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Sokooti S, Flores-Guerrero JL, Heerspink HJL, Garcia E, Connelly MA, Bakker SJL, Dullaart RPF. Lipoprotein particle sizes and incident type 2 diabetes: the PREVEND cohort study. Diabetologia 2022; 65:402-405. [PMID: 34800145 PMCID: PMC8741709 DOI: 10.1007/s00125-021-05603-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Sara Sokooti
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - José L Flores-Guerrero
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Hiddo J L Heerspink
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Erwin Garcia
- Laboratory Corporation of America® Holdings (Labcorp), Morrisville, NC, USA
| | - Margery A Connelly
- Laboratory Corporation of America® Holdings (Labcorp), Morrisville, NC, USA
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Robin P F Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Sokooti S, Flores-Guerrero JL, Heerspink HJL, Connelly MA, Bakker SJL, Dullaart RPF. Triglyceride-rich lipoprotein and LDL particle subfractions and their association with incident type 2 diabetes: the PREVEND study. Cardiovasc Diabetol 2021; 20:156. [PMID: 34321006 DOI: 10.1186/s12933-021-01348-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background Triglyceride-rich lipoproteins particles (TRLP) and low density lipoprotein particles (LDLP) vary in size. Their association with β-cell function is not well described. We determined associations of TRLP and LDLP subfractions with β-cell function, estimated as HOMA-β, and evaluated their associations with incident T2D in the general population. Methods We included 4818 subjects of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study without T2D at baseline. TRLP and LDLP subfraction concentrations and their average sizes were measured using the LP4 algorithm of the Vantera nuclear magnetic resonance platform. HOMA-IR was used as measure of insulin resistance. HOMA-β was used as a proxy of β-cell function. Results In subjects without T2D at baseline, very large TRLP, and LDL size were inversely associated with HOMA-β, whereas large TRLP were positively associated with HOMA-β when taking account of HOMA-IR. During a median follow-up of 7.3 years, 263 participants developed T2D. In multivariable-adjusted Cox regression models, higher concentrations of total, very large, large, and very small TRLP (reflecting remnants lipoproteins) and greater TRL size were associated with an increased T2D risk after adjustment for relevant covariates, including age, sex, BMI, HDL-C, HOMA-β, and HOMA-IR. On the contrary, higher concentrations of large LDLP and greater LDL size were associated with a lower risk of developing T2D. Conclusions Specific TRL and LDL particle characteristics are associated with β-cell function taking account of HOMA-IR. Moreover, TRL and LDL particle characteristics are differently associated with incident T2D, even when taking account of HOMA-β and HOMA-IR. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01348-w.
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Hernáez Á, Castañer O, Goday A, Ros E, Pintó X, Estruch R, Salas-Salvadó J, Corella D, Arós F, Serra-Majem L, Martínez-González MÁ, Fiol M, Lapetra J, de la Torre R, López-Sabater MC, Fitó M. The Mediterranean Diet decreases LDL atherogenicity in high cardiovascular risk individuals: a randomized controlled trial. Mol Nutr Food Res 2017; 61. [PMID: 28371298 DOI: 10.1002/mnfr.201601015] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 03/02/2017] [Accepted: 03/28/2017] [Indexed: 11/08/2022]
Abstract
SCOPE Traditional Mediterranean diet (TMD) protects against cardiovascular disease through several mechanisms such as decreasing LDL cholesterol levels. However, evidence regarding TMD effects on LDL atherogenic traits (resistance against oxidation, size, composition, cytotoxicity) is scarce. METHODS AND RESULTS We assessed the effects of a 1-year intervention with a TMD on LDL atherogenic traits in a random sub-sample of individuals from the PREDIMED study (N = 210). We compared two TMDs: one enriched with virgin olive oil (TMD-VOO, N = 71) and another with nuts (TMD-Nuts, N = 68), versus a low-fat control diet (N = 71). After the TMD-VOO intervention, LDL resistance against oxidation increased (+6.46%, p = 0.007), the degree of LDL oxidative modifications decreased (-36.3%, p<0.05), estimated LDL particle size augmented (+3.06%, p = 0.021), and LDL particles became cholesterol-rich (+2.41% p = 0.013) relative to the low-fat control diet. LDL lipoproteins became less cytotoxic for macrophages only relative to baseline (-13.4%, p = 0.019). No significant effects of the TMD-Nuts intervention on LDL traits were observed versus the control diet. CONCLUSION Adherence to a TMD, particularly when enriched with virgin olive oil, decreased LDL atherogenicity in high cardiovascular risk individuals. The development of less atherogenic LDLs could contribute to explaining some of the cardioprotective benefits of this dietary pattern.
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Affiliation(s)
- Álvaro Hernáez
- Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,PhD Program in Food Sciences and Nutrition, Universitat de Barcelona, Barcelona, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto Goday
- Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Emilio Ros
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Xavier Pintó
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Ramón Estruch
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Human Nutrition Department, Institut d'Investigació Sanitaria Pere Virgili, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, Reus, Spain
| | - Dolores Corella
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, Universidad de Valencia, Valencia, Spain
| | - Fernando Arós
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain
| | - Lluis Serra-Majem
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Miguel Ángel Martínez-González
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
| | - Miquel Fiol
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Balearic Islands Institute for Health Research, Hospital Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Rafael de la Torre
- Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Human Pharmacology and Neurosciences Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - M Carmen López-Sabater
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Nutrition and Bromatology, Faculty of Pharmacy, Universitat de Barcelona, Barcelona, Spain
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Bédard A, Corneau L, Lamarche B, Dodin S, Lemieux S. Sex Differences in the Impact of the Mediterranean Diet on LDL Particle Size Distribution and Oxidation. Nutrients 2015; 7:3705-23. [PMID: 25988764 PMCID: PMC4446774 DOI: 10.3390/nu7053705] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/30/2015] [Accepted: 05/05/2015] [Indexed: 12/11/2022] Open
Abstract
Sex differences have been previously highlighted in the cardioprotective effects of the Mediterranean diet (MedDiet). The objective of this study was to investigate whether sex differences also exist with regard to LDL particle size distribution and oxidation. Participants were 37 men and 32 premenopausal women (24–53 years) with slightly elevated LDL-C concentrations (3.4–4.9 mmol/L) or total cholesterol/HDL-C ≥5.0. Variables were measured before and after a four-week isoenergetic MedDiet. Sex differences were found in response to the MedDiet for the proportion of medium LDL (255–260 Å) (p for sex-by-time interaction = 0.01) and small, dense LDL (sdLDL; <255 Å) (trend; p for sex-by-time interaction = 0.06), men experiencing an increase in the proportion of medium LDL with a concomitant reduction in the proportion of sdLDL, while an opposite trend was observed in women. A sex difference was also noted for estimated cholesterol concentrations among sdLDL (p for sex-by-time interaction = 0.03), with only men experiencing a reduction in response to the MedDiet. The MedDiet marginally reduced oxidized LDL (oxLDL) concentrations (p = 0.07), with no sex difference. Results suggest that short-termconsumption of the MedDiet leads to a favorable redistribution of LDL subclasses from smaller to larger LDL only in men. These results highlight the importance of considering sex issues in cardiovascular benefits of the MedDiet.
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Affiliation(s)
- Alexandra Bédard
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Laval University, Québec, QC G1V 0A6, Canada.
| | - Louise Corneau
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
| | - Benoît Lamarche
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Laval University, Québec, QC G1V 0A6, Canada.
| | - Sylvie Dodin
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- Department of Obstetrics and Gynaecology, Pavillon Ferdinand-Vandry, 1050 Medicine Avenue, Laval University, Québec, QC G1V 0A6, Canada.
| | - Simone Lemieux
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Laval University, Québec, QC G1V 0A6, Canada.
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Saumoy M, Ordóñez-Llanos J, Martínez E, Ferrer E, Domingo P, Ribera E, Negredo E, Curto J, Sánchez-Quesada JL, Di Yacovo S, González-Cordón A, Podzamczer D. Atherogenic properties of lipoproteins in HIV patients starting atazanavir/ritonavir or darunavir/ritonavir: a substudy of the ATADAR randomized study. J Antimicrob Chemother 2014; 70:1130-8. [PMID: 25538166 DOI: 10.1093/jac/dku501] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To assess LDL subfraction phenotype and lipoprotein-associated phospholipase A2 (Lp-PLA2) in naive HIV-infected patients starting atazanavir/ritonavir or darunavir/ritonavir plus tenofovir/emtricitabine. METHODS This was a substudy of a multicentre randomized study. Standard lipid parameters, LDL subfraction phenotype (by gradient gel electrophoresis) and Lp-PLA2 activity (by 2-thio-PAF) were measured at baseline and weeks 24 and 48. Multivariate regression analysis was performed. Results are expressed as the median (IQR). RESULTS Eighty-six (atazanavir/ritonavir, n=45; darunavir/ritonavir, n=41) patients were included: age 36 (31-41) years; 89% men; CD4 319 (183-425) cells/mm(3); and Framingham score 1% (0%-2%). No differences in demographics or lipid measurements were found at baseline. At week 48, a mild but significant increase in total cholesterol and HDL-cholesterol was observed in both arms, whereas LDL cholesterol increased only in the darunavir/ritonavir arm and triglycerides only in the atazanavir/ritonavir arm. The apolipoprotein A-I/apolipoprotein B ratio increased only in the atazanavir/ritonavir arm. At week 48, the LDL subfraction phenotype improved in the darunavir/ritonavir arm (increase in LDL particle size and in large LDL particles), whereas it worsened in the atazanavir/ritonavir arm (increase in small and dense LDL particles, shift to a greater prevalence of phenotype B); the worsening was related to the greater increase in triglycerides in the atazanavir/ritonavir arm. No changes in total Lp-PLA2 activity or relative distribution in LDL or HDL particles were found at week 48 in either arm. CONCLUSIONS In contrast with what occurred in the atazanavir/ritonavir arm, the LDL subfraction phenotype improved with darunavir/ritonavir at week 48. This difference was associated with a lower impact on plasma triglycerides with darunavir/ritonavir.
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Affiliation(s)
- Maria Saumoy
- HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Ordóñez-Llanos
- Biomedical Research Institute IIB Sant Pau, Barcelona, Spain Biochemistry and Molecular Biology Department, Universitat Autònoma, Barcelona, Spain
| | | | - Elena Ferrer
- HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, Hospitalet de Llobregat, Barcelona, Spain
| | - Pere Domingo
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Esteban Ribera
- Infectious Disease Service, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eugenia Negredo
- Fundació Lluita contra la Sida, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Jordi Curto
- HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Silvana Di Yacovo
- HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Daniel Podzamczer
- HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, Hospitalet de Llobregat, Barcelona, Spain
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Ryder JR, Vega-López S, Ortega R, Konopken Y, Shaibi GQ. Lifestyle intervention improves lipoprotein particle size and distribution without weight loss in obese Latino adolescents. Pediatr Obes 2013; 8:e59-63. [PMID: 23576420 PMCID: PMC3898800 DOI: 10.1111/j.2047-6310.2013.00162.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 02/15/2013] [Accepted: 02/20/2013] [Indexed: 11/28/2022]
Abstract
Childhood obesity is associated with a pro-atherogenic phenotype contributing to increased cardiovascular disease (CVD) risk. This single-arm pilot study examined the effects of a lifestyle intervention on lipoprotein particle size and cholesterol distribution in obese Latino adolescents. Fifteen obese Latino adolescents (15.0 ± 1.0 years) completed a 12-week nutrition education and exercise intervention. Low-density lipoprotein (LDL) particle size and distribution of cholesterol in lipoprotein subclasses were determined via polyacrylamide gel electrophoresis. The intervention resulted in increases in mean LDL particle size (269.3 ± 3.4 to 271.6 ± 2.9 Å, P = 0.0003) and cholesterol in large high-density lipoprotein (HDL) subfractions (22.4 ± 11.2 to 26.8 ± 10.6% area, P = 0.007) along with decreases of cholesterol in small LDL (1.6 ± 2.0 to 0.6 ± 1.2% area, P < 0.01) and HDL subfractions (23.2 ± 9.4 to 19.0 ± 6.7% area, P = 0.05). These improvements were observed independent of changes in weight (90.7 ± 26.2 to 89.9 ± 27.8 kg, P > 0.05) and suggest that lifestyle modification in obese youth may reduce cardiovascular risk by shifting lipoprotein particle size and cholesterol distribution to a less atherogenic phenotype.
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Affiliation(s)
- Justin R. Ryder
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
| | - Sonia Vega-López
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ,Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ
| | - Rocio Ortega
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ,College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Yolanda Konopken
- St. Vincent de Paul Virginia G. Piper Medical and Dental Clinic, Phoenix, AZ
| | - Gabriel Q. Shaibi
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ,Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ,College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
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Damasceno NRT, Sala-Vila A, Cofán M, Pérez-Heras AM, Fitó M, Ruiz-Gutiérrez V, Martínez-González MÁ, Corella D, Arós F, Estruch R, Ros E. Mediterranean diet supplemented with nuts reduces waist circumference and shifts lipoprotein subfractions to a less atherogenic pattern in subjects at high cardiovascular risk. Atherosclerosis 2013; 230:347-53. [PMID: 24075767 DOI: 10.1016/j.atherosclerosis.2013.08.014] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 07/26/2013] [Accepted: 08/10/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The PREDIMED trial showed that Mediterranean diets supplemented with either extra-virgin olive oil or nuts reduced incident cardiovascular events compared to a control diet. Consumption of both supplemental foods has been associated with reduced LDL-cholesterol, but it is unknown whether they can shift lipoprotein subfractions to a less atherogenic pattern. We investigated changes in adiposity and lipoprotein subfractions after consumption of the PREDIMED diets. METHODS In a PREDIMED sub-cohort (n = 169), lipoprotein subclasses (particle concentrations and size) were determined by nuclear magnetic resonance spectroscopy at baseline and after intervention for 1 year. RESULTS Participants allocated to the Mediterranean diet supplemented with nuts showed significant reductions from baseline of waist circumference (mean [95% CI]; -5 cm [-7; -3]) and concentrations of medium-small (-27 nmol/l [-46; -8]) and very small LDL (-111 nmol/l [-180; -42]); decreased LDL particle number (a nuclear magnetic resonance-specific measurement) (-98 nmol/l [-184; -11]); and an increase of large LDL concentrations (54 nmol/l [18; 90]), with a net increase (0.2 nmol/l [0.1; 0.4]) of LDL size. The Mediterranean diets with olive oil and nuts increased large HDL concentrations (0.6 μM [0.0; 1.1] and 1.0 μM [0.4; 1.5], respectively). Compared to the other two intervention groups, participants in the nut-enriched diet showed significantly reduced waist circumference (p ≤ 0.006, both) and increased LDL size (p < 0.05, both). CONCLUSION Lipoprotein subfractions are shifted to a less atherogenic pattern by consumption of Mediterranean diets enriched with nuts. The results contribute mechanistic evidence for the reduction of cardiovascular events observed in the PREDIMED trial.
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Affiliation(s)
- Nagila R T Damasceno
- Lipid Clinic, Endocrinology and Nutrition Service, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
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