类分布无差异。
肥胖与脂蛋白亚类谱中促动脉粥样硬化改变相关，即使在无经典代谢危险因素的情况下，这也可能增加心血管疾病风险。另一方面，女性心血管疾病风险优势可能很大程度上与传统脂质危险因素（血浆甘油三酯和HDL - 胆固醇浓度）的差异有关，因为血浆脂蛋白亚类谱的性别差异很小。
