| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Serum total cholesterol screening for the detection of elevated low-density lipoprotein in children and adolescents: the Bogalusa Heart Study Dennison, B. A., D. A. Kikuchi, et al. (1990), Pediatrics 85(4): 472-9. Abstract: The use of serum total cholesterol measurement was evaluated as a screening tool to predict elevated levels of low-density lipoprotein cholesterol in 2857 children and adolescents, aged 5 to 17 years, examined in 1981 and 1982. Subjects were from the biracial community of Bogalusa, Louisiana. For selected serum total cholesterol values (150 to 210 mg/dL, 3.88 to 5.43 mmol/L), sensitivities were higher for blacks than whites and higher for females than males, whereas the positive predictive values were higher for whites than blacks and higher for males than females. With the age-, race-, and sex-specific 95th percentiles of serum total cholesterol levels as cutoff points, only 44% to 50% of subjects with elevated low-density lipoprotein cholesterol levels (greater than or equal to 95th percentile) were detected, and approximately 50% of those identified had false-positive results. Lowering the serum total cholesterol cutoff point increased the sensitivity, but decreased the specificity and positive predictive value. At the 75th percentiles of serum total cholesterol levels, sensitivities were 92% to 95% for females and 100% for males and specificities were 78% to 79%, but the false-positive results increased to 81% to 84%. The low cost and ease of obtaining serum total cholesterol measurements contribute to its appeal as a screening tool for hyperlipidemia. However, its poor test characteristics make serum total cholesterol measurement inefficient as a screening tool for detecting elevated levels of low-density lipoprotein cholesterol in children and adolescents. |
| Serum total cholesterol, apolipoprotein E epsilon 4 allele, and Alzheimer's disease Notkola, I. L., R. Sulkava, et al. (1998), Neuroepidemiology 17(1): 14-20. Abstract: The epsilon 4 allele of the apolipoprotein E (apoE) is associated with Alzheimer's disease (AD) and also with elevated serum total cholesterol and low-density lipoprotein levels. However, the interrelationships between apoE genotype, plasma cholesterol levels and AD risk have been studied very little. We examined the possible role of serum total cholesterol in the pathogenesis of AD in a population-based sample of 444 men, aged 70-89 years, who were survivors of the Finnish cohorts of the Seven Countries Study. Previous high serum cholesterol level (mean level > or = 6.5 mmol/l) was a significant predictor of the prevalence of AD (odds ratio = 3.1; 95% confidence interval = 1.2, 8.5) after controlling for age and the presence of apoE epsilon 4 allele. In men who subsequently developed AD the cholesterol level decreased before the clinical manifestations of AD. We conclude that high serum total cholesterol may be an independent risk factor for AD and some of the effect of the apoE epsilon 4 allele on risk of AD might be mediated through high serum cholesterol. |
| Serum total cholesterol, high-density lipoprotein-cholesterol and triglyceride concentrations in lambs following supplementation with various forms of tocopherol Hidiroglou, N., M. S. Wolynetz, et al. (1993), Reprod Nutr Dev 33(3): 263-8. Abstract: A 61-d study involving 40 crossbred lambs evaluated the effect of various forms of tocopherol provided daily in equimolar amounts on total cholesterol, high-density lipoprotein-cholesterol and triglyceride concentrations in the serum of lambs. Thirty-five lambs were allotted to 7 treatment groups of 5 animals each, supplemented with 300 mg tocopherol either as: 1) DL-alpha-tocopheryl acetate; 2) D-alpha-tocopheryl acetate; 3) D-alpha-tocopheryl succinate; 4) D-alpha-tocopheryl polyethylene glycol 1,000 succinate (TPGS); 5) DL-alpha-tocopheryl nicotinate; 6) DL-alpha-tocopheryl nicotinate (150 mg) + 150 mg TPGS; and 7-D-alpha-tocopheryl acetate (150 mg) + 150 mg TPGS mixed with the commercial flock diet. In addition, another group of 5 lambs were used as control (no vitamin E supplementation). Dietary supplementation of various vitamin E sources resulted in no overall treatment effects for total cholesterol, triglycerides or high density lipoprotein-cholesterol. A significant variation was noticed among animals. The levels of all measured serum components varied throughout the experimental period (P < 0.0001). The day x treatment interaction was not significant (P > 0.05) for any serum measured component. The present data strongly suggest that short-term treatment (< 2 mo) with pharmacological oral doses of various forms of vitamin E did not influence serum lipid metabolism of lambs. The data also showed that the bioavailability of alpha-tocopherol is dependent on the form administered. D-alpha-tocopherol acetate is a highly available form, the bioavailability of which is further increased when combined with D-alpha-tocopheryl polyethylene glycol succinate. |
| Serum total cholesterol, triglycerides and high density lipoproteins (HDL) levels in rabbit during the course of experimental diabetes Wojtowicz, Z., W. Wrona, et al. (2004), Ann Univ Mariae Curie Sklodowska Med 59(2): 258-60. Abstract: The study was conducted on 56 rabbits, of White New Zealand breed, male gender. The average weight of the rabbits was 3 kg. The diabetes was evoked by intravenous injection of 10% alloxan, using the single dose of 100 mg/kg. On the 7th day after administration of alloxan, serum glucose levels were determined. The serum glucose level higher than 11.1 mmol/l was considered an indicator of the presence of diabetes. All the animals included in the study were divided into five groups: the control, 21-day diabetes, 42-day diabetes, 90-day diabetes and 180-day diabetes. Serum total cholesterol, triglycerides and high density lipoproteins levels were determined with enzymatic methods. Our studies revealed a significant increase in cholesterol and triglycerides levels. That mechanism might be responsible for faster development of atheromatosis during the course of diabetes mellitus. |
| Serum total cholesterol: HDL cholesterol ratios in US white and black adults by selected demographic and socioeconomic variables (HANES II) Linn, S., R. Fulwood, et al. (1991), Am J Public Health 81(8): 1038-43. Abstract: BACKGROUND: Framingham Study findings suggest that total cholesterol (TC):High density lipoprotein cholesterol (HDL-C) ratio is a useful summary of the joint contribution of TC and HDL-C to coronary heart disease (CHD) risk. Information on the distribution of TC:HDL-C in the US population is limited to selected populations and the relationship of the ratio distribution and its correlates has received little attention. METHOD: TC/HDL-C ratios were examined in a representative sample of the United States adult population ages 20 to 74 years, between February 1976 and February 1980 during NHANES II, using stratification and multivariate regression analyses. RESULTS: Age-adjusted mean ratios were higher in men compared with women and were higher in Whites compared with Blacks. White men had the highest TC/HDL-C mean ratios. These relationships remained after stratification by age, education, body mass index, alcohol use, cigarette smoking, and physical activity. Using multivariate analyses, the ratios were positively related to BMI, age, and smoking; and negatively related to female sex, alcohol use, being Black, and physical activity. CONCLUSIONS: Using a ratio reference point of greater than or equal to 4.5 from the Framingham study, at least an estimated 44 million persons ages 25 to 74 years in the US were found to be at higher risk of developing coronary heart disease. |
| Serum total, LDL, HDL cholesterol and triglycerides related to age, gender and cigarette smoking in patients with first acute myocardial infarction Vincelj, J., M. Sucic, et al. (1997), Coll Antropol 21(2): 517-24. Abstract: The aim of this study was to examine relationships between total cholesterol, LDL, HDL cholesterol, triglycerides and age, gender, and cigarette smoking in 190 patients (132 men and 58 women) aged 34-87 years with first AMI. The control group included 103 patients (57 men and 46 women) aged 29-90 years without a history of angina pectoris or AMI. High total cholesterol (over 5.2 mmol/L) was observed in 75% of patients with AMI vs. 48% of patients in the control group (p < 0.001). Patients with AMI had significantly higher total cholesterol and LDL cholesterol levels than controls (p < 0.0001). HDL cholesterol levels were significantly lower among patients with AMI than among the control group patients (p < 0.0001). Serum total cholesterol and LDL cholesterol is higher in patients with AMI up to 60 years old, but lower in patients older than 60 years. Women aged less than 50 years had significantly higher HDL cholesterol (p < 0.001), lower LDL cholesterol (p < 0.001), and lower total cholesterol (p < 0.05) than those over 50 years. Smokers with AMI who smoked over 20 cigarettes per day had significantly higher total cholesterol, LDL cholesterol and triglycerides levels than the non-smokers (p < 0.05). These findings suggest important influences of hyperlipoproteinemia and cigarette smoking upon development of myocardial infarction, especially in younger patients. |
| Serum triglycerides and HDL cholesterol--major predictors of long-term survival after coronary surgery Linden, T., G. Bondjers, et al. (1994), Eur Heart J 15(6): 747-52. Abstract: The influence of pre-operative serum lipid levels on late clinical outcome after coronary artery bypass surgery was analysed in 83 patients undergoing coronary bypass surgery for stable angina pectoris. The mean follow-up period for surviving patients was 105 +/- 33 months (range 65-133). Twenty-two patients (27%) had died during follow-up, of whom 14 had sustained a fatal myocardial infarction and four had succumbed to other cardiovascular causes. Thirty-one patients sustained 35 cardiac events, defined as either fatal or non-fatal myocardial infarction, or reoperation, or PTCA during the follow-up period. With univariate analysis, pre-operative serum levels of total cholesterol and triglycerides were significantly related to cardiac events, P < 0.05 and P < 0.05, respectively. In a Cox proportional analysis, cardiac mortality and total mortality were related to serum triglycerides and HDL cholesterol (P < 0.05 and P < 0.01 respectively). Eighty-five percent of the patients with triglycerides < 2.0 mM.l-1 survived for 10 years, while only 48% of patients with triglycerides > 2.0 mM.l-1 remained alive for that period. Figures were similar for subjects with HDL cholesterol > 1.0 mM.l-1 or HDL cholesterol < 1.0 mM.l-1, at 89 and 38%, respectively. Only 28% of the patients with the combination triglycerides > 2.0 mM.l-1 and HDL cholesterol < 1.0 mM.l-1 were alive 10 years after surgery. These data suggest that dyslipidaemia, especially the combination of high serum triglycerides and low HDL cholesterol, is an important factor influencing long-term clinical outcome after coronary bypass surgery. |
| Serum urate and cholesterol levels in endurance trained volunteers during acute and rigorous bed rest conditions Zorbas, Y. G., Y. N. Yaroshenko, et al. (1996), Panminerva Med 38(4): 223-8. Abstract: The objective of this investigation was to determine serum urate and cholesterol concentrations in endurance trained volunteers during exposure to acute (abrupt restriction of muscular activity) and rigorous bed rest conditions of seven days. The studies were performed on 30 long distance runners aged 22-25 who had a peak of VO2 of 65.5 +/- 2.7 ml.kg-1.min-1 on the average prior to their participation in the study. The volunteers were divided into three equal groups: the volunteers in the 1st group were under normal ambulatory conditions (control subjects), the volunteers of the 2nd group subjected to an acute bed rest regime (acute bed rested subjects) and the volunteers of the 3rd group were submitted to a rigorous bed rest regime (rigorous bed rested subjects). All volunteers were on an average of 14.2 km/day before taking part in the study. The 2nd and 3rd groups of volunteers were kept under a rigorous bed rest regime for seven days. During the perbed rest period and during the actual bed rest periods (acute and rigorous bed rest periods) serum cholesterol and uric acid levels were measured. During the 1st day of acute and rigorous bed rest periods serum uric acid and cholesterol concentrations increased significantly (p < or = 0.05), on the 3rd day increased somewhat more and during the 7th day they increased further. These changes were more pronounced during acute than rigorous bed rest conditions. It was concluded that increases in uric acid and cholesterol concentrations in serum appear to reflect more stresses that associated with acute than rigorous bed rest conditions in endurance trained volunteers. |
| Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine Miettinen, T. A., M. Vuoristo, et al. (2000), Am J Clin Nutr 71(5): 1095-102. Abstract: BACKGROUND: Cholesterol metabolic studies are simplified in colectomized patients because of rapid intestinal passage and reduced bacterial action. OBJECTIVE: Our objective was to study the effect on cholesterol and plant sterol metabolism of feeding a margarine containing stanol ester to 11 colectomized patients. DESIGN: A margarine containing 2 g stanol was consumed for 7-18 d. Serum, biliary, and fecal lipids were measured before and during consumption of the margarine. RESULTS: Serum cholesterol concentrations and the ratio of plant sterol to cholesterol decreased after 1 d of consumption of stanol esters (P < 0.05). After 7 d, serum cholesterol decreased by 16% (P < 0.01), cholesterol absorption efficiency decreased by approximately 40%, and fecal output of cholesterol as neutral sterols (but not as bile acids) increased by 36%. Biliary bile acid composition and the molar percentage of biliary cholesterol were unchanged. Increased ratios of cholesterol precursor sterols in serum and bile indicated enhanced cholesterol synthesis during consumption of stanol esters; the percentage absorption of plant sterols and the ratios of plant sterols to cholesterol decreased, whereas serum and biliary plant stanols and their biliary secretion gradually increased. In feces, 95% of cholesterol and 90% of plant stanols were in unesterified form. CONCLUSIONS: In colectomized patients, effective inhibition of cholesterol absorption and lowering of serum cholesterol concentrations and plant sterol ratios occurs within 1 d of the start of consumption of stanol esters. The composition of major bile lipids is unchanged, indicating that gallstone formation is unlikely. Small amounts of plant stanols are recovered in serum and bile during consumption of stanol esters but effectively are secreted through bile, thereby balancing the intake-induced increase in their absorption. |
| Serum-plasma differences in total cholesterol: what correction factor should be used? Wickus, G. G. and R. O. Dukerschein (1992), Jama 267(2): 234-5. |
| Sesame lignans modulate cholesterol metabolism in the stroke-prone spontaneously hypertensive rat Ogawa, H., S. Sasagawa, et al. (1995), Clin Exp Pharmacol Physiol Suppl 22(1): S310-2. Abstract: 1. Effects of sesamin and episesamin (an epimer of sesamin) on lipid metabolism, in particular cholesterol metabolism, were examined in normocholesterolaemic and hypercholesterolaemic stroke-prone spontaneously hypertensive rats (SHRSP). 2. In normocholesterolaemic SHRSP fed a regular diet, both sesamin and episesamin significantly increased the concentration of serum total cholesterol, which was due to an increase of high density lipoprotein (HDL) subfraction rich in apoE (apoE-HDL). In addition, both substances effectively decreased serum very low density lipoprotein (VLDL). In the liver, only episesamin significantly decreased the activity of microsomal acyl-CoA:cholesterol acyltransferase. 3. In hypercholesterolaemic SHRSP fed a high-fat and high-cholesterol diet (HFC diet), only episesamin improved serum lipoprotein metabolism with an increase in apoA-I and a decrease in apoB. In the liver, both sesamin and episesamin significantly suppressed cholesterol accumulation. Interestingly, only episesamin significantly increased the activity of microsomal cholesterol 7alpha-hydroxylase. 4. These results indicate that sesamin may be effective in preventing cholesterol accumulation in the liver. In comparison with sesamin, episesamin may be effective in the regulation of cholesterol metabolism in the serum and liver. |
| Seven-year trends in plasma low-density-lipoprotein-cholesterol in young adults: the CARDIA Study Bild, D. E., D. R. Jacobs, et al. (1996), Ann Epidemiol 6(3): 235-45. Abstract: To identify determinants of recent secular trends in lipids and characterize their influence on age-related increases in LDL-cholesterol, we examined a cohort of black and white men and women aged 18-30 in 1985-1986. Secular trends were determined by comparing participants aged 25-30 at baseline with those aged 25-30 at year 7 (2788 and 1395 participants, respectively). LDL-cholesterol was lower among those 25-30 at year 7 (5.9 to 10.2 mg/dL, depending on race-sex group; P < 0.001); weight was higher (8.3 to 12.5 lb; P < 0.001); Keys score was lower (-4.2 to -7.3 units; P < 0.001); and use of oral contraceptives was greater (white women only, P < 0.01). Among 4086 participants followed for 7 years, LDL-cholesterol changed little or decreased, despite substantial weight increases in all groups (11.6 to 19.0 lb; P < 0.001). Keys scores decreased by 6.1 to 8.0 units, and use of oral contraceptives decreased (P < 0.001). Declining secular trends in LDL-cholesterol occurred despite upward trends in weight; the decline was associated with lower dietary fat and cholesterol and offset expected age-related increases in LDL-cholesterol. |
| Several mechanisms contribute to the abnormal fatty acid composition of serum phospholipids and cholesterol esters in cholestatic children with extrahepatic biliary atresia Robberecht, E., B. Koletzko, et al. (1997), Prostaglandins Leukot Essent Fatty Acids 56(3): 199-204. Abstract: The fatty acid compositions of serum phospholipids and cholesterol esters and direct bilirubinemia were determined in 11 children with cholestasis due to extrahepatic biliary atresia. The levels of the different fatty acids in these lipid classes were compared with those of 22 appropriate controls and correlations with conjugated bilirubinemia were calculated. Significant differences were found in the levels of several fatty acids in these lipid classes, some of which were related to conjugated bilirubinemia. Relationships between fatty acids in phospholipids and cholesterol esters which exist in the control group were either absent or different in the patient group. The results found are compatible with the concept that malabsorption, overflow in blood of phospholipids, which are excreted in bile in healthy individuals, and liver disease per se contribute to the deviating fatty acid compositions. They suggest that administration in the diet may be required of preformed long chain polyunsaturated fatty acids in an easily absorbable form. |
| Severe hyperreninemic hypertension associated with spontaneous renal cholesterol crystal embolization Tanaka, M., K. Matsuo, et al. (2004), Clin Exp Nephrol 8(2): 150-4. Abstract: A 70-year-old man was admitted because of severe hypertension and renal insufficiency. Marked elevation in plasma renin activity (PRA; 34.2 ng/ml per h) was noted. Five days later, the patient developed hemorrhagic duodenal ulcers and panperitonitis, went into shock, and died. An autopsy revealed severe atherosclerosis with marked ulceration in the abdominal aorta. Renal histology showed multiple cholesterol crystal embolization (CCE) associated with infarction. Cholesterol crystals were also detected in the vessels of the gastrointestinal system, including the liver, stomach, colon, and pancreas. Although not common, spontaneous CCE should be considered in elderly patients who present with abrupt onset of severe hypertension associated with renal insufficiency. The most important finding in this patient was severe hyperreninemia. Although potentiation of the renin-angiotensin-aldosterone system is the suggested mechanism for the hypertension in renal CCE, we could not find any reported case of renal CCE with hyperreninemia. It is reasonable to consider that severe hyperreninemia might be overlooked in renal CCE. PRA should be measured in patients with renal CCE, because it may give important information for selecting antihypertensive agents and improving the prognosis. To clarify this possibility, an accumulation of similar cases is necessary. |
| Severe lower limb ischaemia with pulses: cholesterol embolisation--a little known complication of aortic surgery Hawthorn, I. E., J. Rochester, et al. (1993), Eur J Vasc Surg 7(4): 470-4. Abstract: Cholesterol embolisation is a little known complication of aortic surgery and radiological procedures with a mortality of 81%. Treatment has been poorly described and inadequate. We report a case in which we have followed an aggressive policy of treatment using modern vascular techniques not previously described in this condition. |
| Severe recurrent digestive hemorrhage caused by cholesterol crystal embolism Lehnert, F., J. L. Pallot, et al. (1992), Presse Med 21(6): 270. |
| Sex and time differences in the associations of non-high-density lipoprotein cholesterol versus other lipid and lipoprotein factors in the prediction of cardiovascular death (The Rancho Bernardo Study) von Muhlen, D., R. D. Langer, et al. (2003), Am J Cardiol 91(11): 1311-5. Abstract: Non-high-density lipoprotein (HDL) cholesterol (total cholesterol TC minus HDL cholesterol) has been suggested as the preferred lipid fraction to predict cardiovascular disease. We compared the ability of lipids, lipoproteins, the ratio of total to HDL cholesterol (TC/HDL), and non-HDL cholesterol to predict fatal coronary heart disease (CHD) and cardiovascular disease in 1,386 women and 1,094 men (mean age 69 years). After 10 years, there were more deaths in men (n = 310) than women (n = 268), but the proportions of deaths attributed to CHD (23% and 25%, respectively) and cardiovascular disease (48% and 47%) were similar. In men, age-adjusted values for non-HDL cholesterol, TC/HDL ratio, and triglycerides each predicted a significantly increased risk of CHD and cardiovascular disease; none of these associations was independent of pack-years of smoking, systolic blood pressure, fasting plasma glucose, body mass index, and physical activity. In women, age-adjusted non-HDL cholesterol levels did not predict CHD or cardiovascular disease events before or after adjusting for these covariates and for estrogen replacement therapy. In women, only the ratio of TC to HDL cholesterol predicted CHD and cardiovascular disease deaths independent of estrogen use and other risk factors. Observed associations were sensitive to time, being evident in women at 3 and 5 years, and lost thereafter, but not apparent before 10 years in men. Thus, non-HDL cholesterol is not superior to individual lipids, lipoproteins, or their ratios in the prediction of cardiovascular death in older adults. |
| Sex difference in high density lipoprotein cholesterol in six countries Davis, C. E., D. H. Williams, et al. (1996), Am J Epidemiol 143(11): 1100-6. Abstract: It is known that women have higher levels of high density lipoprotein (HDL) cholesterol than men. The authors examined the association between HDL cholesterol and biologic sex in 8,631 women and 10,690 men aged 45-54 years from six countries studied between 1972 and 1989. The variation in the sex difference for HDL cholesterol was significant; the smallest difference (0.06 mmol/liter) was seen in China and the largest (0.40 mmol/liter) in Canada. Adjustment for differences in body mass index, smoking, alcohol use, and heart rate reduced but did not eliminate the variability. The sex difference in HDL cholesterol levels, usually assumed to be due to biologic factors, differs across cultures and may be related to environmental factors. |
| Sex difference in serum 7 alpha-hydroxycholesterol levels in the rat reflect hepatic activity of 3 beta-hydroxy-delta 5-C27-steroid dehydrogenase and cholesterol 7 alpha-hydroxylase Maeda, Y., Y. Ando, et al. (1997), J Gastroenterol 32(4): 502-6. Abstract: Factors that affect serum levels of 7 alpha-hydroxycholesterol were studied in the rat. Serum levels of 7 alpha-hydroxycholesterol differed in male and female rats fed regular chow (male; 0.2 +/- 0.1 nmol/ml (mean +/- SD); n = 8; female; 0.4 +/- 0.1 nmol/ml; n = 8). When rats were fed with chow to which 3% cholestyramine had been added, the level increased significantly, particularly in female rats (male; 0.6 +/- 0.3 nmol/ml; n = 8; female; 2.4 +/- 1.5 nmol/ml; n = 8). The liver activity of cholesterol 7 alpha-hydroxylase, the rate-limiting enzyme for degradation of cholesterol, did not show any sex differences, irrespective of whether the animals were fed with regular chow (male; 51 +/- 15 pmol/min per mg protein; n = 8; female; 58 +/- 21 pmol/min per mg protein; n = 8), or the cholestyramine-supplemented chow (male; 162 +/- 33 pmol/min per mg protein; n = 8; female; 172 +/- 33 pmol/min per mg protein; n = 8). In contrast, the activity of 3 beta-hydroxy-delta 5-C27-steroid dehydrogenase, which acts after cholesterol 7 alpha-hydroxylase in the catabolism of cholesterol, showed a marked difference between the sexes. In both sexes this enzyme activity was higher in cholestyramine-treated rats (male; 963 +/- 78 pmol/min per mg protein; n = 8; female; 708 +/- 106 pmol/min per mg protein, n = 8) compared to that in that rats received regular chow (male; 622 +/- 83 pmol/min per mg protein; n = 8; female; 469 +/- 41 pmol/min per mg protein; n = 8). If the serum level of 7 alpha-hydroxycholesterol depended solely on the enzyme activity of cholesterol 7 alpha-hydroxylase, it would be difficult to explain these sex differences, since there were no sex differences in levels of cholesterol 7 alpha-hydroxylase. These results clearly indicate that, in the rat, the serum level of 7 alpha-hydroxycholesterol depends not only on cholesterol 7 alpha-hydroxylase activity but also on 3 beta-hydroxy-delta 5-C27-steroid dehydrogenase activity. |
| Sex difference in the regulation of plasma high density lipoprotein cholesterol by genetic and environmental factors Kauma, H., M. J. Savolainen, et al. (1996), Hum Genet 97(2): 156-62. Abstract: Association between high density lipoprotein (HDL) cholesterol concentration and restriction fragment length polymorphisms at the cholesteryl ester transfer protein (CETP) gene locus was studied in a random population-based cohort of 526 Caucasian subjects (259 men, mean age 50.9 years, and 267 women, mean age 51.8 years). HDL cholesterol concentration was adjusted for age, body mass index, alcohol consumption, smoking and plasma triglyceride and low density lipoprotein cholesterol levels. In females, the HDL cholesterol levels were associated with TaqIB polymorphism (1.46 mmol/l in the B1B1 genotype, 1.56 mmol/l in B1B2 and 1.72 mmol/l in B2B2, P = 0.0001 for the trend). In contrast, this was not observed in men (1.24, 1.20, 1.27 mmol/l, NS). The association was seen even in women who were current smokers (1.41, 1.56, 1.75 mmol/l, n = 72, P = 0.007), but not in male smokers (1.26, 1.19, 1.14 mmol/l, n = 102, NS). In male non-smokers the association was weak (1.22, 1.20, 1.32 mmol/l, n = 157, P = 0.05). In postmenopausal women not receiving hormone replacement therapy (n = 108), the association continued to be present, although weaker (1.50, 1.58, 1.70 mmol/l, P = 0.06). CETP activity (n = 101) tended to be lower in subjects with the B2B2 genotype. In conclusion, a clear-cut sex difference was observed in the genotype effect on plasma HDL cholesterol levels. The slight attenuation of the gene dosage effect after menopause suggests that the gender difference may be, at least in part, due to sex hormones. A genetic subgroup (men with the B2B2 genotype) particularly susceptible to the HDL cholesterol decreasing effect of smoking could be demonstrated. |