Objective: To assess whether changes in total and regional adiposity affect the odds for becoming hypercholesterolemic.
Methods and Procedures: Changes in BMI and waist circumference were compared to self-reported physician-diagnosed hypercholesterolemia in 24,397 men and 10,023 women followed prospectively in the National Runners' Health Study.
Results: Incident hypercholesterolemia were reported by 3,054 men and 519 women during (mean ± s.d.) 7.8 ± 1.8 and 7.5 ± 2.0 years of follow-up, respectively. Despite being active, men's BMI increased by 1.15 ± 1.71 kg/m2 and women's BMI increased by 0.96 ± 1.89 kg/m2. The odds for developing hypercholesterolemia increased significantly in association with gains in BMI and waist circumferences in both sexes. A gain in BMI ≥2.4 kg/m2 significantly (P < 0.0001) increased the odds for hypercholesterolemia by 94% in men and 129% in women compared to those whose BMI declined (40 and 76%, respectively, adjusted for average of the baseline and follow-up BMI, P < 0.0001). A gain of ≥6 cm in waist circumference increased men's odds for hypercholesterolemia by 74% (P < 0.0001) and women's odds by 70% (P < 0.0001) relative to those whose circumference declined (odds increased 40% at P < 0.0001 and 49% at P < 0.01, respectively adjusted for average circumference). BMI and waist circumference at the end of follow-up were significantly associated (P < 0.0001) with the log odds for hypercholesterolemia in both men (e.g., coefficient ± s.e.: 0.115 ± 0.011 per kg/m2) and women (e.g., 0.119 ± 0.019 per kg/m2) when adjusted for baseline values, whereas baseline BMI and circumferences were unrelated to the log odds when adjusted for follow-up values.
Discussion: These observations are consistent with the hypothesis that weight gain acutely increases the risk for hypercholesterolemia.