One third of the variability in HDL-cholesterol level in a large dyslipidaemic population is predicted by age, sex and triglyceridaemia: The Paris La Pitié Study

Curr Med Res Opin. 2006 Jun;22(6):1149-60. doi: 10.1185/030079906X104821.

Abstract

Objective: The objective of this study was to identify key determinants of high-density lipoprotein-cholesterol (HDL-C) level, including subclinical inflammation and insulin resistance, and to determine the prevalence of a low HDL-C phenotype in dyslipidaemic patients at high cardiovascular risk.

Methods: In a cross-sectional study, we assessed the prevalence of low HDL-C phenotypes in 14 667 dyslipidaemic patients attending our specialised lipid clinic and evaluated the potential relationships between HDL-C level and 16 clinical and biological parameters.

Results: In univariate analysis, women exhibited higher plasma concentrations of HDL-C as compared with men. Levels of triglycerides, fasting blood glucose, uric acid, waist circumference, body mass index, high sensitivity C-reactive protein (hs-CRP), insulin resistance (as HOMA-IR index) and smoking were all negatively correlated with HDL-C, whereas age was positively correlated with HDL-C levels. Moderate drinkers (10-30 g/day) displayed higher HDL-C concentrations as compared with abstinent subjects; in contrast, consumption of more than 30 g alcohol/day was associated with a further non-significant elevation of HDL-C levels as compared to moderate drinkers. Multivariate analysis identified eight independent correlates of HDL-C. Age, sex and TG accounted for 37% of variability in HDL-C; modifiable factors including waist circumference, alcohol consumption and smoking, in addition to HOMA-IR and hs-CRP, accounted for an additional 5% of the variability in HDL-C. Using a cut-off of 40 mg/dL (1.03 mmol/L) for men and 50 mg/dL (1.29 mmol/L) for women, 33% and 28% of men and women displayed low levels of HDL-C.

Conclusion: Eight independent determinants of HDL-C account for 41% of variability in HDL-C in our dyslipidaemic population. Three of them, i.e. age, sex and degree of triglyceridaemia accounted for more than one third of such variability. The high prevalence of low HDL-C phenotypes in dyslipidaemic patients at elevated cardiovascular risk emphasises the need for both lifestyle and pharmacological strategies of intervention to raise HDL-C.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cholesterol, HDL / blood*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertriglyceridemia / blood*
  • Hypertriglyceridemia / complications
  • Hypertriglyceridemia / epidemiology
  • Male
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Sex Factors

Substances

  • Cholesterol, HDL