Low density lipoprotein cholesterol is inversely correlated with abdominal visceral fat area: a magnetic resonance imaging study.
BACKGROUND
Visceral Fat Area (VFA) is an independent predictor of coronary disease. While low density lipoprotein cholesterol (LDL-C) is used to determine risk and guide therapy, its accuracy fails in obese patients who may have low LDL-C despite high VFA.


OBJECTIVE
We sought to describe the relationship between VFA, LDL-C and to describe shifting cholesterol metabolism with increasing VFA.


METHODS
42 High-risk vascular patients not on lipid-lowering therapy provided a fasting lipid profile and underwent magnetic resonance imaging (MRI) to quantify VFA and subcutaneous fat area (SFA) at the L4-L5 disc. Comparisons: 1. Correlation between VFA, SFA, LDL-C and the standard lipid panel 2. Correlation between VFA, SFA and markers of cholesterol synthesis (desmosterol, lathosterol) and cholesterol absorption (cholestanol, sitosterol).


RESULTS
VFA was inversely correlated with LDL-C (r = -0.348) indicating potential discordance between cardiovascular risk and LDL-C. However, VFA was appropriately correlated with other markers of increased risk: r = -0.361 with HDL-C, r = 0.503 with VLDL-C, r = 0.499 with TG (all p < 0.05). VFA did not correlate significantly with non-HDL-C. VFA correlated positively with cholesterol synthesis markers (desmosterol, lathosterol) and negatively with an absorption marker (cholestanol).


CONCLUSIONS
LDL-C is inversely correlated with VFA and this may explain the loss of the relationship between LDL-C and cardiovascular events in the obese. While Non-HDL-C did not correlate positively with VFA, the absence of a negative correlation suggests that it may be a more appropriate lipid target in an increasingly obese world.
Royal Brisbane and Women's Hospital, University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia. drmhoenig@yahoo.com.au
Michel R
MR
Hoenig
Gary
G
Cowin
Raymond
R
Buckley
Christine
C
McHenery
Allan
A
Coulthard
D050153:Abdominal Fat / Q000502:physiology*; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D011517:Prothrombin Time
D001786:Blood Glucose; D008078:Cholesterol, LDL; D007328:Insulin; D008055:Lipids; D002097:C-Reactive Protein; D002784:Cholesterol
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