Can cholesterol be too low? A retrospective correlation of cholesterol lab values to other markers of cardiovascular disease risk

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S33-S34
Author(s):  
P Petersen ◽  
A Chambliss

Abstract Introduction/Objective Most recommendations for lipid panel reference ranges are one-sided (desirable total cholesterol is <200 mg/dL, optimal LDL cholesterol [LDL-C] is <100 mg/dL). However, recent studies suggest risks for cardiovascular diseases or mortality at very low cholesterol values. In this retrospective study, we investigated the association between lipid panel results and surrogate markers of cardiovascular disease to test the hypothesis that very low cholesterol levels are associated with increases in cardiovascular risk. Methods/Case Report Patients with lipid panels reported from April 2020-March 2021 at LAC+USC Medical Center were included. Lipid panels (total cholesterol, LDL-C, HDL-C, triglycerides) and laboratory results representing risk factors for cardiovascular disease (troponin T (TnT), NT-pro brain natriuretic peptide (BNP), hemoglobin A1c (HbA1c), high sensitivity C-reactive protein (CRP)) were collated. Lipid panel values were compared against the percentage of patients with non-optimal laboratory results for the cardiovascular risk markers. Results (if a Case Study enter NA) Decreasing total cholesterol levels vs. the percentage of patients with high TnT or BNP showed a U-curve with a nadir at 200-240 mg/dL (elevated TnT: 15%, BNP: 49%) and further increased with lower cholesterol levels <60 mg/dL (TnT: 56%, BNP: 92%); HbA1c (U-curve, nadir: 160-180 mg/dL); and CRP (90% at cholesterol <60 mg/dL; 43% at 220-240 mg/dL). Decreasing HDL-C against all markers of cardiovascular disease demonstrated a continued downtrend below optimal HDL-C levels. Decreasing LDL-C vs. the percentage of high TnT showed a U-curve with a nadir at 120-140 mg/dL; BNP (uptrends in the optimal range of LDL-C); HbA1c (U-curve, nadir: 90-100 mg/dL); and CRP (uptrends with decreasing LDL-C). TnT and BNP decreased with increasing triglycerides, while HbA1c increased with increasing triglycerides. Data points (TnT: n > 5,000; BNP: n > 3,000; HbA1c: n > 29,000; CRP: n > 4,500). Conclusion Very low concentrations of total cholesterol and LDL-cholesterol are associated with elevated markers of cardiovascular risk. Laboratories may wish to consider incorporating low ends to total cholesterol and LDL-cholesterol reference ranges.

2017 ◽  
Vol 3 (1) ◽  
pp. 7-14
Author(s):  
Okon Ekwere Essien ◽  
Iya Eze Bassey ◽  
Rebecca Mtaku Gali ◽  
Alphonsus Ekpe Udoh ◽  
Uwem Okon Akpan ◽  
...  

Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol ( P = .010), LDL cholesterol ( P = .021), BMI ( P = .001), and waist circumference ( P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.


Author(s):  
Leilah K Grant ◽  
Charles A Czeisler ◽  
Steven W Lockley ◽  
Shadab A Rahman

Abstract Context Dyslipidemia and cardiovascular disease are common in shift workers and eating at night may contribute to this pathophysiology. Objective To examine the effects of eating at different times of day on lipid profiles. Design Two 24-hour baseline days with 8 hours of sleep, 3 meals (breakfast, lunch, dinner) and a snack, followed by a 40-hour constant routine (CR) with hourly isocaloric meals. Setting Intensive Physiological Monitoring Unit, Brigham and Women’s Hospital. Participants Twenty-one healthy adults [23.4 ± 2.7 years, 5F] Intervention Forty-hour CR. Main Outcome Measures A standard clinical lipid panel, consisting of total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), was assayed in blood samples collected 4-hourly across ~4 days. Results When participants ate at night, levels of TG were similar to eating during the day, however, these levels at night were reached with consuming approximately half the calories. Additionally, 24-hour levels of TG were 10% higher when meals were consumed hourly across 24 hours compared to consuming a typical 3-meal schedule while awake during the day and sleeping at night. The endogenous circadian rhythms of TG, which peaked at night, were shifted earlier by ~10 hours under baseline conditions, whereas the rhythms in total cholesterol, HDL-C, and LDL-C remained unchanged and peaked in the afternoon. Conclusions The time-of-day dependency on postprandial lipid metabolism, which leads to hypersensitivity in TG responses when eating at night, may underlie the dyslipidemia and elevated cardiovascular disease risk observed in shift workers.


2015 ◽  
Vol 7 (2) ◽  
pp. 137-142
Author(s):  
Karla Rojas Suárez ◽  
Lourdes Rojas Espinoza

Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Costa Rica is no exception, with high levels of cholesterol and triglycerides in all age groups, and lack of adherence to treatment as one of the main challenges. We analyze the variation in test results of lipid pro le in one control and one telemedicine group in the staff of a Costa Rican university. We followed 62 patients aged 20-70 years, with tests done after fasting 12 hours, and 6 months to a year between samples. A questionnaire was used to calculate rates of factors that affect the variation in laboratory results. The patients had greater commitment to self care in the telemedicine group, achieving a reduction in total cholesterol levels, with little or no variation in other lipoproteins, and a slight increase in triglyceride levels.


2021 ◽  
pp. 1966-1970
Author(s):  
Widiyanto Widiyanto ◽  
Mulyono Mulyono ◽  
Sutrisno Sutrisno ◽  
Eko Pangestu ◽  
Marry Christiyanto ◽  
...  

Background and Aim: Healthy goat meat is an essential aspect in increasing consumer acceptance for this livestock product. The research aimed to examine the effect of goat meat containing low cholesterol and rich omega-6 fatty acid on the performance and blood lipid status of white rats (Rattus norvegicus). Materials and Methods: Thirty 2-month-old male white rats (R. norvegicus) weighing 195-230 g were randomly divided into three groups, with each group consisting of 10 rats. Group I was treated with a control feed (T0; BR I concentrate). Group II (T1) was treated with a mixed feed containing 50% control feed and 50% goat meat. Group III (T2) was treated with a mixed feed comprising 50% control feed and 50% goat meat with low cholesterol and rich omega-6 fatty acids. Each treatment was given ad libitum for 30 days. The variables measured were dry matter and organic matter consumption, daily body weight gain, feed conversion, triglyceride levels, total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and atherogenic index (AI). The data were analyzed statistically using analysis of variance in a completely randomized design. Results: The total, HDL, and LDL cholesterol levels at T0, T1, and T2 were as follows: 99.97, 35.97, and 50.43 mg/dL (total cholesterol); 108.35, 33.92, and 58.17 mg/dL (HDL cholesterol); and 101.43, 38.09, and 48.65 mg/dL (LDL cholesterol). The highest HDL and the lowest LDL cholesterol levels (p<0.05) were observed in the T2 treatment group, which had the lowest AI (1.69 vs. 1.77 and 2.19). Conclusion: The consumption of goat with low cholesterol and rich omega-6 fatty acids reduces the total cholesterol and LDL cholesterol, raises the HDL cholesterol levels, and decreases the AI.


2006 ◽  
Vol 96 (S1) ◽  
pp. S89-S93 ◽  
Author(s):  
Rosa M. Ortega ◽  
Ana Palencia ◽  
Ana M López-Sobaler

Hypercholesterolaemia is one of the main factors contributing to the appearance and progression of CVD, which is the main cause of death in the adult population of industrialized societies. By 2020, projections suggest that it will continue to hold first place, by then causing 37 % of all deaths. Therapeutic life-style changes to reduce cardiovascular risk include dietary modifications, such as the inclusion of phytosterols or plant sterols (known since the 1950s to reduce cholesterol levels). These help prevent the absorption of cholesterol and thus condition a reduction in total cholesterol and LDL-cholesterol levels, and ultimately in cardiovascular mortality. The fat-soluble nature of these sterols rendered margarine one of the best vehicles by which to supply them in the diet. Indeed, margarine was the first food to contain cholesterol-reducing phytosterols to be approved by the EU (in agreement with its regulations on new foods and food ingredients, 258/97/CE). Presently, phytosterols can be emulsified with lecithin and thus delivered in non-fat or low-fat foods and beverages. Margarine and dairy products (yoghurt and milk) enriched in phytosterols have proved better at lowering total cholesterol and LDL-cholesterol levels than have enriched cereals and their derivatives, although all can be of help, depending on the characteristics of each subject. The reduction in carotenoid bioavailability caused by sterols is minimized by increasing fruit and vegetable consumption. Individuals who habitually consume phytosterols should also follow traditional advice such as eating less dietary fat and increasing their physical activity. Phytosterols have been shown to be safe and effective in lowering cholesterol levels in many rigorous studies. In few areas of nutrition is there such consensus. Diet professionals should feel comfortable in prescribing phytosterols/stanols for the treatment of hypercholesterolaemia. They are safe whether taken alone or in combination with cholesterol-reducing drugs, such as statins and fibrates. Reinforcement counselling is essential, as therapy is effective only if compliance is good.


2021 ◽  
Vol 84 (4) ◽  
pp. 431-441
Author(s):  
Kinga Michnik ◽  
Maciej Mularczyk ◽  
Marta Stępień-Słodkowska

Abstract The Polish national program for the prevention of cardiovascular disease (CHUK) uses the Systematic Coronary Risk Evaluation (SCORE) index which evaluates the upcoming risk of death from cardiovascular causes for a 10 year period, based on information such as age, systolic blood pressure, cholesterol levels, smoking and gender. The aim of this study was to determine health indicators in the population enrolled in the program and identify the relationships between the cardiovascular risk factors. The data was collected from 303 participating individuals; 172 women (aged 35 to 58 years) and 131 men (aged 31 to 60 years). The SCORE index showed a statistically significant positive relationship between CVD and the male gender. The higher frequency of 3–4% and 5–9% for SCORE index in men indicates that they were at a higher risk of cardiovascular incidents. The increased risk of a cardiovascular incidence in men was associated with a higher mean arm circumference, waist circumference, BMI, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL cholesterol, triglyceride and fasting glucose. HDL cholesterol and heart rate were statistically significantly higher in women. Among the study subjects, the most common parameters above the normal range were elevated LDL cholesterol and total cholesterol. The highest correlation with the SCORE index was observed for the age of the subjects, total cholesterol and LDL cholesterol, regardless of gender. The results showed that biochemical parameters and blood pressure were above normal values in almost all subjects. Men had significantly less favorable parameters compared to women of similar age range. According to the SCORE index, total cholesterol and LDL cholesterol significantly increased the risk of cardiovascular incident regardless of gender. Women were characterized by a lower risk of cardiovascular incident according to the SCORE index.


2018 ◽  
Vol 16 (1) ◽  
pp. 1 ◽  
Author(s):  
AZRUL HILDAN SAFRIZAL

<p>The pattern and lifestyle of today's society with the presence of an interner facility makes people spend more time sitting out than on exercise and increased consumption of high-fat foods may increase the risk of cardiovascular disease. An effective therapy is needed in preventing the occurrence of cardiovascular disease. Hyperbaric oxygen now starts to develop for the treatment of several diseases, which in turn can increase the gene forming antioxidant enzymes and ROS. To determine effect of hyperbaric oxygen therapy on total cholesterol levels of wistar white rats (Rattusnovergicus) induced bye high fat. The study was carried out in an expeative post test only group control of three groups. One group is given standard feed. All groups induced high-fat diet and standard feed. Of the two groups induced, one group was given hyperbaric oxygen therapy with a dose of 3 x 30 minutes for six days on day 7 at a blood test to determine total cholesterol levels<strong>. </strong>One way Anova parametric statistic test showed that p = 0.007 &lt; α proved hypothesis that hyperbaric oxygen therapy giving effect to total cholesterol level of white mice of jantangalurist rings induced by high fat diet. Total cholesterol was significantly different between K (-) and K (+) and between K (-) and P. It was found that hyperbaric oxygen therapy had an effect on total cholesterol level dose of 3x30 minutes for six days.</p>


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