title: Small, dense low-density lipoprotein and C-reactive protein in obese subjects with and without other criteria for the metabolic syndrome.
abstract: BACKGROUND
  Although obesity is an important cardiovascular risk factor, growing evidence shows that a substantial portion of obese subjects can be considered metabolically healthy but obese (MHO). However the extent to which obese subjects manifest small, dense low-density lipoprotein (LDL) particles without other characteristics of the metabolic syndrome (MS) remains unknown.
  
  
  OBJECTIVE
  The purpose of this study was to determine the difference between MHO (only meeting the obesity criteria) and obese subjects meeting all the criteria for the MS with regard to LDL size and high-sensitivity C-reactive protein (hs-CRP), as a biomarker of inflammation.
  
  
  METHODS
  Two hundred obese subjects (168 women, mean age 36.5 ± 5 years [range, 20-60]; mean body mass index [BMI; calculated as kg/m(2)] 39 ± 5 [range, 30-80.4]) were studied for LDL particles size and hs-CRP levels.
  
  
  RESULTS
  Of 200 enrolled obese subjects, 55 were defined MHO subjects meeting only obesity criteria. The other 145 met all five criteria and were defined as having MS. Although MHO and MS subjects had similar BMI, MHO subjects had a lower percentage of small LDL particles (8% vs 29%, P < 0.001), higher average LDL diameter (274 ± 5 vs 270 ± 7 Å, P < 0.001), and lower hs-CRP levels (P < 0.05) than MS patients.
  
  
  CONCLUSIONS
  The major finding of this study is that MHO subjects compared to equally obese subjects meeting the criteria of the MS have statistically significant differences in size of LDL and concentration of hs-CRP. However, the absolute differences are very small and of uncertain clinical significance.
authors.affiliation: Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Iacobellis
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Ribaudo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zappaterreno
authors.forename: Concetta Valeria
authors.initials: CV
authors.lastname: Iannucci
authors.forename: Frida
authors.initials: F
authors.lastname: Leonetti