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Ethnic differences observed in lipids, lipoproteins for women with prediabetes, obesity
Black women with overweight or obesity and prediabetes have higher levels of HDL cholesterol and apolipoprotein A-I and larger HDL particle size vs. white women with overweight or obesity and prediabetes, yet experience more cardiovascular disease than their white counterparts, recent findings suggest.
“In the present study, HDL [cholesterol] and ApoA-I, the largest protein of HDL particle, regarded as a potent anti-atherogenic protein, were higher in [black] than [white] women,” wrote Trudy Gaillard, PhD, RN, CDE, assistant professor of clinical nursing at the University of Cincinnati College of Nursing, and Kwame Osei, MD, professor emeritus of medicine and exercise physiology in the division of endocrinology, diabetes and metabolism at Ohio State University Wexner Medical Center in Columbus. “However, this apparent CVD benefit of HDL [cholesterol] and ApoA-I does not appear to occur in [black women].”
Gaillard and Osei analyzed data from 110 black and white women with overweight or obesity and prediabetes (69 black; mean age, 47 years; mean BMI, 37.8 kg/m²). Participants underwent whole-body DXA scanning, an oral glucose tolerance test and frequently sampled IV glucose tolerance test on two separate days, and provided baseline fasting blood samples for the measurement of serum insulin, C-peptide, glucose and lipids/lipoproteins (total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, ApoA-I and ApoB-100). Researchers measured HDL, LDL and very low-density lipoprotein particle sizes (small, medium and large) and concentrations with nuclear magnetic resonance.
Black women with prediabetes tended to have a higher BMI vs. white women (38.8 kg/m² vs. 36 kg/m²; P = .02); there were no between-group differences observed for insulin sensitivity. Mean triglycerides, however, were lower in black women vs. white women (84.2 mg/dL vs. 125 mg/dL; P < .0001), as were mean fasting serum glucose, insulin and C-peptide. HDL cholesterol (52.6 mg/dL vs. 48.2 mg/dL; P = .08) and ApoA-I (153.6 mg/dL vs. 142.7 mg/dL; P = .03) tended to be higher in black vs. white women, as was HDL large particle concentration (6.1µmol/L vs. 4.6 µmol/L; P = .02).
Black woman also exhibited a lower mean total very low-density lipoprotein particle concentration vs. white women (39.9 nmol/L vs. 59.2 nmol/L; P .001). There were no between-group differences observed for total LDL particle concentrations, but mean small LDL particle concentrations were lower among black woman vs. white women (538.8 nmol/L vs. 638.4 nmol/L; P = .07).
“We conclude that [nuclear magnetic resonance] spectroscopy provided better lipoprotein profiles for atherogenesis than traditional measurements in overweight/obese [black women] compared with [white] women with prediabetes,” the researchers wrote. “Nevertheless, because [black] women suffer twofold to fourfold higher CVD mortality, we speculate that the favorable lipids and lipoproteins derived using traditional and [nuclear magnetic resonance] methods in our study are unable to explain the paradoxically higher CVD morbidity and mortality previously found in [black] women compared with [white] women and warrant further investigations.” – by Regina Schaffer
Disclosure: The study was supported by the American Diabetes Association. The researchers report no relevant financial disclosures.