Significance of high HDL cholesterol levels in Japanese men with metabolic syndrome

Abstract

Objective The objective was to clarify the significance of high high-density lipoprotein cholesterol (HDLC) levels in the metabolic syndrome (MetS). The evaluation focused on insulin resistance as an indicator of early-stage MetS. Methods and Subjects Of 2705 men who first underwent an annual health check-up at Tokai University Hachioji Hospital, 2129 men were included in this study, after exclusion of those on medication for hypertension, diabetes or dyslipidemia, and those with a prior history of ischemic heart disease, cerebrovascular disease or chronic renal failure. MetS risk factors include the following five parameters: waist circumference, blood pressure, plasma glucose, triglycerides and HDL-C. The correlations between HDL-C and number of MetS risks with homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed. HOMA-IR, number of risks, habits of smoking, exercise and drinking alcohol, stratified by HDL-C levels, were compared in MetS subjects. Results In cases with ≤2 risk factors, the higher the HDL-C, the lower the HOMA-IR. However, with ≥3 risk factors for MetS, the HOMA-IR increased when HDL-C was ≥90 mg/dL. In MetS subjects, the rate of alcohol intake ≥75 g/day was high when HDL-C was ≥90 mg/dL. Conclusion In MetS subjects with high HDL-C levels, insulin resistance was increased. Therefore, in persons with high HDL-C levels, it is important to monitor the amount of alcohol consumption and reduce alcohol consumption to <75 g/day. © 2011 The Japanese Society of Internal Medicine.