High-density-lipoprotein metabolism during a very-low-calorie diet

Abstract

We examined the changes in high-density-lipoprotein (HDL) metabolism in eight female obese patients undergoing a very-low-calorie diet (VLCD). In the first half of the study, HDL cholesterol (HDL-C), apolipoprotein A-I (apo A-I), and apo A-II showed a parallel decrease. Although lipoprotein lipase (LPL) and hepatic lipase (HTGL) did not change, lecithin: cholesterol acyltransferase (LCAT) decreased. In the latter half of the protocol, HDL-C and apo A-I increased whereas apo A-II decreased, resulting in increased apo A-I-A-II ratios. There was no change in LPL, HTGL, or LCAT. LCAT and apolipoprotein composition may be important in HDL-C changes after VLCD.

The Effects of Very-Low-Calorie Diets on HDL: A Review

“…HDL 2 , Apo A-I, and pre- β 1 are associated with cardioprotection and are found to be reduced in the obesity [35]. In response to the VLCD, Shoji et al [29] observed that the initial decrease in HDL 2 was associated with decreased lecithin cholesterol ester transfer protein (LCAT) (which plays an important role in the formation of HDL 2 [36]) while Apo A-1 increased. Apo A-1 activates LCAT, which may explain the delayed improvement in HDL [29].…”

“…The energy intake from VLCDs ranged from 400–600 kcal/d. Two studies included women only [29] and one study included type 2 diabetic patients only [30]. The format of the different interventions varied widely, and is described in more detail in Table 3.…”

“…At this stage, HDL had decreased significantly in 4 studies [8, 29, 30], and increased in one study [21]. At the end of the studies, HDL was increased in at least one arm of 3 studies [21, 30, 31], only two of which were significant [21, 31].…”

“…At the end of the studies, HDL was increased in at least one arm of 3 studies [21, 30, 31], only two of which were significant [21, 31]. HDL decreased in at least one arm of 3 studies [8, 29, 30] none of which were significant.…”

Aggressive diets and lipid responses

“…HDL cholesterol responses are not that uniform: several studies documented a decrease of HDL cholesterol levels [70,73,[76][77][78][79] when lipid profiles were measured within the first 2 to 8 weeks of VLCDs. Others report increases in HDL cholesterol, but in these studies lipid profiles were measured later, at about 3 to 12 months into the VLCD program [72,74,79]. HDL cholesterol responses appear to be biphasic.…”