© 1995 American Heart Association, Inc.
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Persistence of Low HDL-C Levels After Weight Reduction in Older Men With Small LDL Particles
From the Department of Medicine, Division of Gerontology, University of Maryland School of Medicine and Baltimore Veterans Affairs Medical Center, Geriatrics Research, Education, and Clinical Center, Baltimore, Md, and the Life Sciences Division (R.M.K.), Department of Molecular and Nuclear Medicine, Lawrence Berkeley Laboratory, University of California, Berkeley.
Correspondence to Leslie I. Katzel, MD, PhD, Baltimore VA Medical Center, Geriatrics Service (18), 10 N Greene St, Baltimore, MD 21201.
Abstract LDL subclass pattern B is characterized by a
predominance of small LDL particles (LDL peak particle size 
255 Å)
and is associated with increased plasma triglyceride (TG) and reduced
HDL cholesterol (HDL-C) concentrations. This study compared the effect
of weight loss on lipoprotein and glucose metabolism in 15 healthy,
obese (body mass index [BMI], 30.9±2.4 kg/m2), older
(60±9 years) men with LDL pattern B and in 25 men of comparable age
and BMI with LDL pattern A (LDL peak particle size 
260 Å). At
baseline, men with LDL pattern B had higher TG and lower apolipoprotein
(apo) A-I, HDL-C, and HDL2-C levels
(P<.001) than men with LDL pattern A, while the total
cholesterol and LDL cholesterol levels and fasting and 2-hour
postprandial glucose and insulin levels did not differ between groups.
With weight loss (10.1±3.6 kg) there were significant decreases in
2-hour postprandial glucose and insulin levels in men with LDL patterns
B and A (P<.05). However, the change in plasma TG, HDL-C,
HDL2-C, and apoA-I levels with weight loss differed
between groups. In men with LDL pattern A, plasma TG levels decreased
by 15% (P<.001) compared with a 34% (P<.001)
decrease in LDL pattern B (two-factor ANOVA, P<.01). Plasma
HDL-C concentrations increased by 0.16 mmol/L (P<.001) in
the men with LDL pattern A but by only 0.07 mmol/L in the men with LDL
pattern B (two-factor ANOVA, P<.05). After weight loss,
only 5 of the 15 men with LDL pattern B had HDL-C levels above 0.90
mmol/L (35 mg/dL), whereas 22 of 25 men with LDL pattern A had HDL-C
levels above 0.90 mmol/L (
2=18,
P<.0001). Furthermore, with weight loss, 11 of the 15 men
with LDL pattern B increased their LDL peak particle diameter; 7
converted to intermediate LDL pattern, and 4 converted to LDL pattern
A. By comparison, there were no significant changes in weight,
lipoprotein, or apolipoprotein concentrations at 1-year follow-up in 12
metabolic control subjects. Thus, despite significant reductions in
weight and body fat and concomitant decreases in plasma TG and insulin
levels, HDL-C and HDL2 subspecies levels remain low
in men with LDL pattern B.
Key Words: LDL subclasses • HDL • triglycerides • insulin resistance • abdominal obesity
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