腹部和臀股脂肪沉积与餐后脂血症呈负相关。

Abdominal and gluteofemoral fat depots show opposing associations with postprandial lipemia.

机构信息

Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.

出版信息

Am J Clin Nutr. 2021 Oct 4;114(4):1467-1475. doi: 10.1093/ajcn/nqab219.

DOI:10.1093/ajcn/nqab219

PMID:34254976

Abstract

BACKGROUND

High postprandial lipemia is associated with increased risk of cardiovascular disease, independently of fasting lipid concentrations. Abdominal and gluteofemoral fat depots handle lipoproteins differently, which could affect postprandial lipemia and contribute to the relation between abdominal fat distribution and cardiovascular disease risk.

OBJECTIVES

We aimed to study the influences of higher abdominal compared with gluteofemoral fat on postprandial lipemia after a high-fat meal in individuals with obesity.

METHODS

A total of 755 adults with obesity from a randomized controlled trial in 7 European countries consumed a liquid high-fat meal. Concentrations of triglycerides (TG), glycerol, free fatty acids, and the cholesterol component of remnant-like particles (RLP), LDL, and HDL were measured postprandially for 3 h. Associations of waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR) with changes in postprandial lipid concentrations, adjusted for fasting concentrations and BMI, were examined using linear regression models. To assess whether the association of WHR with postprandial lipemia could be causal, we performed instrumental variable analyses using a genetic score of 442 variants known to be associated with WHR adjusted for BMI in 2-stage least-squares regression models.

RESULTS

WHR was associated with higher TG and RLP cholesterol concentrations, independent of fasting lipid concentrations and BMI. Instrumental variable analyses suggested that the associations of WHR with postprandial TG (β = 0.038 μmol/Lmin, SE = 0.019 μmol/Lmin, P = 0.044) and RLP cholesterol concentrations (β = 0.059 mmol/L, SE = 0.025 mmol/L, P = 0.020) may be causal. WC and HC showed opposite effects: higher WC was associated with higher TG and RLP cholesterol concentrations whereas higher HC was associated with lower concentrations.

CONCLUSIONS

Our results suggest that higher fat deposition abdominally versus gluteofemorally may be causally associated with elevated postprandial lipemia after a high-fat meal, independent of fasting lipid concentrations and BMI. Furthermore, higher abdominal and gluteofemoral fat depots show opposing effects on postprandial lipemia.This trial was registered at www.isrctn.com as ISRCTN25867281.

摘要

背景

餐后高甘油三酯血症与心血管疾病风险增加有关，独立于空腹血脂浓度。腹部和臀股脂肪库对脂蛋白的处理方式不同，这可能会影响餐后血脂，也可能导致腹部脂肪分布与心血管疾病风险之间的关系。

目的

我们旨在研究与臀股脂肪相比，腹部脂肪较高对肥胖个体高脂餐后的餐后血脂的影响。

方法

来自 7 个欧洲国家的一项随机对照试验的 755 名肥胖成年人饮用了一种液体高脂餐。在 3 小时内检测餐后甘油三酯（TG）、甘油、游离脂肪酸以及残粒样脂蛋白（RLP）、LDL 和 HDL 的胆固醇成分浓度。采用线性回归模型，在校正空腹浓度和 BMI 后，分析腰围（WC）、臀围（HC）和腰臀比（WHR）与餐后血脂浓度变化的关系。为了评估 WHR 与餐后血脂的关系是否具有因果关系，我们在 2 阶段最小二乘法回归模型中，使用了一个经过 BMI 调整的与 WHR 相关的 442 个已知变体的遗传评分作为工具变量进行了分析。

结果

WHR 与 TG 和 RLP 胆固醇浓度升高独立于空腹血脂浓度和 BMI 相关。工具变量分析表明，WHR 与餐后 TG（β=0.038 μmol/Lmin，SE=0.019 μmol/Lmin，P=0.044）和 RLP 胆固醇浓度（β=0.059 mmol/L，SE=0.025 mmol/L，P=0.020）的关系可能具有因果关系。WC 和 HC 表现出相反的作用：较高的 WC 与较高的 TG 和 RLP 胆固醇浓度相关，而较高的 HC 与较低的浓度相关。