scholarly journals Optimal cut-off points after a daily meal corresponding to fasting goal levels of LDL-C and non-HDL-C in Chinese patients with coronary heart disease

2020 ◽  
Author(s):  
Li-Ling Guo ◽  
Yan-qiao Chen ◽  
Qiu-zhen Lin ◽  
Feng Tian ◽  
Qun-Yan Xiang ◽  
...  

Abstract Background: Although the detection of non-fasting blood lipids has been recommended in patients with coronary heart disease (CHD), the non-fasting cut-off points corresponding to the fasting goals of LDL-C < 1.8 mmol/Land non-HDL-C < 2.6 mmol/L, respectively, have not been explored. Methods: This study enrolled 397 inpatients with CHD. One hundred and ninety-seven patients took statins for < 1 month (m) or did not take any statin before admission (i.e. CHD1 group), while 204 patients took statins for ≥ 1 m before admission (i.e. CHD2 group). Blood lipid levels were measured at 0 h, 2 h, and 4 h after a daily breakfast. Results: Non-fasting low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels significantly decreased after a daily meal ( P < 0.05). Both fasting and non-fasting LDL-C or non-HDL-C levels were significantly lower in the CHD2 group. The percent attainment of LDL-C < 1.8 mmol/L at 2 h or 4 h after a daily breakfast was significantly higher than that of its fasting point ( P < 0.05), whereas that of non-HDL-C < 2.6 mmol/L was significantly higher only at 4 h ( P < 0.05). Analysis of c-statistic showed that non-fasting cut-off points for LDL-C and non-HDL-C were 1.5 mmol/L and 2.4 mmol/L, corresponding to their fasting goal levels of 1.8 mmol/L and 2.6 mmol/L, respectively. When postprandial LDL-C and non-HDL-C goal attainments were re-evaluated by non-fasting cut-off points, there were no significant differences in percent attainment between fasting and non-fasting states. Conclusions: Determination ofnon-fasting cut-off points is important to evaluate the efficacy of cholesterol-lowering therapy if blood lipids are detected after a daily meal.

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiuzhen Lin ◽  
Yan Fu ◽  
XueYan Zang ◽  
Qiming Liu ◽  
Ling Liu

The level of low-density lipoprotein cholesterol (LDL-C) decreases to a certain extent after daily meals; however, the influencing factor of this phenomenon has not been fully elucidated. This study included 447 patients with coronary heart disease (CHD). Serum levels of blood lipid parameters at 0, 2, and 4 hours (h) after a daily breakfast were monitored in all subjects. The levels of total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C) and non-HDL-C significantly decreased, while those of triglycerides (TG) and remnant cholesterol (RC) significantly increased from baseline to 4 h in both male and female patients (P &lt; 0.05). Multiple linear regression analysis showed that fasting LDL-C level, the non-fasting change in RC level at 4 h and fasting TG level were significant predictors of the non-fasting change in LDL-C level at 4 h in patients with CHD, and fasting LDL-C level was the most significantly associated with the non-fasting change in LDL-C level. Patients with lower levels of fasting LDL-C had smaller non-fasting changes in LDL-C levels. When the fasting LDL-C level was &lt;1.4 mmol/L, both absolute reduction and percent reduction in LDL-C level at 4 h were almost zero, which means that the non-fasting LDL-C level at 4 h was approximately equivalent to its fasting value (P &lt; 0.05). This result indicated that the non-fasting changes in LDL-C levels were influenced by fasting LDL-C levels in patients with CHD. When the fasting LDL-C level was &lt;1.4 mmol/L, the non-fasting LDL-C level could replace the fasting value to guide treatment.


2021 ◽  
Vol 8 ◽  
Author(s):  
Li-Ling Guo ◽  
Yan-qiao Chen ◽  
Qiu-zhen Lin ◽  
Feng Tian ◽  
Qun-Yan Xiang ◽  
...  

This study aimed to compare the percentage attainment of fasting and non-fasting LDL-C and non-HDL-C target levels in coronary heart disease (CHD) patients receiving short-term statin therapy. This study enrolled 397 inpatients with CHD. Of these, 197 patients took statins for &lt;1 month (m) or did not take any statin before admission (CHD1 group), while 204 patients took statins for ≥1 m before admission (CHD2 group). Blood lipid levels were measured at 0, 2, and 4 h after a daily breakfast. Non-fasting LDL-C and non-HDL-C levels significantly decreased after a daily meal (P &lt; 0.05). Both fasting and non-fasting LDL-C or non-HDL-C levels were significantly lower in the CHD2 group. The percentage attainment of LDL-C &lt;1.4 mmol/L at 2 and 4 h after a daily breakfast was significantly higher than that during fasting (P &lt; 0.05), but the percent attainment of non-fasting non-HDL-C &lt;2.2 mmol/L was close to its fasting value (P &gt; 0.05). Analysis of c-statistic showed that non-fasting cut-off points for LDL-C and non-HDL-C were 1.19 and 2.11 mmol/L, corresponding to their fasting goal levels of 1.4 and 2.2 mmol/L, respectively. When post-prandial LDL-C and non-HDL-C goal attainments were re-evaluated using non-fasting cut-off points, there were no significant differences in percentage attainment between fasting and non-fasting states. Non-HDL-C is more stable than LDL-C in assessing the percent attainment of non-fasting lipid for coronary heart disease patients. If we want to use LDL-C to assess the percent attainment of post-prandial blood lipids, we may need to determine a lower non-fasting cut-off point.


2020 ◽  
Author(s):  
Li-ling Guo ◽  
Yan-qiao Chen ◽  
Qiu-zhen Lin ◽  
Feng Tian ◽  
Li-yuan Zhu ◽  
...  

Abstract Background: This study aimed to compare the percentage attainment of fasting and non-fasting LDL-C and non-HDL-C target levels in coronary heart disease (CHD) patients receiving short-term statin therapy.Methods: This study enrolled 397 inpatients with CHD. Of these, 197 patients took statins for < 1 month (m) or did not take any statin before admission (CHD1 group), while 204 patients took statins for ≥ 1 m before admission (CHD2 group). Blood lipid levels were measured at 0 h, 2 h, and 4 h after a daily breakfast.Results: Non-fasting LDL-C and non-HDL-C levels significantly decreased after a daily meal (P < 0.05). Both fasting and non-fasting LDL-C or non-HDL-C levels were significantly lower in the CHD2 group. The percentage attainment of LDL-C < 1.4 mmol/L at 2 h and 4 h after a daily breakfast was significantly higher than that during fasting (P < 0.05), but the percent attainment of non-fasting non-HDL-C < 2.2 mmol/L was close to its fasting value (P > 0.05). Analysis of c-statistic showed that non-fasting cut-off points for LDL-C and non-HDL-C were 1.19 mmol/L and 2.11 mmol/L, corresponding to their fasting goal levels of 1.4 mmol/L and 2.2 mmol/L, respectively. When postprandial LDL-C and non-HDL-C goal attainments were re-evaluated using non-fasting cut-off points, there were no significant differences in percentage attainment between fasting and non-fasting states.Conclusions: Non-HDL-C is more stable than LDL-C in assessing the percent attainment of non-fasting lipid for coronary heart disease patients. If we want to use LDL-C to assess the percent attainment of postprandial blood lipids, we may need to determine a lower non-fasting cut-off point.


2020 ◽  
Vol 27 (15) ◽  
pp. 1617-1626 ◽  
Author(s):  
Roshni Joshi ◽  
S Goya Wannamethee ◽  
Jorgen Engmann ◽  
Tom Gaunt ◽  
Deborah A Lawlor ◽  
...  

Aims Elevated low-density lipoprotein cholesterol (LDL-C) is a risk factor for cardiovascular disease; however, there is uncertainty about the role of total triglycerides and the individual triglyceride-containing lipoprotein sub-fractions. We measured 14 triglyceride-containing lipoprotein sub-fractions using nuclear magnetic resonance and examined associations with coronary heart disease and stroke. Methods Triglyceride-containing sub-fraction measures were available in 11,560 participants from the three UK cohorts free of coronary heart disease and stroke at baseline. Multivariable logistic regression was used to estimate the association of each sub-fraction with coronary heart disease and stroke expressed as the odds ratio per standard deviation increment in the corresponding measure. Results The 14 triglyceride-containing sub-fractions were positively correlated with one another and with total triglycerides, and inversely correlated with high-density lipoprotein cholesterol (HDL-C). Thirteen sub-fractions were positively associated with coronary heart disease (odds ratio in the range 1.12 to 1.22), with the effect estimates for coronary heart disease being comparable in subgroup analysis of participants with and without type 2 diabetes, and were attenuated after adjustment for HDL-C and LDL-C. There was no evidence for a clear association of any triglyceride lipoprotein sub-fraction with stroke. Conclusions Triglyceride sub-fractions are associated with increased risk of coronary heart disease but not stroke, with attenuation of effects on adjustment for HDL-C and LDL-C.


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