Abnormal high-density lipoproteins in overweight adolescents with atherogenic dyslipidemia

• Published in: Pediatrics (Evanston) 2011-06, Vol.127 (6), p.e1521-e1527
• Main Authors: Medina-Urrutia, Aida, Juarez-Rojas, Juan G, Cardoso-Saldaña, Guillermo, Jorge-Galarza, Esteban, Posadas-Sánchez, Rosalinda, Martínez-Alvarado, Rocio, Caracas-Portilla, Nacú, Mendoza Pérez, Enrique, Posadas-Romero, Carlos
• Format: Article
• Language: English
• Subjects: Adolescent; Atherosclerosis - blood; Atherosclerosis - complications; Atherosclerosis - epidemiology; Body Weight; Cross-Sectional Studies; Dyslipidemias - blood; Dyslipidemias - complications; Dyslipidemias - epidemiology; Female; Follow-Up Studies; Humans; Incidence; Insulin resistance; Lipoproteins; Lipoproteins, HDL; Male; Mexico - epidemiology; Obesity; Overweight - blood; Overweight - complications; Overweight - epidemiology; Pediatrics; Risk Factors; Teenagers
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2010-1395

This study aimed to evaluate high-density lipoprotein functionality and the cardiovascular risk factor profile in the overweight pediatric population. We hypothesized that overweight adolescents with low high-density lipoprotein cholesterol and elevated triglyceride plasma levels have metabolic abnormalities and dysfunctional high-density lipoprotein particles, similar to those reported in adults. Overweight adolescents with (group 1 [n = 21]) and without (group 2 [n = 36]) atherogenic dyslipidemia (high-density lipoprotein cholesterol: ≤ 40 mg/dL and triglycerides: ≥ 150 mg/dL) and normal-weight normolipidemic subjects, as a reference (group 3 [n = 36]), were included. The cardiovascular risk factor profile (lipids, lipoproteins, high-sensitivity C-reactive protein, and insulin), high-density lipoprotein subclass distribution, composition, and cholesterol efflux capacity were studied. Group 1 adolescents showed abnormalities in high-density lipoprotein subclass distribution and high-density lipoprotein chemical composition, as well as a significantly lower capacity to promote cholesterol efflux (14.8 ± 2.8, 16.5 ± 3.8, 20.4 ± 3.5, for groups 1, 2 and 3, respectively). High-density lipoprotein(2a) (R(2) = 0.212, β = 0.472, P < .0001) and the Tanner score (R(2) = 0.054, β = -0.253, P = .02) were the independent predictors of cholesterol efflux. Group 1 also showed a higher degree of cardiovascular abnormalities (an adverse lipoprotein profile, greater insulin resistance and systemic inflammation; and lower low-density lipoprotein size) than group 2, even after BMI and Tanner score adjustment. This study suggests that atherogenic dyslipidemia identifies overweight adolescents with quantitative, qualitative, and functional high-density lipoprotein abnormalities. Atherogenic dyslipidemia seems to be a marker of an increased risk for developing cardiovascular disease and indicates that those adolescents should be a target of aggressive prevention programs and lipid management guidelines.