scholarly journals Beyond LDL-Cholesterol: The Role of Low HDL-Cholesterol and Elevated TG in Residual Cardiovascular Risk Remaining After Statin Therapy

2008 ◽  
Vol 14 (8 Supp A) ◽  
pp. 6-15 ◽  
Author(s):  
Karol E. Watson
Keyword(s):  
Cardiovascular Risk ◽  
Statin Therapy ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Residual Cardiovascular Risk ◽  
Low Hdl

scholarly journals Diabeteses dyslipidaemia és atherosclerosis

2016 ◽  
Vol 157 (19) ◽  
pp. 746-752 ◽  
Author(s):  
László Márk ◽  
Győző Dani
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
High Risk ◽  
Statin Therapy ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Small Dense Ldl ◽  
Target Values ◽  
Postprandial Triglyceride ◽  
Low Hdl

The incidence and the public health importance of diabetes mellitus are growing continuously. Despite the improvement observed in the latest years, the leading cause of morbidity and mortality of diabetics are cardiovascular diseases. The diagnosis of diabetes mellitus constitutes such a high risk as the known presence of vascular disease. Diabetic dyslipidaemia is characterised by high fasting and postprandial triglyceride levels, low HDL level, and slightly elevated LDL-cholesterol with domination of atherogenic small dense LDL. These are not independent components of the atherogenic dyslipidaemia, but are closely linked to each other. Beside the known harmful effects of low HDL and small dense LDL, recent findings confirmed the atherogenicity of the triglyceride-rich lipoproteins and their remnants. It has been shown that the key of this process is the overproduction and delayed clearance of triglyceride-rich lipoproteins in the liver. In this metabolism the lipoprotein lipase has a determining role; its function is accelerated by ApoA5 and attenuated by ApoC3. The null mutations of the ApoC3 results in a reduced risk of myocardial infarction, the loss-of-function mutation of ApoA5 was associated with a 60% elevation of triglyceride level and 2.2-times increased risk of myocardial infarction. In case of diabetes mellitus, insulin resistance, obesity, metabolic syndrome and chronic kidney disease the non-HDL-cholesterol is a better marker of the risk than the LDL-cholesterol. Its value can be calculated by subtraction of HDL-cholesterol from total cholesterol. Target values of non-HDL-cholesterol can be obtained by adding 0.8 mmol/L to the LDL-cholesterol targets (this means 3.3 mmol/L in high, and 2.6 mmol/L in very high risk patients). The drugs of first choice in the treatment of diabetic dyslipidaemia are statins. Nevertheless, it is known that even if statin therapy is optimal (treated to target), a considerable residual (lipid) risk remains. For its reduction treatment of low HDL-cholesterol and high triglyceride levels is obvious by the administration of fibrates. In addition to statin therapy, fenofibrate can be recommended. Orv. Hetil., 2016, 157(19), 746–752.

scholarly journals Prevalence of Dyslipidaemia and Pre-Diabetes Among Women with Polycystic Ovary Syndrome (PCOS): Do We Overestimate Cardiovascular Risk?

2019 ◽  
Vol 51 (08) ◽  
pp. 539-545
Author(s):  
Krzysztof C. Lewandowski ◽  
Justyna Płusajska ◽  
Wojciech Horzelski ◽  
Andrzej Lewiński
Keyword(s):  
Cardiovascular Risk ◽  
Total Cholesterol ◽  
Glucose Intolerance ◽  
Ldl Cholesterol ◽  
Polycystic Ovary ◽  
Hdl Cholesterol ◽  
Convincing Evidence ◽  
Common Belief ◽  
Low Hdl ◽  
Prevalence Of Obesity

AbstractPCOS is widely accepted as associated with an increased cardiovascular risk, however, without convincing evidence of an increased cardiovascular mortality. We assessed prevalence of obesity, glucose intolerance, and dyslipidaemia in 490 women with PCOS, aged 24.75±8.05 years, diagnosed according to the Rotterdam consensus criteria. Fifty-two percent of women had BMI<26 kg/m2, 81.8% had total cholesterol<200 mg/dl, 82.8% had LDL cholesterol<130 mg/dl (48.3%<100 mg/dl), 81.4% had triglycerides<150 mg/dl, 96.08% had fasting glucose<100 mg/dl, 90.3% had glucose<140 mg/dl at 120′ of OGTT. The most frequent abnormality was low HDL cholesterol, as only 33.9% had LDL>60 mg/dl. Combination of several risk factors related to dyslipidaemia was, however, relatively rare, for example, a combination of raised total cholesterol and LDL cholesterol was present only in 2.9% of subjects. An increase in BMI, total cholesterol, LDL-cholesterol, and glucose concentrations at 120′ of OGTT was more pronounced in women, who had raised concentrations of at least two androgens (n=172, 35.1%), yet there was no increase in insulin resistance parameters, that is, HOMA-IR, QUICKI, McAuley, or Belfiore index. Contrary to common belief, over 50% of women with PCOS have normal body weight, and with exception of lower HDL cholesterol, most have no significant dyslipidaemia or glucose intolerance. Women with normal or borderline abnormal androgens, who form the majority of PCOS subjects, seem to have more healthy metabolic profile. This might be one of the reasons for the absence of evidence of an increased CV mortality in women with PCOS.

scholarly journals HDL Measures, Particle Heterogeneity, Proposed Nomenclature, and Relation to Atherosclerotic Cardiovascular Events

2011 ◽  
Vol 57 (3) ◽  
pp. 392-410 ◽  
Author(s):  
Robert S Rosenson ◽  
H Bryan Brewer ◽  
M John Chapman ◽  
Sergio Fazio ◽  
M Mahmood Hussain ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Animal Studies ◽  
Hdl Cholesterol ◽  
Epidemiological Data ◽  
Clinical Effects ◽  
Particle Structure ◽  
Residual Cardiovascular Risk ◽  
Hdl Subfractions ◽  
Macrophage Cholesterol Efflux ◽  
Low Hdl

BACKGROUND A growing body of evidence from epidemiological data, animal studies, and clinical trials supports HDL as the next target to reduce residual cardiovascular risk in statin-treated, high-risk patients. For more than 3 decades, HDL cholesterol has been employed as the principal clinical measure of HDL and cardiovascular risk associated with low HDL-cholesterol concentrations. The physicochemical and functional heterogeneity of HDL present important challenges to investigators in the cardiovascular field who are seeking to identify more effective laboratory and clinical methods to develop a measurement method to quantify HDL that has predictive value in assessing cardiovascular risk. CONTENT In this report, we critically evaluate the diverse physical and chemical methods that have been employed to characterize plasma HDL. To facilitate future characterization of HDL subfractions, we propose the development of a new nomenclature based on physical properties for the subfractions of HDL that includes very large HDL particles (VL-HDL), large HDL particles (L-HDL), medium HDL particles (M-HDL), small HDL particles (S-HDL), and very-small HDL particles (VS-HDL). This nomenclature also includes an entry for the pre-β-1 HDL subclass that participates in macrophage cholesterol efflux. SUMMARY We anticipate that adoption of a uniform nomenclature system for HDL subfractions that integrates terminology from several methods will enhance our ability not only to compare findings with different approaches for HDL fractionation, but also to assess the clinical effects of different agents that modulate HDL particle structure, metabolism, and function, and in turn, cardiovascular risk prediction within these HDL subfractions.

Abstract P347: Serum 25-hydroxy Vitamin D, Cardiovascular Risk Markers, And Incident Myocardial Infarction In A High Risk Community Population

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jaeun Yang ◽  
Christopher Naugler ◽  
Lawrence de Koning
Keyword(s):  
Myocardial Infarction ◽  
Vitamin D ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Ldl Cholesterol ◽  
Fasting Glucose ◽  
Hdl Cholesterol ◽  
Risk Markers ◽  
25 Oh Vitamin D

Background: It is unclear whether vitamin D deficiency is associated with a higher risk of cardiovascular disease, and through what biochemical pathways this could occur. We investigated the relationship between serum 25-OH vitamin D and typical cardiovascular risk markers as well as incident myocardial infarction (MI) in a large group of high-risk individuals from the community of Calgary, Alberta, Canada. Methods: Calgary Laboratory Services databases were queried for age, sex, body mass index (BMI), personal healthcare number (PHN) and first available serum 25-OH vitamin D measure from patients who received an electrocardiogram or urine creatinine clearance test from 2010-2013. Data was linked by PHN to first available laboratory results for total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, fasting glucose and HbA1c as well as Alberta Health Services hospital discharge data for first myocardial infarction (ICD-10: I21.1-9) occurring after 25-OH vitamin D measurement. Multiple linear and logistic regression were used to examine all associations. Results: There were 36 000-50 000 complete patient records for analysis of each of the risk markers, with a median follow-up of 8-11 months. A 30 mmol/L increase in serum 25-OH vitamin D was associated with significantly (p<0.001) lower total cholesterol (-0.07 mmol/L), LDL cholesterol (-0.06 mmol/L), triglycerides (-0.14 mmol/L), fasting glucose (-0.12 mmol/L), and HbA1c (-0.13% mmol/L), but higher HDL cholesterol (+0.06 mmol/L) after adjusting for age, sex, BMI, monthly hours of sun-exposure and time between measures. Among these individuals, there were 458 cases of MI occurring after 25-OH vitamin D measurement, with a median follow-up of 1 year. In a case-cohort analysis that included 2500 controls, a 30 mmol/L increase in 25-OH vitamin D was associated with a 21% (p<0.001) lower odds of MI after multivariate adjustment. This association was strongly attenuated after adjusting LDL, HDL, fasting glucose and HbA1c. Conclusion: In a high-risk group of community patients from Calgary, Alberta, Canada, higher serum 25-OH vitamin D was associated with a lower risk of MI, which was explained by changes in commonly measured cardiovascular risk markers. Further study is needed to determine whether changes in cardiovascular risk markers are causally related to changes in 25-OH vitamin D.

scholarly journals Changes in socio-economic status and lipoproteins in Chilean adolescents: a 16-year longitudinal study

2018 ◽  
Vol 22 (2) ◽  
pp. 344-353
Author(s):  
Zachary J Madewell ◽  
Estela Blanco ◽  
Raquel Burrows ◽  
Betsy Lozoff ◽  
Sheila Gahagan
Keyword(s):  
Social Capital ◽  
Longitudinal Study ◽  
Linear Models ◽  
Ldl Cholesterol ◽  
Economic Status ◽  
Hdl Cholesterol ◽  
Varimax Rotation ◽  
Socio Economic Status ◽  
Low Hdl ◽  
Environmental Capital

AbstractObjectiveThe present longitudinal study assessed whether changes in socio-economic status (SES) from infancy to adolescence were associated with plasma lipoprotein concentrations in adolescence, of which low HDL-cholesterol (HDL-C) and high LDL-cholesterol (LDL-C), TAG and total cholesterol (TC) concentrations are associated with higher cardiovascular risk.DesignSES, assessed using the modified Graffar Index, was calculated at 1, 5, 10 and 16 years. Principal components factor analysis with varimax rotation extracted two orthogonal SES factors, termed ‘environmental capital’ and ‘social capital’. Generalized linear models were used to analyse associations between environmental and social capital at 1 and 16 years and outcomes (HDL-C, LDL-C, TAG, TC) at 16 years, as well as changes in environmental and social capital from 1–5, 5–10, 10–16 and 1–16 years, and outcomes at 16 years.SettingSantiago, Chile.ParticipantsWe evaluated 665 participants from the Santiago Longitudinal Study enrolled at infancy in Fe-deficiency anaemia studies and examined every 5 years to age 16 years.ResultsSocial capital in infancy was associated with higher HDL-C in adolescence. Environmental capital in adolescence was associated with higher LDL-C and TC during adolescence. Changing environmental capital from 1–16 years was associated with higher LDL-C. Changing environmental capital from 1–5 and 1–16 years was associated with higher TC.ConclusionsImprovements in environmental capital throughout childhood were associated with less healthy LDL-C and TC concentrations in adolescence. We found no evidence of associations between changing environmental capital and HDL-C or TAG, or changing social capital and HDL-C, LDL-C, TAG or TC.

scholarly journals GLYCEMIC AND LIPIDEIC STATUS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2014 ◽  
Vol 04 (01) ◽  
pp. 009-014
Author(s):  
A. Harish Rao
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Fasting Glucose ◽  
Hdl Cholesterol ◽  
Serum Levels ◽  
Glucose Levels ◽  
Low Hdl ◽  
One Year

Abstract: Objective: to know the glycemic and lipidaemic status in patients with acute myocardial infarction, and with the secondary objective to know the effect of age, gender, diabetes, smoking, hypertension on fasting glucose and lipid levels. Methods and materials: The 74 patients admitted for acute myocardial infarction during the study period of one year were analysed for fasting glucose values and serum levels of total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Results: The mean serum concentrations of total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol were 233.28±45.34, 139.22±41.71, 171.43±36.53 and 27.07±36.53 respectively. Mean levels of total cholesterol, HDL cholesterol, triglycerides and fasting glucose values were not affected by age, gender, BMI, hypertension and smoking. BMI >30kg/m2 was associated with increased levels of total cholesterol(p=0.013) and LDL cholesterol(p=0.014). Also increase LDL cholesterol was seen in male gender(p=0.04). The prevalence of hypercholesterolemia, hypertriglyceridemia and low HDL cholesterol was 82.4%,77% and 78% respectively. Diabetes had no effect on lipid profile. Conclusion: our study highlighted the prevalence of dyslipidemias associated with myocardial infarction but not significant impact of fasting glucose levels.

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