title: At-risk serum cholesterol profile at both ends of the nutrition spectrum in West African adults? The Benin study.
abstract: Low HDL-cholesterol (HDL-C), using as cut-offs 1.03 mmol/L in men and 1.29 mmol/L in women, was observed in more than 25% apparently healthy adults (n = 541) in a cross-sectional study on nutrition transition and cardiometabolic risk factors (CMRF) in Benin, West Africa. Both overweight/obesity (35.3%) and underweight (11.3%) were present, displaying the double burden of malnutrition. We examined in more depth the association of low HDL-C with nutrition and with other CMRF. Metabolic syndrome components were assessed, plus the ratio of total cholesterol (TC)/HDL-C and serum homocysteine. Insulin resistance was based on Homeostasis Model Assessment. We also measured BMI and body composition by bio-impedance. Dietary quality was appraised with two non-consecutive 24 h recalls. Low HDL-C was associated with much higher TC/HDL-C and more abdominal obesity in men and women and with more insulin resistance in women. The rate of low HDL-C was highest (41.9%) among the overweight/obese subjects (BMI ≥ 25), but it also reached 31.1% among the underweight (BMI < 18.5), compared with 17.3% among normal-weight subjects (p < 0.001). Lower dietary micronutrient adequacy, in particular, in vitamins A, B3, B12, zinc and calcium, was associated with low HDL-C when controlling for several confounders. This suggests that at-risk lipoprotein cholesterol may be associated with either underweight or overweight/obesity and with poor micronutrient intake.
authors.affiliation: TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, PO Box 6128, Downtown Station, Montreal, QC H3C 3J7, Canada. helene.delisle@umontreal.ca
authors.forename: Hélène
authors.initials: H
authors.lastname: Delisle
authors.forename: Gervais
authors.initials: G
authors.lastname: Ntandou
authors.forename: Roger
authors.initials: R
authors.lastname: Sodjinou
authors.forename: Charles
authors.initials: C
authors.lastname: Couillard
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
mesh_terms: D000328:Adult; D001541:Benin / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D044383:Black People; D015992:Body Mass Index; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects; D050171:Dyslipidemias / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology; D008019:Life Style; D016014:Linear Models; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status / Q000208:ethnology*; D056128:Obesity, Abdominal / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D018977:Micronutrients; D006710:Homocysteine