title: Predominance of small dense LDL differentiates metabolically unhealthy from metabolically healthy overweight adults in Korea.
abstract: OBJECTIVE
  The purposes of this study were (1) to determine the association between lipoprotein subfraction profiles and metabolically healthy overweight (MHO) phenotype, as defined by visceral adiposity; and (2) to identify the strongest predictor of metabolic health among the lipoprotein measurements.
  
  
  METHODS
  This cross-sectional study was comprised of 462 overweight patients, who were classified as MHO or non-MHO based on their visceral adipose tissue (VAT) area to subcutaneous adipose tissue area (SAT) ratio (VAT/SAT ratio). Serum lipoprotein subfraction analyses and other metabolic parameters were measured.
  
  
  RESULTS
  Among the overweight participants, two hundred fifty-five individuals (53.7%) had the MHO phenotype. After adjusting for age, sex, medication, lifestyle factors, and confounding metabolic characteristics, the non-MHO group showed significantly higher lipid levels and a greater prevalence of unfavorable lipid profiles. LDL subclass pattern type B was the most significant predictor of the non-MHO phenotype (odds ratio 2.70; 95% CI 1.55-4.69), while serum LDL cholesterol level was not a significant predictor of the non-MHO phenotype.
  
  
  CONCLUSIONS
  Lipoprotein subfraction particle measurements were significantly associated with the non-MHO phenotype and a higher VAT/SAT ratio, with small dense LDL predominance being the most significant predictor of MHO phenotype. These findings will help identify MHO and non-MHO phenotypes and perhaps lead to a development of cost-effective individualized treatments.
authors.affiliation: Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sue
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Clinical Nursing Science, Yonsei University College of Nursing, Nursing Policy Research Institute, Biobehavioral Research Center, Seoul, Korea.
authors.forename: Hyangkyu
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Duk-Chul
authors.initials: DC
authors.lastname: Lee
authors.affiliation: Biostatistics Collaboration Units, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hye-Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Electronic address: indi5645@yuhs.ac.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Lee
mesh_terms: D050154:Adiposity / Q000502:physiology; D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism; D007723:Korea; D008074:Lipoproteins / Q000378:metabolism; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism*; D050177:Overweight / Q000097:blood* / Q000378:metabolism*
chemical_list: D008074:Lipoproteins; D008077:Lipoproteins, LDL
keywords: Lipoprotein subfraction; Overweight; Small dense low-density lipoprotein (LDL); Visceral to subcutaneous adipose tissue ratio (VAT/SAT ratio)