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Impaired protection against diabetes and coronary heart disease by high-density lipoproteins in Turks.

Abstract
The issue of whether or not incident type 2 diabetes mellitus and coronary heart disease (CHD) can be predicted by high-density lipoprotein (HDL) cholesterol in both sexes needs investigation. A representative sample of 3035 middle-aged Turkish adults free of CHD at baseline was studied with this purpose prospectively over a mean of 7.8 years. High-density lipoprotein cholesterol levels were found to be correlated in women positively with plasma fibrinogen and weakly with waist girth and C-reactive protein, and to be not correlated with fasting insulin. High-density lipoprotein cholesterol protected men against future CHD risk (for a 12-mg/dL increment: relative risk = 0.80 [95% confidence interval, 0.69-0.95]) after multivariable adjustment in logistic regression analyses for age, smoking status, physical activity grade, hypertension, abdominal obesity, diabetes, and lipid-lowering drugs. However, men were not protected against risk of diabetes. In women, HDL cholesterol was not associated with risk for CHD, whereas intermediate (40-60 mg/dL) compared with lower HDL cholesterol levels proved protective against risk of diabetes (relative risk = 0.57 [95% confidence interval, 0.36-0.90]) after adjustments that included apolipoprotein A-I tertiles. Yet higher serum concentrations failed to yield protection against diabetes. It was concluded that HDL particles confer partially lacking protection against cardiometabolic risk among Turks, and this impairment is modulated by sex. This highly important observation may result from a setting of prevailing chronic subclinical inflammation.
AuthorsAltan Onat, Günay Can, Erkan Ayhan, Zekeriya Kaya, Gülay Hergenç
JournalMetabolism: clinical and experimental (Metabolism) Vol. 58 Issue 10 Pg. 1393-9 (Oct 2009) ISSN: 1532-8600 [Electronic] United States
PMID19570555 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Apolipoproteins
  • Cholesterol, HDL
  • Lipoproteins, HDL
  • Triglycerides
  • C-Reactive Protein
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Anthropometry
  • Apolipoproteins (blood)
  • Blood Pressure (physiology)
  • C-Reactive Protein (metabolism)
  • Cholesterol, HDL (blood)
  • Coronary Disease (blood, epidemiology)
  • Data Interpretation, Statistical
  • Diabetes Mellitus (blood, epidemiology)
  • Female
  • Humans
  • Lipoproteins, HDL (blood)
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Triglycerides (blood)
  • Turkey (epidemiology)
  • Waist-Hip Ratio

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