“Isolated” Low High-Density Lipoprotein Cholesterol

1997 ◽  
Vol 31 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Vickie M Wilt ◽  
John G Gums

OBJECTIVE: To present information on the function, structure, and importance of high-density lipoprotein cholesterol (HDL-C) and to evaluate the current literature regarding the controversy of managing patients with an “isolated” low HDL-C concentration. DATA SOURCE: A MEDLINE search was performed (1966–June 1996) to identify English-language clinical and review articles pertaining to HDL-C. Some articles were identified through the bibliography of selected articles. STUDY SELECTION: All articles were considered for possible inclusion in the review. Pertinent information, as judged by the authors, was selected for discussion. DATA EXTRACTION: Important historical lipid studies, recent review articles, and clinical trials involving therapy for HDL-C were evaluated. DATA SYNTHESIS: The structure, function, and measurement of HDL-C and the state of an isolated low HDL-C are discussed for background. Lifestyle modification measures to increase HDL-C, medications to avoid, estrogen replacement, and lipid-altering agents used to raise an isolated low HDL-C are presented. CONCLUSIONS: An isolated low HDL-C concentration poses a risk for coronary heart disease. The management of this state is controversial. The first step in management is in agreement with experts and includes lifestyle modification (e.g., weight reduction, diet, smoking cessation, aerobic exercise). Estrogen replacement therapy and discontinuance of drugs that secondarily lower HDL-C are additional treatment options. The use of lipid-altering agents has been used in some patients. Nicotinic acid appears to be an effective agent for an isolated low HDL-C. A large clinical trial evaluating the effect of treating an isolated low HDL-C for primary and secondary prevention of coronary events is needed.

2022 ◽  
Author(s):  
Rui Zhang ◽  
Xing Zhang ◽  
Xingming Tang ◽  
Liwen Tang ◽  
Sijia Shang ◽  
...  

Abstract BackgroundLow levels of high-density lipoprotein-cholesterol (HDL-C) and diabetes are common in patients undergoing peritoneal dialysis (PD). The aim of this study was to investigate the association between diabetes coexisting with a low level of HDL-C and the first episode of peritoneal dialysis-related peritonitis (PDRP) in patients with PD.MethodsWe retrospectively investigated patients with PD from January 1, 2003, to May 31, 2020 in four PD centers. Patients with PD were divided into four groups: no comorbidity, low HDL-C only, diabetes only, and diabetes plus low HDL-C. The clinical and laboratory baseline data of the four groups were collected and compared. The association between diabetes coexisting with low HDL-C levels and the first episode of PDRP was analysed by multivariate Cox regression analysis. ResultsA total of 1013 patients with PD were recorded in our study. The mean age was 49.94±14.32 years, and 597 (58.99%) were males. A total of 301 (29.7%) patients had their first episodes of PDRP, and low HDL-C levels existed with diabetes in 72 patients with PD. After adjusting for confounding factors, a low level of HDL-C coexisting with diabetes was significantly associated with the first episode of PDRP in our study (hazard ratio: 1.93, 95% CI: 1.03-3.61, p<0.05). The associations between HDL-C, diabetes and PDRP were consistent in the following subgroups: sex, age, pre-existing CVD (all P interaction > 0.05).ConclusionsLow levels of HDL-C alone or diabetes alone were not independent risk factors for PDRP. Patients with both diabetes and low HDL-C levels were at high risk for PDRP.


2010 ◽  
Vol 163 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Elena Succurro ◽  
Franco Arturi ◽  
Alessandro Grembiale ◽  
Fiorella Iorio ◽  
Irma Laino ◽  
...  

AimsLow IGF1 levels have been associated with an increased cardiovascular risk. It is unknown however whether IGF1 mediates the atherosclerotic process by modulating high-density lipoprotein cholesterol (HDL-C) independently from confounders. To address this issue, we evaluated the association between IGF1 levels and HDL-C in nondiabetic subjects.MethodsA cross-sectional analysis was used in the context of the CAtanzaro MEtabolic RIsk factors Study. One thousand and four participants (aged 20–69 years), for whom HDL-C and IGF1 measurements were available, were eligible for the study.ResultsAfter adjusting for gender and age, IGF1 levels were positively correlated with HDL-C, and negatively correlated with body mass index (BMI), waist circumference, blood pressure (BP), triglyceride, fasting insulin, and homeostasis model assessment (HOMA). In a logistic regression model adjusted for age and gender, IGF1 in the lowest tertile (<125 ng/ml) was associated with an increased risk of having low HDL-C (odds ratio (OR) 2.14, 95% confidence interval (CI) 1.4–3.0; P=4×10−5) compared with the highest tertile (>186 ng/ml). When BMI, waist circumference, total cholesterol, triglyceride, and HOMA index were added to the model, IGF1 remained significantly associated with increased risk of low HDL-C (OR 1.52, 95% CI 1.01–2.31; P=0.04). A stepwise multivariate regression analysis in a model including age, gender, BMI, total cholesterol, triglycerides, IGF1, HOMA, and BP showed that the variables significantly associated with HDL-C were gender (P<0.0001), triglycerides (P<0.0001), total cholesterol (P<0.0001), BMI (P<0.0001), IGF1 levels (P<0.0001), and HOMA (P=0.001), accounting for 32.6% of its variation.ConclusionsThese data provide evidence that IGF1 may be an independent modulator for HDL-C in nondiabetic individuals.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 824-831
Author(s):  
Sheldon M. Polonsky ◽  
Loretta A. Simbartl ◽  
Dennis L. Sprecher

Objective. To determine whether lipid disorders can be predicted in parents after such disorders are identified initially in their children. Although this relation has been well determined for children with high cholesterol or low-density lipoprotein cholesterol (LDL-C), it has not been as well described for disorders involving triglycerides (TG) or high-density lipoprotein cholesterol (HDL-C), or their interaction with LDL-C. Methods. Serum lipid values were obtained from 232 families in the comparison population of a large genetics study. Subjects were classified into four groups based on their lipid status: 1) isolated LDL-C disorder, defined by a high LDL-C level and normal TG and HDL-C levels; 2) isolated TG/HDL-C disorder, defined by either high TG, low HDL-C, or both, and normal LDL-C; 3) combined disorder, defined by high LDL-C in addition to either high TG, low HDL-C, or both; and 4) normal, defined by the absence of any of the above disorders. The frequencies of these disorders were noted in both parents and children, and logistic regression analyses were conducted to determine whether the presence of these disorders in at least one child in the family could predict similar disorders in the parents. Results. Children with isolated LDL-C or TG/HDL-C disorder were more likely to have parents with the same disorder as themselves (P = .002 and P = .04, respectively). Children with the combined disorder were more likely to have parents with any lipid disorder (P = .009), but especially isolated LDL-C (P = .002) and isolated TG/HDL-C (P = .05). Conclusion. A classification scheme defining disorders of TG and HDL-C, LDL-C, or a combination can be useful for predicting lipid disorders in parents after such disorders are identified initially in their children.


2011 ◽  
Vol 2 ◽  
pp. JCM.S7863 ◽  
Author(s):  
Yasushi Wakida ◽  
Satoshi Suzuki ◽  
Hirohiko Nomura, on behalf of APPROACH-J Investigators ◽  
Tatsuya Isomura

Safety and efficacy of combination therapy of pitavastatin and fenofibrate were examined in consecutive case series with fasting serum triglycerides ≥ 150 mg/dL despite receiving pitavastatin 1 or 2 mg daily for over 2 months and additionally administered micronized fenofibrate 67 mg daily for another 4 to 16 weeks. Such low doses were selected in consideration of safety, and normal liver and renal functions were incorporated in inclusion criteria. In result, a total of 56 cases were examined. The addition of fenofibrate 67 mg to pitavastatin 1 mg/2 mg yielded a 36.8%/35.6% reduction in triglycerides and 6.4%/12.4% elevation in high-density lipoprotein cholesterol, respectively. Almost 70% of the patients achieved triglycerides <150 mg/dL. Statistically significant elevation and decrease were observed in high-density lipoprotein cholesterol level and low-density lipoprotein cholesterol, respectively. Laboratory tests for liver, renal and muscle function statistically significantly elevated after starting fenofibrate co-administration, which were considered comparable to the effect of fenofibrate alone. No myopathy or serious adverse events were reported. In conclusion, while the safety and tolerability need to be further examined over the longer term, and careful monitoring is still needed, this regimen could be considered as one of the treatment option for hypercholesterolemia associated with hypertriglyceridemia.


2021 ◽  
Vol 64 (6) ◽  
pp. 410-415
Author(s):  
Kyungchul Song ◽  
Ho-Seong Kim ◽  
Hyun Wook Chae

Background: As dyslipidemia at a young age is a risk factor for cardiovascular disease in adulthood, the screening and management of dyslipidemia in children and adolescents might be an important health issue. This review deals with issues related to the prevalence, diagnosis, screening, and treatment of pediatric dyslipidemia.Current Concepts: In Korea, the prevalence of pediatric dyslipidemia was 19.7% between 2007 and 2009. Dyslipidemia was defined according to the guidelines of the Korean Society of Pediatric Endocrinology: total cholesterol ≥200 mg/dL, low-density lipoprotein cholesterol ≥130 mg/dL, triglycerides ≥130 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, or non-high-density lipoprotein cholesterol ≥145 mg/dL.Discussion and Conclusion: We recommend universal screening tests for dyslipidemia at ages 9–11 years and 17–21 years. Diet and lifestyle modifications are essential in the treatment of dyslipidemia. In children aged ≥10 years with a poor response to lifestyle modification, drug therapy is recommended. Pediatric dyslipidemia should be diagnosed and treated properly to reduce adult cardiovascular diseases and improve quality of life in this age group.


2019 ◽  
Vol 8 (3) ◽  
pp. 381 ◽  
Author(s):  
Kei Nakajima ◽  
Ryoko Higuchi ◽  
Taizo Iwane ◽  
Michi Shibata ◽  
Kento Takada ◽  
...  

Background: It is unknown whether extremely high high-density lipoprotein cholesterol (HDL-C) has a protective effect against diabetes, which plays a key role in cardiovascular disease. Methods: In a community-based cohort study of 387,642 subjects (40–68 years old) without diabetes, the incidence of diabetes 6 years later was determined according to baseline HDL-C (≤39, 40–49, 50–59, 60–69, 70–79, 80–89, 90–99, 100–109, or ≥110 mg/dL). Results: At baseline, HDL-C ≥100 mg/dL was present in 12,908 subjects (3.3%), who had a better lipid profile and a high prevalence of heavy alcohol consumption and habitual exercise. The incidences of diabetes according to baseline HDL-C were 14.7, 11.2, 7.7, 5.3, 3.8, 2.8, 2.7, 2.5, and 3.5 per 1000 person-years, respectively. The adjusted relative risks (ARRs) for diabetes showed concave relationships with HDL-C, with minima at 80–89 mg/dL. The ARR (95% CI) of the lowest HDL-C category was 1.56 (1.40–1.74) and of the highest HDL-C category was 1.46 (1.18–1.81) (both p < 0.001), regardless of alcohol consumption. The latter ARR was higher in men (n = 219,047) (2.45 (1.70–3.53), p < 0.0001) after adjustment for baseline glycemic index. Conclusion: Both extremely high and low HDL-C represent risks for diabetes, which deserves further study.


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