Week 11 - Blood Lipids Cardiovascular Disease

Blood Lipids Cardiovascular Disease Milly Ryan-Harshman, PhD, RD Atherogenic Dyslipidemia S Atherogenic Dyslipidemia High triglycerides, low HDL cholesterol levels and an increase in the number of small, dense LDL particles are characteristics of atherogenic dyslipidemia. This phenotype is influenced by both genetic and environmental factors. Major LDL Subclasses Major LDL Subclasses Major LDL Subclasses P c Dietary Effects on LDL Subclasses Dietary Effects on LDL Subclasses Characteristics of main types of hyperlipoproteinemias Genetic polymorphisms, blood lipid levels, and dietary intervention Click to edit Master title style Click to edit Master text styles Second level Third level Fourth level Fifth level Click to edit Master title style Click to edit Master subtitle style Chol Chol Low-fat, high carbohydrate Larger LDL Smaller LDL Apo B Apo B Less cholesterol per particle, but a similar number of particles, i.e., same Apo B (major structural protein). Chol Chol Chol Chol Chol Chol Chol Low-fat, high carbohydrate Reduced number of particles, i.e., less Apo B. Weight reduction, low fat diet, no alcohol Risk of atherosclerosis is not clear Very greatly increased Normal or slightly increased VLDL increased, chylomicrons increased, HDL decreased Weight reduction, low carbohydrate diet, no alcohol Possible risk, especially for coronary atherosclerosis Greatly increased Normal or slightly increased VLDL increased, HDL decreased IV Weight reduction, maintain low cholesterol balanced diet Very strong risk, especially in peripheral and coronary arteries Greatly increased Greatly increased IDL greatly increased III Low cholesterol, low-fat diet Very strong risk of coronary atherosclerosis Normal in type IIa, slightly increased in type IIb Greatly increased LDL greatly increased II Low fat diet, no alcohol No increased risk of atherosclerosis Very greatly increased Normal or slightly increased Chylomicrons greatly increased HDL decreased Dietary Treatment Risk Triglycerides Total cholesterol (TC) Lipoproteins Affected Type High intakes of saturated fat and cholesterol yield greater than expected serum cholesterol increases greater LDL-C reductions when consuming low-fat, low cholesterol diet High Highest Highest ApoE4 allele at the APOE gene Tendency toward cholesterol raising effect of high saturated fat intake Inter- mediate Intermediate ApoE3 allele at the APOE gene Ability to lower serum cholesterol enhanced by higher intakes of saturated fat cholesterol high intakes of sucrose associated with high serum TGs High Low Low ApoE2 allele at the APOE gene Effect on TG Effect on TC Polymorphism Increased HDL-C levels in response to higher dietary fat content CC genotype (most common among Caucasians) at the hepatic lipase gene GG allele in women had higher HDL-C concentrations when PUFAs were 4 of total energy, but women with the GA allele had higher HDL-C concentrations only when PUFAs were 8 of total energy As intake of PUFAs increases, HDL-C levels decrease G allele at the APOA1 gene (More common) Individuals with low HDL-C levels and this allele might benefit from higher intakes of PUFAs Increased concentration with increased intakes of PUFAs A allele at the APOA1 gene A low-fat, high carbohydrate diet tends to convert to LDL sub-type that increases risk of IHD Large, buoyant LDL particle sub-type Phenotype A (both phenotypes appear to be inherited as a single gene trait) Low fat diet appropriate to reduce risk of ischemic heart disease (IHD) High Small, dense LDL particle sub-type Low Increased mass of VLDL/IDL Phenotype B (increased apolipoprotein B, the major protein component of LDL decreased apolipo-protein A-I, the major component of HDL Higher HDL levels among moderate drinkers ADH3 allele (slower alcohol metabolism) Highest HDL-C concentrations achieved when total fat intake was 30 of energy and low in animal fat (Mediterranean diet) Higher dietary fat content decreases HDL-C levels TT genotype at the hepatic lipase gene