Body mass index correlates with atherogenic lipoprotein profile even in nonobese, normoglycemic, and normolipidemic healthy men

Objective: To establish a relationship between body mass index (BMI), lipid, and lipoprotein parameters among nonobese, normoglycemic, and normolipidemic healthy men without any cardiovascular, metabolic, or chronic diseases.

Methods: A total of 297 healthy, nonsmoking males between 20 and 75 years were recruited. Exclusion criteria included familial hypercholesterolemia, any chronic diseases, and BMI ≥ 30 kg/m(2). Lipid and lipoprotein particles were determined by standard methods, with the use of ultracentrifugation and nuclear magnetic resonance (NMR). Cholesterol in remnant-like particles (RLPc) was also determined.

Results: These healthy volunteers were separated into two groups: normoweight (BMI > 19 kg/m(2) and <25 kg/m(2) [n = 143]) and overweight (BMI ≥ 25 kg/m(2) and <30 kg/m(2) [n = 154]). Overweight participants were older (P < .001) compared to normoweight. Both groups had low-density lipoprotein (LDL) cholesterol levels (<130 mg/dL) considered as desirable, and although both groups had plasma triglyceride levels within the nonpathological range, overweight participants presented with 30% higher triglyceride levels (P < .001) and 9% lower high-density lipoprotein cholesterol (P < .001) compared to normoweight individuals. Although LDL was comparable between groups, NMR analysis showed that overweight participants had 27% more total LDL particles due to a 16% decrease in large LDL (P < .001) and 70% increase in the smaller subclasses (P < .001). In overweight participants, NMR analysis also showed a 2-fold increase in large very low-density lipoprotein (P = .001), and 30% more medium very low-density lipoprotein particles (P = .020). Overweight participants also had 70% more intermediate-density lipoprotein particles (P = .010), a 30% decrease in large high-density lipoprotein particles (P < .001), and a 39% increase in RLPc levels (P = .005). Results were adjusted for age and fat intake.

Conclusion: BMI correlates with a shift toward a more proatherogenic lipoprotein profile even in individuals whose lipid levels were not elevated.