title: Dietary and genetic probes of atherogenic dyslipidemia.
abstract: A goal of dietary management of cardiovascular disease risk in patients with obesity and metabolic syndrome is improvement in the atherogenic dyslipidemia comprising elevated triglyceride, reduced high-density lipoprotein (HDL) cholesterol, and increased numbers of small, dense low-density lipoprotein (LDL) particles. Individuals with a genetically influenced trait characterized by a high proportion of small, dense LDL (phenotype B) respond to a low-fat, high-carbohydrate diet with greater reduction of LDL cholesterol, apoprotein B, and mid-sized LDL2 particles than unaffected subjects (phenotype A). In contrast, in phenotype A subjects there is a reciprocal shift from large LDL1 to small LDL3 such that a high proportion convert to phenotype B. There is evidence for heritable effects on these diet-induced subclass changes and for the involvement of specific genes. For example, a haplotype of the APOA5 gene associated with increased plasma triglyceride and small, dense LDL predicts greater diet-induced reduction of LDL2, a haplotype-specific effect that is strongly correlated with both increased VLDL precursors and LDL4 products. Understanding of such diet-genotype interactions may help to elucidate mechanisms that are responsible for phenotype B and for its differential dietary responsiveness. This information may also ultimately help in identifying those individuals who are most likely to achieve cardiovascular risk benefit from specific dietary interventions.
authors.affiliation: Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA. RKrauss@chori.org
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Krauss
mesh_terms: D050197:Atherosclerosis / Q000178:diet therapy* / Q000453:epidemiology / Q000235:genetics*; D050171:Dyslipidemias / Q000178:diet therapy* / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D024821:Metabolic Syndrome / Q000178:diet therapy / Q000453:epidemiology / Q000235:genetics; D009765:Obesity / Q000178:diet therapy / Q000453:epidemiology / Q000235:genetics; D012307:Risk Factors