Lipoprotein particle subclass profiles among metabolically healthy and unhealthy obese and non-obese adults: does size matter?

Objectives: No data regards lipoprotein particle profiles in obese and non-obese metabolic health subtypes exist. We characterised lipoprotein size, particle and subclass concentrations among metabolically healthy and unhealthy obese and non-obese adults.
Methods: Cross-sectional sample of 1834 middle-aged Irish adults were classified as obese (BMI ≥30 kg/m(2)) and non-obese (BMI <30 kg/m(2)). Metabolic health was defined using three metabolic health definitions based on various cardiometabolic abnormalities including metabolic syndrome criteria, insulin resistance and inflammation. Lipoprotein size, particle and subclass concentrations were determined using nuclear magnetic resonance (NMR) spectroscopy.
Results: Lipoprotein profiling identified a range of adverse phenotypes among the metabolically unhealthy individuals, regardless of BMI and metabolic health definition, including increased numbers of small low density lipoprotein (LDL) (P < 0.001) and high density lipoprotein (HDL) particles (P < 0.001), large very low density lipoprotein (VLDL) particles (P < 0.001) and greater lipoprotein related insulin resistance (P < 0.001). The most significant predictors of metabolic health were lower numbers of large VLDL (ORs 2.72-3.13 and 2.49-3.86, P < 0.05 among obese and non-obese individuals, respectively) and small dense LDL particles (ORs 1.78-2.39 and 1.50-1.94, P < 0.05) and higher numbers of large LDL (ORs 1.82-2.66 and 2.84-3.27, P < 0.05) and large HDL particles (ORs 1.88-2.58 and 1.81-3.49, P < 0.05).
Conclusions: Metabolically healthy adults displayed favourable lipoprotein particle profiles, irrespective of BMI and metabolic health definition. These findings underscore the importance of maintaining a healthy lipid profile in the context of overall cardiometabolic health.
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