Associations of HDL, HDL2, and HDL3 Cholesterol and Apolipoproteins A-I and B with Lifestyle Factors in Healthy Women and Men: The Stanford Five City Project,

Background. Measures of the two major high-density lipoprotein (HDL) subfractions, HDL2 and HDL3, and the major apolipoproteins of HDL and low-density lipoprotein (LDL), Apo A-I and Apo B, may be etiologically important factors in the development of coronary artery disease. The association of lifestyle factors with these lipoprotein-related variables remains unclear. Methods. HDL-C, HDL2-C, HDL3-C, Apo A-I, and Apo B levels were determined in a population-based sample of 1,027 healthy women and men aged 25–64 years, from four California cities who participated in the 1989/1990 survey of the Stanford Five City Project. In this cross-sectional study we examined the independent associations of these lipoprotein-related variables with body mass index (BMI), cigarette smoking, daily energy expenditure, alcohol intake, dietary intake, and hormone use (oral contraceptives and estrogen replacement therapy). Results. In general, BMI and alcohol intake were the strongest independent predictors of the lipoprotein-related variables. The negative association of BMI with HDL-C was attributable primarily to the association with the HDL2-C subfraction, while for alcohol intake the positive association with HDL-C was attributable primarily to the association with HDL3-C, particularly in men. Among men, but not women, energy expenditure was a significant independent predictor of each of the lipoprotein-related variables, with positive associations observed for HDL-C, HDL2-C, HDL2-C, and Apo A-I and a negative association observed for Apo B (P < 0.005). Conclusions. Data from this population-based sample suggest that specific lifestyle factors are more strongly associated with some lipoprotein-related variables than with others, with notable gender differences.