ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Smoking and obesity make a bad problem worse: genetics and lifestyle affect high density lipoprotein levels in Turks [Anatol J Cardiol]
Anatol J Cardiol. 2006; 6(1): 60-67

Smoking and obesity make a bad problem worse: genetics and lifestyle affect high density lipoprotein levels in Turks

Uğur Hodoğlugil1, Robert W. Mahley2
1From Department of Pharmacology Faculty of Medicine, Gazi University, Ankara Turkey
2From the Gladstone Institute of Cardiovascular Disease, Cardiovascular Research Institute, and Departments of Medicine and Pathology, University of California, San Francisco, CA 94158, USA

Low levels of high density lipoprotein cholesterol (HDL-C) are an independent risk factor for coronary heart disease. The Turkish Heart Study revealed very low levels of plasma HDL-C in the Turkish population, a fact confirmed by the Heart Disease and Risk Factors in Tur- kish Adults study. Low HDL-C levels have also been observed in Turks living in the United States, Germany, and the Netherlands. Dietary habits do not explain the low HDL-C levels, which were found in Turkish Heart Study participants from six regions of Turkey with signifi- cant differences in typical diets. Among newborns and pre-pubescent children, plasma HDL-C levels were similar in Turks and western Eu- ropeans. After puberty, however, HDL-C levels declined significantly in Turkish boys and girls. These results suggest a genetic basis for the low HDL-C levels. In fact, hepatic lipase activity modulated by sex hormones was 25-30% higher in the Turkish population than in other populations. Elevated hepatic lipase activity is clearly associated with low plasma HDL-C in many studies. Results of a recent genome-wi- de scan for plasma HDL-C in Turks revealed a linkage on chromosome 15q22 where the hepatic lipase gene is located and that low HDL- C was 80% heritable. In addition, evidence for an interaction between HDL-C levels and modifiable environmental factors, particularly smo- king and obesity, came from the study of cholesterol ester transfer protein TaqIB polymorphism. This polymorphism was associated with plasma HDL-C levels in Turks. Subjects with the B2B2 genotype-both smokers and nonsmokers-had higher plasma HDL-C levels. Interes- tingly, B2B2 subjects were protected from the HDL-C-lowering effect of smoking, whereas B1B1 subjects who smoked had significantly lo- wer HDL-C levels. A similar interaction was observed between TaqIB polymorphism and obesity. In conclusion, low HDL-C levels in Turks were modulated by genetic factors and their interaction with modifiable environmental factors, such as smoking and obesity.

Keywords: Smoking, obesity, HDL cholesterol, cholesterol ester transfer protein, Turkish population, polymorphism

Uğur Hodoğlugil, Robert W. Mahley. Smoking and obesity make a bad problem worse: genetics and lifestyle affect high density lipoprotein levels in Turks. Anatol J Cardiol. 2006; 6(1): 60-67
Manuscript Language: English


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