This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

An Under-recognized Contributor to Dyslipidemia in White American Women

Margo A. Denke, MD; Christopher T. Sempos, PhD; Scott M. Grundy, MD, PhD

Arch Intern Med. 1994;154(4):401-410.

Abstract
Background
Whether the association between excess body weight and dyslipidemia is consistent across different age ranges in women has yet to be determined.

Methods
The relationship between body weight adjusted for height as calculated by body mass index (BMI; kilograms per square meter) and serum lipid and lipoprotein levels in white women was examined using crosssectional data from the Second National Health and Nutrition Examination Survey. Mean lipid levels were determined for six different categories of BMI: (1) 21.0 or less; (2) 21.1 to 23.0; (3) 23.1 to 25.0; (4) 25.1 to 27.0; (5) 27.1 to 30.0; and (6) more than 30.0, and three age groups: premenopausal women, 20 through 44 years; perimenopausal women, 45 through 59 years; and postmenopausal women, 60 through 74 years.

Results
Compared with BMI category 2, a BMI in category 5 for premenopausal women was associated with 0.46 mmol/L (18 mg/dL) higher total cholesterol levels, 0.68 mmol/L (26 mg/dL) higher non—high-density lipoprotein (HDL) cholesterol levels, and 0.44 mmol/L (17 mg/ dL) higher low-density lipoprotein (LDL) cholesterol levels. For perimenopausal women and postmenopausal women the same change in BMI was associated with much smaller differences in total cholesterol of 0.16 and 0.16 mmol/L (6 and 5 mg/dL), non-HDL of 0.24 and 0.20 mmol/L (9 and 8 mg/dL), and LDL levels of 0.13 and 0.03 mmol/L (5 and 1 mg/dL). More impressively, rising BMI was associated with consistently higher triglyceride levels of 0.54 to 0.40 mmol/L (48 to 35 mg/dL) and consistently lower HDL levels of 0.23 to 0.13 mmol/L (9 to 5 mg/dL), in all three age groups.

Conclusion
For young women, excess body weight was associated with higher total, non-HDL and LDL-cholesterol levels, higher triglyceride levels, and lower HDL-cholesterol levels. In older women, although similar differences in triglyceride levels and HDL-cholesterol levels were observed, excess body weight was associated with smaller differences in total, non-HDL, and LDL cholesterol. More striking than the weightassociated differences in total, non-HDL, and LDL-cholesterol levels were the differences in these lipid parameters observed with age alone. Specifically, age category differences were twofold to eightfold greater than differences observed between categories of BMI within a given age. Nevertheless, because the lower HDL cholesterol concentrations associated with excess body weight were age independent, total cholesterol-HDL cholesterol ratios were highest in obese postmenopausal women. Although age and hormonal status are important affecters of lipoprotein risk factors, body weight also worsens the degree of dyslipidemia in white women.

(Arch Intern Med. 1994;154:401-410)

Author Affiliations
From the Center for Human Nutrition (Drs Denke and Grundy), Departments of Internal Medicine (Drs Denke and Grundy) and Biochemistry and Clinical Nutrition (Dr Grundy), University of Texas Southwestern Medical Center at Dallas; and Division of Health Examination Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md (Dr Sempos).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lipid profiles in middle-aged men and women after famine exposure during gestation: the Dutch Hunger Winter Families Study
Lumey et al.
Am. J. Clin. Nutr. 2009;89:1737-1743.
ABSTRACT | FULL TEXT  

Comparison of demography, diet, lifestyle, and serum lipid levels between the Guangxi Bai Ku Yao and Han populations
Ruixing et al.
J. Lipid Res. 2007;48:2673-2681.
ABSTRACT | FULL TEXT  

Raising HDL Cholesterol in Patients With Diabetes
DOC News 2007;4:4-4.
FULL TEXT  

Waist Girth Does Not Predict Metabolic Complications in Severely Obese Men.
Lemieux et al.
Diabetes Care 2006;29:1417-1419.
FULL TEXT  

Trends in Serum Lipids and Lipoproteins of Adults, 1960-2002
Carroll et al.
JAMA 2005;294:1773-1781.
ABSTRACT | FULL TEXT  

Association of Intentional Changes in Body Weight with Coronary Heart Disease Event Rates in Overweight Subjects Who Have an Additional Coronary Risk Factor
Eilat-Adar et al.
Am J Epidemiol 2005;161:352-358.
ABSTRACT | FULL TEXT  

References
Circulation 2002;106:3373-3421.
FULL TEXT  

Women's Healthy Lifestyle Project: A Randomized Clinical Trial : Results at 54 Months
Kuller et al.
Circulation 2001;103:32-37.
ABSTRACT | FULL TEXT  

Individual Cholesterol Variation in Response to a Margarine- or Butter-Based Diet: A Study in Families
Denke et al.
JAMA 2000;284:2740-2747.
ABSTRACT | FULL TEXT  

Low levels of high density lipoproteins in Turks, a population with elevated hepatic lipase: high density lipoprotein characterization and gender-specific effects of apolipoprotein E genotype
Mahley et al.
J. Lipid Res. 2000;41:1290-1301.
ABSTRACT | FULL TEXT  

Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology
Grundy et al.
J Am Coll Cardiol 1999;34:1348-1359.
FULL TEXT  

Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations : A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology
Grundy et al.
Circulation 1999;100:1481-1492.
FULL TEXT  

Elevated hepatic lipase activity and low levels of high density lipoprotein in a normotriglyceridemic, nonobese Turkish population
Bersot et al.
J. Lipid Res. 1999;40:432-438.
ABSTRACT | FULL TEXT  

A Comparison of Estrogen Replacement, Pravastatin, and Combined Treatment for the Management of Hypercholesterolemia in Postmenopausal Women
Davidson et al.
Arch Intern Med 1997;157:1186-1192.
ABSTRACT  

National Cholesterol Education Program Recommendations for Cholesterol Testing in Young Adults : A Science-Based Approach
Cleeman and Grundy
Circulation 1997;95:1646-1650.
FULL TEXT  

Dyslipoproteinemias in systemic lupus erythematosus: influence of disease, activity, and anticardiolipin antibodies
Borba and Bonfa
Lupus 1997;6:533-539.
ABSTRACT  

Hypertension in the Elderly: Implications and Generalizability of Randomized Trials
Mulrow et al.
JAMA 1994;272:1932-1938.
ABSTRACT