American Journal of Epidemiology Vol. 136, No. 5: 546-557
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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The Relation of High Density Lipoprotein Cholesterol and Its Subfractions to Apolipoprotein A-l and Fasting Triglycerides: The Role of Environmental Factors
The Atherosclerosis Risk in Communities (ARIC) Study
1Department of Medicine, Baylor College of Medicine, and The Methodist Hospital Houston, TX
2Epidemiology and Biometry Program, National Heart, Lung, and Blood Institute Bethesda, MD
3Department of Biostatistics, University of North Carolina Chapel Hill, NC
Reprint requests to Dr. A. Richey Sharrett, Federal Building, Room 2C08, Epidemiology and Biometry Program, National Heart, Lung, and Blood Institute, Bethesda, MD 20892.
Cross-sectional analysis of four general representative populations of middle-aged adults In the United States in 1986–1989 provides estimates of the close relation of high density lipoprotein cholesterol (HDL cholesterol) to its major structural apolipoprotein (apolipoprotein A-l) and to fasting plasma triglyceride levels. HDL cholesterol differences of approximately 0.4 mg were associated with 1-mg differences in apolipoprotein A-l; differences of 20% in HDL cholesterol (reductions) were associated with triglyceride doublings. Variation in apolipoprotein A-l and triglyceride concentration together accounted for 66% of the population variance in HDL cholesterol. The uniformity of this pattern in the four race-sex groups studied suggests an important role of triglyceride-cholesterol transfer as a determinant of HDL cholesterol. The fundamental relations observed among HDL cholesterol, apolipoprotein A-l, and triglycerides were unaltered by levels of factors under personal volition. The volitional factors appeared to influence HDL cholesterol indirectly: Obesity and physical activity were affected primarily through their associations with triglycerides, and alcohol use and smoking through associations with apolipoprotein A-l. The association of alcohol use with elevated HDL cholesterol was attenuated in persons with greater body mass. Am J Epidemiol 1992; 136: 546–57
alcohol drinking; apolipoproteins A; exercise; lipoproteins, HDL; obesity; smoking; triglycerides
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