Age exacerbates triglyceride-induced HDLC-lowering in women

Background and Aims: Elevated concentrations of HDL cholesterol (HDLc) protect against atherosclerotic cardiovascular disease. There are important age and gender differences both in cardiovascular risk and HDL metabolism. One immediate effect of elevated triglycerides is a decrease in HDLc. Our hypothesis is that the inverse relation between TG and HDLc is age and sex-dependent. Methods: We studied 4.754 adults from the general population participating in the [email protected] study (n=2020 men and n=2734 women). Lipoprotein particles were determined by NMR. To estimate the association between HDLc and TG we used linear regression models, and known confounders (age, gender, BMI, alcohol, diet, physical activity, smoking, diabetes mellitus) were included in multivariable regression models. Results: We identified interactions between TG and gender (p=0.001) and TG and age (p=0.001). Consequently, we stratified the population by gender and age. In women at 20 and 30 years of age, TGs did not affect HDLc. However, as they became older, the decrease in HDLc per 1mmol/L increase of TG doubled from -0.102 mmol/L at the age of 50 to -0.204 at the age of 80. Interestingly in men the effect of TGs on HDLc remained constant at all ages. The NMR data showed that HDLc decrease was mostly induced by large VLDL and affected only middle and small HDL particles. Conclusions: Although at early ages the decrease in HDLc associated with an increase in TG is lower in women than in men, after 50s the effect on HDLc due to such increase in TG becomes significantly higher in women.