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. 2015 Apr 22:15:412.
doi: 10.1186/s12889-015-1747-9.

Association of high-density lipoprotein with development of metabolic syndrome components: a five-year follow-up in adults

Xiangtong Liu  1   2 , Lixin Tao  3   4 , Kai Cao  5   6 , Zhaoping Wang  7 , Dongning Chen  8 , Jin Guo  9   10 , Huiping Zhu  11   12 , Xinghua Yang  13   14 , Youxin Wang  15   16 , Jingjing Wang  17   18 , Chao Wang  19   20 , Long Liu  21   22 , Xiuhua Guo  23   24
Affiliations

Association of high-density lipoprotein with development of metabolic syndrome components: a five-year follow-up in adults

Xiangtong Liu et al. BMC Public Health. .

Abstract

Background: High-density lipoprotein (HDL) is associated with the incidence of metabolic syndrome (MetS). It is unclear whether subjects with different HDL levels develop different components of MetS over time. Our study aimed to determine what MetS components tend to emerge and change relative to different levels of HDL.

Methods: During the period 2007 to 2012, 4,905 adults in Tongren and Xiaotangshan Hospitals in Beijing were included with no MetS, self-reported type 2 diabetes, or cardiovascular disease at baseline. An association rule was used to determine the changes of MetS components over time.

Results: The incidence of MetS at follow-up was 3.40% for men and 1.50% for women in the high-normal HDL group; 6.65% and 4.55%, respectively, in the normal HDL group; and 11.05% and 6.45%, respectively, in the low HDL group. The most common transition was from healthy to healthy in normal-high or normal HDL groups (47.2% to 63.8%), whereas 11.7% to 39.9% of subjects with low HDL returned to healthy status or stayed unchanged in the low HDL group. The most common new-onset components were elevated blood pressure (9.2 to 10.0%), elevated high-density lipoprotein (5.5 to 11.0%), and raised fasting glucose (5.4 to 5.5%) in the groups with normal-high or normal HDL.

Conclusions: The incidence of MetS increased in parallel with the decrease in HDL. Adults with a low HDL level were more susceptible to developing MetS over time. Low HDL seemed to be a pre-existing phase of MetS and may be a crucial status for MetS prevention.

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Figures

Figure 1
Figure 1
The accumulated incidence of MetS in subjects aged 20-44, stratified by gender and high-density lipoprotein level. *Compared with high-normal HDL group of same gender using χ2 test, P < 0.025. #Compared with male counterpart using χ2 test, P < 0.05.
Figure 2
Figure 2
The accumulated incidence of MetS in subjects aged 45-65, stratified by gender and high-density lipoprotein level. *Compared with high-normal HDL group of same gender using χ2 test, P < 0.025.
Figure 3
Figure 3
The support and confidence rate of the top five transitions in all subjects from 2007/2008 to 2011/2012 stratified by sex and high-density lipoprotein groups. (A) in high-normal HDL group of males; (B) in normal HDL group of males; (C) in low HDL group of males; (D) in high-normal HDL group of females; (E) in normal HDL group of females; (F) in low HDL group of females. Abbreviations: H, health, with the absence of any MetS components; BP, high blood pressure; TG, raised triglycerides level; GLU, high fasting plasma glucose; HDL, increased high-density lipoprotein level.
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