Fat distribution and gender differences in serum lipids in men and women from four European communities

We studied male/female differences in serum lipids in randomly selected 38-year-old men (n = 337) and women (n = 342) from various cities in The Netherlands, Sweden, Italy, and Poland. Overall, men had higher triglycerides and total cholesterol levels and lower HDL-levels compared to women (P less than 0.001). Adjustment for smoking habits, city, and body mass index did not remove the gender difference. Further adjustments for waist circumference alone and waist/hip and waist/thigh circumference ratio removed the gender differences in serum triglycerides and total cholesterol. Only adjustment for waist/thigh ratio removed the gender difference in HDL-cholesterol but linear relationships were different in men and women. The average male/female difference in serum lipids, particularly for total and LDL-cholesterol varied considerably among centers. In analyses of the data from the separate centers we found that sex differences in serum triglycerides and HDL-cholesterol in all 4 centers disappeared when adjusted for waist circumference alone and for waist/hip and waist/thigh ratio. For total and LDL-cholesterol, however, adjustment for circumference ratios tended to increase the male/female difference in 2 of the 4 centers. It is concluded that, in European men and women, fat distribution may be responsible for male/female differences in serum triglycerides but that such conclusions are less clear for HDL-, total- and LDL-cholesterol.