Relationship between HDL₃ subclasses and waist circumferences on the prevalence of metabolic syndrome: KMSRI-Seoul Study

Objective: Limited information is available on the association of HDL subtypes and the risk of metabolic syndrome (MetSyn). The objective of the present study was to investigate the association of HDL subspecies with the prevalence of MetSyn in new outpatients. Methods: Five hundred forty-one new outpatients (366 males and 175 females) were enrolled in two hospitals participating in the KMSRI-Seoul Study. The new criteria for the Korean MetSyn based on the 2005 KHANES were used. Medical questionnaires, anthropometric measurements, 3-day recall dietary assessments, and blood biomarker analyses were performed. Unconditional logistic regression models were used to estimate crude and odds ratios (ORs) and 95% confidence intervals (CIs) with multivariate adjustments. The proportions of HDL subtypes were measured after subtypes were identified by 4-30% gradient gel electrophoresis. Results: Of the subjects, 50.8% were classified as MetSyn; blood pressure (BP) and fasting blood sugar (FBS) among the five criteria did not differ by gender. Increasing the HDL_2b subtype significantly reduced the risk of MetSyn in males and females. The association of small size HDL_3b with the risk of MetSyn was stronger in females than in males: adjusted ORs (95% CIs) for the 3rd tertile of HDL_3b compared to the 1st tertile were 3.79 (CI, 2.00-7.18) in males and 11.2 (CI, 2.1-59.6) in females. However, a decreased waist circumference (WC), BP, and triglycerides (TG) were observed with increased large HDL particles in males. Conclusions: Small-sized HDL was associated with increased MetSyn risk factors and closely related to WC, BP, TG, and HOMA-IR, particularly in males.