Nutrient patterns are associated with discordant apoB and LDL: a population-based analysis.

Area of Science:

• Nutritional Science
• Cardiovascular Health
• Biochemistry

Background:

• Elevated apolipoprotein B (apoB) alongside LDL-cholesterol indicates a higher risk for atherosclerotic cardiovascular disease (CVD).
• Understanding the relationship between nutrient patterns and apoB/LDL-cholesterol discordance is crucial for targeted interventions.
• Previous research has not fully elucidated the specific nutrient patterns associated with discordant apoB and LDL-cholesterol levels.

Purpose of the Study:

• To investigate the associations between apolipoprotein B (apoB) and LDL-cholesterol discordance and nutrient patterns (NP).
• To identify specific nutrient intakes that contribute to or mitigate the risk associated with discordant apoB/LDL-cholesterol levels.
• To analyze these associations using data from the National Health and Nutrition Examination Survey (NHANES).

Main Methods:

• Participants were categorized into four groups based on established LDL-cholesterol and apoB cut-offs.
• Nutrient patterns (NP) were defined using principle component analysis.
• Machine learning (ML) and structural equation models were employed to assess nutrient intake associations with apoB/LDL-cholesterol discordance.

Main Results:

• Three distinct nutrient patterns were identified, explaining 63.2% of nutrient consumption variance.
• Nutrient Pattern 1 (NP1) was rich in saturated fatty acids (SFA), carbohydrates, and vitamins.
• Nutrient Pattern 2 (NP2) was high in fiber, minerals, and polyunsaturated fatty acids (PUFA).
• Nutrient Pattern 3 (NP3) was characterized by high dietary cholesterol, protein, and sodium (Na).
• Individuals with discordantly high apoB to LDL-cholesterol showed higher NP1 consumption and lower NP2 consumption.
• Machine learning identified total fat, SFA, and thiamine as having unfavorable dietary contributions, while MUFA, folate, fiber, and selenium (Se) had favorable contributions to discordantly high apoB/LDL-cholesterol levels.
• Higher apoB relative to LDL-cholesterol was linked to greater adherence to NP1, whereas lower apoB levels correlated with NP3 consumption.

Conclusions:

• Nutrient patterns are significantly associated with apoB/LDL-cholesterol discordance.
• Dietary intake, particularly SFA and total fat, plays a critical role in unfavorable apoB/LDL-cholesterol profiles.
• Favorable nutrient profiles, including fiber and MUFA, may mitigate risks associated with discordant lipid levels.