EXCESS BODY-WEIGHT - AN UNDER-RECOGNIZED CONTRIBUTOR TO DYSLIPIDEMIA IN WHITE AMERICAN WOMEN

Background: Whether the association between excess body weight and dys lipidemia is consistent across different age ranges in women has yet t o be determined.Methods: The relationship between body weight adjusted for height as calculated by body mass index (BMI; kilograms per squar e meter) and serum lipid and lipoprotein levels in white women was exa mined using cross-sectional data from the Second National Health and N utrition Examination Survey. Mean lipid levels were determined for six different categories of BMI: (1) 21.0 or less: (2) 21.1 to 23.0; (3) 23.1 to 25.0; (4) 25.1 to 27.0; (5) 27.1 to 30.0; and (6) more than 30 .0, and three age groups: premenopausal women, 20 through 44 years; pe rimenopausal women, 45 through 59 years; and postmenopausal women, 60 through 74 years. Results: Compared with BMI category 2, a BMI in cate gory 5 for premenopausal women was associated with 0.46 mmol/L (18 mg/ dL) higher total cholesterol levels, 0.68 mmol/L (26 mg/dL) higher non -high-density lipoprotein (HDL) cholesterol levels, and 0.44 mmol/L (1 7 mg/ dL) higher low-density lipoprotein (LDL) cholesterol levels. For perimenopausal women and postmenopausal women the same change in BMI was associated with much smaller differences in total cholesterol of 0 .16 and 0.16 mmol/L (6 and 5 mg/dL), non-HDL of 0.24 and 0.20 mmol/L ( 9 and 8 mg/dL), and LDL levels of 0.13 and 0.03 mmol/L (5 and 1 mg/dL) . More impressively, rising BMI was associated with consistently highe r triglyceride levels of 0.54 to 0.40 mmol/L (48 to 35 mg/dl) and cons istently lower HDL levels of 0.23 to 0.13 mmol/L (9 to 5 mg/dL), in al l three age groups. Conclusion: For young women, excess body weight wa s associated with higher total, non-HDL and LDL-cholesterol levels, hi gher triglyceride levels, and lower HDL-cholesterol levels. In older w omen, although similar differences in triglyceride levels and HDL-chol esterol levels were observed, excess body weight was associated with s maller differences in total, non-HDL, and LDL cholesterol. More striki ng than the weight-associated differences in total, non-HDL, and LDL-c holesterol levels were the differences in these lipid parameters obser ved with age alone. Specifically, age category differences were twofol d to eightfold greater than differences observed between categories of BMI within a given age. Nevertheless, because the lower HDL cholester ol concentrations associated with excess body weight were age independ ent, total cholesterol-HDL cholesterol ratios were highest in obese po stmenopausal women. Although age and hormonal status are important aff ecters of lipoprotein risk factors, body weight also worsens the degre e of dyslipidemia in white women.