Associations of anthropometry and lifestyle factors with HDL subspecies according to apolipoprotein C-III

Abstract

The presence of apoC-III on HDL impairs HDL's inverse association with coronary heart disease (CHD). Little is known about modifiable factors explaining variation in HDL subspecies defined according to apoC-III. The aim was to investigate cross-sectional associations of anthropometry and lifestyle with HDL subspecies in 3,631 participants from the Diet, Cancer, and Health study originally selected for a case-cohort study (36% women; age 50-65 years) who were all free of CHD. Greater adiposity and less activity were associated with higher HDL containing apoC-III and lower HDL lacking apoC-III. Per each 15 cm higher waist circumference, the level of HDL containing apoC-III was 2.8% higher (95% CI: 0.4, 5.3; P = 0.024) and the level of HDL not containing apoC-III was 4.7% lower (95% CI: -6.0, -3.4; P = <0.0001). Associations for physical activity were most robust to multivariable modeling. Each 20 metabolic equivalent task hours per week reported higher physical activity was associated with 0.9% (95% CI: -1.7, -0.1; P = 0.031) lower HDL containing apoC-III and 0.5% higher (95% CI: 0.1, 1.0; P = 0.029) HDL lacking apoC-III. Lower alcohol consumption was associated with lower HDL lacking apoC-III (percent difference per 15 g/day: 1.58 (95% CI: 0.84, 2.32; P = <0.0001). Adiposity and sedentary lifestyle were associated with a less favorable HDL subspecies profile.

Keywords: epidemiology; high density lipoprotein; obesity.

Fig. 1.

Percent differences (95% CI) in concentrations of HDL with and without apoC-III in the Danish Diet, Cancer, and Health study (n = 3,631) adjusted for age (continuous), sex (male, female), future CHD case status (whether participant developed CHD during 10 years of follow-up), and the HDL with or without apoC-III concentration, respectively (age- and sex-adjusted model). The multivariable model is additionally adjusted for educational attainment (≤7 years, 8–10 years, >10 years), diabetes medication intake (yes, no), diabetes (yes, no), antihypertensive medication intake (yes vs. no), hypertension (yes, no), waist circumference (continuous; physical activity only), physical activity (continuous), smoking status [never smoker, former smoker, light current smoker (<15 g/day), moderate current smoker (15–25 g/day), heavy current smoker (≥25 g/day)], and alcohol consumption (continuous).