Lipoprotein particle distribution and size, insulin resistance, and metabolic syndrome in Alaska Eskimos: The GOCADAN study

Abstract: Background: Metabolic syndrome (MS) is associated with dyslipidemia, and insulin resistance (IR) may be a main determinant of this dyslipidemia. Objective: To determine how lipoprotein particle concentration and size are related to MS and IR in a population-based sample of Alaska Eskimos. Design: Participants underwent a physical exam, personal interview, collection of biological specimens, and diagnostic tests. Setting: This study was conducted in the Norton Sound region of Alaska. Participants: One thousand one hundred fifty-eight Inupiat Eskimo adults (women=653, men=505). Main outcome measures: Lipoprotein particle profile was evaluated by nuclear magnetic resonance (NMR) and related to presence of MS and level of IR. Results: Participants with MS had (a) significantly higher concentrations of all VLDLs and a larger VLDL size (women, p =0.007; men, p =0.0001); (b) higher concentrations of small LDL (women, p <0.0001; men, p =0.09) and lower concentrations of large LDL (women, p <0.0001), leading to a smaller overall LDL size (women, p <0.0001; men, p <0.05); (c) significantly lower concentrations of large HDL (both genders, p <0.0001) and an increase in intermediate (women, p <0.05) and small HDL (women, p <0.0001; men, p <0.004). Lipoprotein profile with increasing HOMA-IR resembled that of individuals with MS. Conclusions: In this population MS is characterized by lipoprotein distribution and size abnormalities independent of obesity, age, and other cardiovascular risk factors, including lipid concentration. IR seems the major determinant. [Copyright &y& Elsevier]