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The role of adiposity, diet and inflammation on the discordance between LDL-C and apolipoprotein B

Webb, RJ, Mazidi, M, Lip, GYH, Kengne, AP, Banach, M and Davies, IG (2021) The role of adiposity, diet and inflammation on the discordance between LDL-C and apolipoprotein B. Nutrition, Metabolism and Cardiovascular Diseases. ISSN 0939-4753

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Background and aims: While low-density lipoprotein cholesterol (LDL-C) is a good predictor of atherosclerotic cardiovascular disease, apolipoprotein B (ApoB) is superior when the two markers are discordant. We aimed to determine the impact of adiposity, diet and inflammation upon ApoB and LDL-C discordance.
Methods and results: Machine learning (ML) and structural equation models (SEMs) were applied to the National Health and Nutrition Examination Survey to investigate cardiometabolic and dietary factors when LDL-C and ApoB are concordant/discordant. Mendelian randomisation (MR) determined whether adiposity and inflammation exposures were causal of elevated/decreased LDL-C and/or ApoB. ML showed body mass index (BMI), dietary saturated fatty acids (SFA), dietary fibre, serum C-reactive protein (CRP) and uric acid were the most strongly associated variables (R2 = 0.70) in those with low LDL-C and high ApoB. SEMs revealed that fibre (b = −0.42, p = 0.001) and SFA (b = 0.28, p = 0.014) had a significant association with our outcome (joined effect of ApoB and LDL-C). BMI (b = 0.65, p = 0.001), fibre (b = −0.24, p = 0.014) and SFA (b = 0.26, p = 0.032) had significant associations with CRP. MR analysis showed genetically higher body fat percentage had a significant causal effect on ApoB (Inverse variance weighted (IVW) = Beta: 0.172, p = 0.0001) but not LDL-C (IVW = Beta: 0.006, p = 0.845).
Conclusion: Our data show increased discordance between ApoB and LDL-C is associated with cardiometabolic, clinical and dietary abnormalities and that body fat percentage is causal of elevated ApoB.

Item Type: Article
Uncontrolled Keywords: 11 Medical and Health Sciences
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Elsevier BV
Date Deposited: 03 Feb 2022 11:04
Last Modified: 07 Dec 2022 00:50
DOI or ID number: 10.1016/j.numecd.2021.12.004
URI: https://researchonline.ljmu.ac.uk/id/eprint/16226
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