scholarly journals Non-HDL Cholesterol Versus LDL Cholesterol as a CVD Risk Factor in Diabetic Subjects

2014 ◽  
Vol 31 (4) ◽  
pp. 199-203
Author(s):  
M Saiedullah ◽  
S Begum ◽  
S Hayat ◽  
SM Kamahuddin ◽  
MR Rahman ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Upward Trend ◽  
Cvd Risk ◽  
Cross Sectional

Objective: Serum low density lipoprotein (LDL) cholesterol is considered as the primary target of lipid lowering therapy and non-high density lipoprotein (HDL) cholesterol is the recommended second target. Recent studies claimed that non-HDL cholesterol is a better predictor of cardiovascular diseases (CVD) than LDL cholesterol. In this study we aimed to compare non-HDL cholesterol and LDL cholesterol as a CVD risk factor in confirmed diabetic subjects. Materials and methods: In this cross-sectional observational study, 1042 confirmed diabetic subjects selected randomly were included. HbA1cResults: In the total subjects, 767 (74%) subjects had LDL cholesterol > 100 mg/dL and 822 (79%) subjects had non- HDL cholesterol > 130 mg/dL. HbA1c values were different (p<0.02) in five groups and showed upward trend (p<0.01). All the lipid parameters studied were significantly different in five groups (p<0.0001) and TC, TG and non-HDL cholesterol showed upward trend (p<0.0001), but HDL cholesterol and LDL cholesterol showed downward trend (p<0.0001). Odds ratio (OR) of likelihood of risk individuals regarding non-HDL cholesterol compared to LDL cholesterol were 0.50 (p<0.001), 1.32 (p>0.05), 2.96 (p<0.001), 6.49 (p<0.001) and 9.37 (p<0.001) for TG concentrations of up to 150 mg/dL, 151-200 mg/dL, 201-250 mg/dL, 251-300 mg/dL and 301-400 mg/dL respectively with relative risk of 0.60, 1.24, 2.43, 4.83, 5.10. Conclusion: LDL cholesterol is a better tool for the detection of high-risk individuals than non-HDL cholesterol at TG concentration up to 150 mg/dL, whereas non-HDL cholesterol is better than LDL cholesterol at TG concentration above 200 mg/dL as a CVD risk factor. DOI: http://dx.doi.org/10.3329/jbcps.v31i4.21004 J Bangladesh Coll Phys Surg 2013; 31: 199-203

Abstract 194: Discordance in Apolipoprotein B vs. non-HDL-C and the Cholesterol-Enriched Phenotype: Insights From the National Health and Nutrition Examination Survey (NHANES) 2011-2012

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Renato Quispe ◽  
Mariana Lazo ◽  
Allan Sniderman ◽  
Erin D Michos ◽  
Peter P Toth ◽  
...  
Keyword(s):  
Apolipoprotein B ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cross Sectional Survey ◽  
Cvd Risk ◽  
Prognostic Information ◽  
Cross Sectional ◽  
Nationally Representative

Background: Apolipoprotein B (apoB) levels in plasma are proportional to the number of all atherogenic, non-high-density lipoprotein (HDL) particles. Non-HDL-C concentration - the aggregate cholesterol carried by apoB-containing particles - is usually highly correlated with apoB levels. This study aimed to describe individuals with discordance between these lipid measures, especially apoB<non-HDL-C discordance, as there are few prior data on this cholesterol-enriched particle phenotype. Methods: We analyzed 2,804 participants of NHANES 2011-2012, a nationally representative US cross-sectional survey with direct apoB and standard lipid fasting measurements. We assigned population percentiles to non-HDL-C and apoB levels and created groups with 5-10 or >10 percentile units of discordantly low apoB (apoB<non-HDL-C: “cholesterol-enriched”) or high apoB (apoB>non-HDL-C: “cholesterol-depleted”). We compared lipids levels and other clinical characteristics across groups. Results: Discordance >5 percentile units was present in 50.9% of individuals. Compared with the cholesterol-depleted group, the cholesterol-enriched phenotype was characterized by a lower prevalence of obesity, diabetes, and hypertension. We found higher levels of low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and HDL-C in cholesterol-enriched compared with cholesterol-depleted groups, whereas triglycerides were similar across groups. Lipid levels were consistent after excluding individuals on lipid-lowering therapy. Conclusion: Despite having higher levels of non-HDL-C and LDL-C, the cholesterol-enriched phenotype had a more favorable cardiovascular risk factor profile compared with the cholesterol-depleted phenotype. Triglycerides were notably low and similar across groups. Evaluation for discordance at both ends of the spectrum may provide additional prognostic information on CVD risk, but further outcomes studies are needed.

Lipids

2015 ◽  
Author(s):  
Željko Reiner ◽  
Olov Wiklund ◽  
John Betteridge
Keyword(s):  
Familial Hypercholesterolaemia ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lifestyle Changes ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
First Line ◽  
Cvd Risk ◽  
Low Concentrations

Dyslipidaemia, particularly elevated low-density lipoprotein (LDL) cholesterol, is one of the most important risk factors for cardiovascular disease (CVD). Low concentrations of high-density lipoprotein (HDL) cholesterol are independently associated with high CVD risk, while moderately elevated triglycerides are considered to be a marker of increased CVD risk. The presence of dyslipidaemias secondary to other conditions must be excluded before beginning treatment. All patients with familial hypercholesterolaemia are at high risk and should be treated by lipid-lowering therapy. Lifestyle changes are the backbone of treatment for dyslipidaemia. Statins are recommended as the first-line drugs for hypercholesterolaemia while fibrates are used primarily to decrease elevated triglycerides. If the treatment targets cannot be reached by monotherapy with lipid-lowering drugs, combination treatment may be needed.

scholarly journals Lipid profiles in smoking and non-smoking male adolescents

2014 ◽  
Vol 54 (4) ◽  
pp. 232
Author(s):  
Sigit Prastyanto ◽  
Mei Neni Sitaresmi ◽  
Madarina Julia
Keyword(s):  
Total Cholesterol ◽  
Tobacco Smoking ◽  
Ldl Cholesterol ◽  
Smoking Status ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Profiles ◽  
Cross Sectional ◽  
Mean Differences

Background The prevalence of smoking in adolescentstends to increase. Smoking is associated with a higher risk ofdyslipidemia.Objective To compare the lipid profiles of tobacco-smoking andnon-tobacco-smoking male adolescents.Methods We performed a cross- sectional study in three vocationalhigh schools in Yogyakarta from January to April 2011. Dataon smoking status, duration of smoking and number cigarettesconsumed per day were collected by questionnaires. We randomlyselected 50 male smokers and 50 male non-smokers as the studysubjects.Results Mean differences between smokers and non-smokerswere 44.5 (95%CI 28. 7 to 60.1) mg/dL for triglyceride levels; 8.0(95% CI 1.0 to 14.9) mg/dL for low density lipoprotein (LDL)cholesterol; 11.8 (1.1 to 22.4) mg/dL for total cholesterol and -5.7mg/dL (95% CI -8.8 to -2.6) for high density lipoprotein (HDL)cholesterol. Mean differences (95% CI) between smokers whohad engaged in smoking for > 2 years and those who had smokedfor :S:2 years were -18.1 (95% CI -33 .9 to -2.3) mg/dL for totalcholesterol; -49.4 (95% CI -67.2 to -3 1.5) mg/dL for triglycerides.Mean differences between those who smoked > 5 cigarettes/dayand :s:5 cigarettes per day were -18 .4 (95% CI -32.8 to -4.1) mg/dL for total cholesterol and -29.1 (95% CI -53.6 to -4.6) mg/dLfor triglycerides.Conclusion Smoking more than 5 cigarettes/day significantlyincreases total cholesterol, LDL cholesterol, and triglyceridelevels, as well as reduces HDL cholesterol levels; while smokingmore than 2 years significantly increases total cholesterol andtriglyceride levels

Bezafibrate

1983 ◽  
Vol 21 (19) ◽  
pp. 75-76
Keyword(s):  
High Density Lipoprotein ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Significant Risk ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Low Density ◽  
Cholesterol Levels ◽  
The Uk

Bezafibrate (Bezalip - MCP), an analogue of clofibrate (Atromid-S), has been marketed in the UK for two years. Like clofibrate 1 it lowers both triglyceride and total cholesterol levels in plasma. The reduction is usually in low-density lipoprotein (LDL) cholesterol, whilst high-density lipoprotein (HDL) cholesterol rises. Like other lipid-lowering drugs, it should be used only where appropriate dietary measures have failed and where the hyperlipidaemia poses a significant risk.2

Abstract 3330: Effect of Achieved Low-density Lipoprotein Cholesterol Level by Atorvastatin on Stabilization of Coronary Plaques - Results from TWINS study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Katsuki Okada ◽  
Yasunori Ueda ◽  
Satoshi Saito ◽  
Atsushi Hirayama ◽  
Kazuhisa Kodama
Keyword(s):  
Cholesterol Level ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Plaque ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Yellow Plaque ◽  
The Mean

Background We have previously reported the stabilization and regression of coronary plaque by atorvastatin using both angioscopy and IVUS. However, it has not been clarified if plaque stabilization is achieved through the reduction of cholesterol level or the direct effect of statin. Then, we analyzed the effect of achieved low-density lipoprotein (LDL) cholesterol level on the stabilization of coronary plaque. Methods Twenty-nine patients with hypercholesterolemia and coronary heart disease were studied. They received lipid-lowering therapy with atorvastatin (10 –20 mg/day) for 80 weeks and were divided into 2 groups by the achieved LDL cholesterol level at 80-week follow up (low LDL group: LDL cholesterol < median value, and high LDL group: LDL cholesterol ≥ median value). Angioscopic examination was performed before and after 80 weeks treatment with atorvastatin. Angioscopic findings of coronary yellow plaque characteristics were divided into six grades (grade 0 to 5) to evaluate vulnerability of plaques; and the mean grade of each patient was evaluated. Results In all 29 patients, LDL cholesterol level was reduced (146.2 to 87.9 mg/dl; p<0.001) and the mean yellow plaque grade was decreased (1.4 to 1.2; p=0.002) at 80-week follow up. LDL cholesterol level was reduced both in low LDL group (140.3 to 75.9 mg/dl; p<0.001) and in high LDL group (151.7 to 99.1 mg/dl; p<0.001). Angioscopic examination showed significant improvement of the grade in low LDL group (1.4 to 1.1; p=0.012) at 80-week follow up, but no significant difference in high LDL group (1.4 to 1.3; p=0.11). Conclusions Lipid-lowering therapy with atorvastatin stabilized coronary plaques, and this effect was larger in the patients LDL cholesterol was reduced more.

Abstract P179: Uncontrolled Cholesterol Levels In Patients With Severe Hypercholesterolemia

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nicole Groth ◽  
Catherine P Benziger
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Heart Association ◽  
Cross Sectional Study ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cross Sectional ◽  
Lowering Therapy ◽  
Cholesterol Guidelines ◽  
European Society Of Cardiology

Introduction: The 2018 American Heart Association/American College of Cardiology cholesterol guidelines recommends patients who have phenotypic severe hypercholesterolemia (SH), defined as a low-density lipoprotein-cholesterol (LDL-c) > 190 mg/dL, be started on maximally tolerated statin therapy without further risk stratification due to high risk for cardiovascular disease (CVD). SH patients on guideline-directed medical therapy (GDMT) should have 50% reduction in their LDL-c levels, with optimal being < 100 mg/dL for primary prevention and <70 mg/dL for secondary prevention. The 2019 European Society of Cardiology/European Atherosclerosis Society cholesterol guidelines recommend an optimal LDL-c level < 55 mg/dL. Hypothesis: LDL-c levels vary by intensity of medication and are not at target in patients with SH in a large rural healthcare system. Methods: We used an electronic medical record-based SH registry defined by ever having an LDL-c > 190 mg/dL since 01/01/2000 (n=17,925) at Essentia Health (MN, WI, and ND). In this cross-sectional study, patients were excluded if they had: no recent visit within the past 5 years (n=209), <20 or >75 years (n=3,153), listed as being on a statin but intensity was unavailable (n=1,934), or had no recent lab (n=998). Methods: We included 12,283 patients (68.5%)(mean age 59.4 + 10.1 years; 59.5% female) with SH and of these only 22.9% were on a high-intensity statin or proprotein convertase subtilisin/kexin type 9 inhibitor. Of the patients that were not on any lipid-lowering therapy (n=4,971; 40.5%), only 16.8% (n=837) had a statin allergy or intolerance documented. Figure 1 shows the most recent LDL-c levels; <10% of patients in each group had a most-recent LDL-c <70 mg/dL, and 9.4% had an LDL-c <55mg/dL. Conclusions: Most SH patients remain untreated or undertreated with GDMT with recent LDL-c levels above target. More aggressive lipid-lowering therapy in patients with SH is needed to reduce risk of CVD.

Diabetic dyslipidaemia

2002 ◽  
Vol 2 (1_suppl) ◽  
pp. S12-S17 ◽  
Author(s):  
François Berthezène
Keyword(s):  
Insulin Resistance ◽  
Treatment Approach ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Risk Factor Modification ◽  
Leading Role ◽  
The Relationship

Dyslipidaemia is likely to play a leading role in the cardiovascular risk associated with diabetes. Diabetic dyslipidaemia is characterised by hypertriglyceridaemia, a shift from large low-density lipoprotein (LDL) to smaller denser particles, and reduced high-density lipoprotein (HDL) cholesterol. Dyslipidaemia is closely associated with insulin resistance. Patients with diabetic dyslipidaemia should receive lipid lowering therapy with statins or fibrates, as appropriate. Due to the relationship between dyslipidaemia and insulin resistance, treatment of insulin resistance should be included in multifactorial risk factor modification. Thiazolidinediones such as pioglitazone may provide a useful treatment approach.

Retrospective Evaluation of the Lipid-Lowering Effects of Atorvastatin

2000 ◽  
Vol 16 (3) ◽  
pp. 89-91
Author(s):  
Lucinda M Buys ◽  
Kurt A Rosenkrans
Keyword(s):  
Family Medicine ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Case Series ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Close Monitoring ◽  
Retrospective Case

Objective: To evaluate the lipid-lowering effects, particularly changes in high-density lipoprotein (HDL) cholesterol, associated with atorvastatin use in a typical outpatient family medicine practice. Design: Retrospective case series. Setting: A community-based family medicine residency program. Patients: One hundred twenty-three patients with hyperlipidemia. Interventions: Treatment with atorvastatin to meet National Cholesterol Education Program (Adult Treatment Program) II goals. Main Outcome Measures: Fasting lipid profiles, including total cholesterol, low-density lipoprotein (LDL) cholesterol, HDL cholesterol, and triglycerides. Results: Atorvastatin lowered total cholesterol, LDL cholesterol, and triglycerides. HDL cholesterol was essentially unchanged from baseline to follow-up. In a subset of patients (∼50%), HDL cholesterol decreased by 13.1%. In the remainder of patients, HDL cholesterol increased by 10.7%. The decrease of HDL cholesterol was as much as 24 mg/dL. Conclusions: Atorvastatin is an effective agent for lowering total cholesterol, LDL cholesterol, and triglycerides. In a subset of patients, atorvastatin appeared to lower HDL cholesterol. Close monitoring of HDL cholesterol concentrations while patients are receiving atorvastatin is important.

RELATIONSHIP BETWEEN THE ENVIRONMENTAL ENDOCRINE DISRUPTOR BISPHENOL A AND DYSLIPIDEMIA: A FIVE-YEAR PROSPECTIVE STUDY

2020 ◽  
Vol 26 (4) ◽  
pp. 399-406
Author(s):  
Ruolin Li ◽  
Shumin Yang ◽  
Rufei Gao ◽  
Yin Deng ◽  
Jiahuan Liu ◽  
...  
Keyword(s):  
Bisphenol A ◽  
Odds Ratio ◽  
Regression Models ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Low Density ◽  
Cross Sectional ◽  
Low Hdl

Objective: To investigate whether serum bisphenol A (BPA) concentration is related to the occurrence of dyslipidemia. Methods: A total of 574 adults were enrolled at baseline and followed up for 5 years. Concentrations of serum BPA, triglycerides (TGs), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol were measured. Dyslipidemia was defined as the existence of one or more of the following conditions: high-LDL-cholesterolemia (LDL ≥140 mg/dL), hypertriglyceridemia (TGs ≥150 mg/dL), or low-HDL-cholesterolemia (HDL <40 mg/dL). Participants were stratified into tertiles according to low, median, and high baseline serum BPA levels. Multivariable linear and logistic regression models were used. Data from baseline and follow-up were used for cross-sectional and longitudinal analyses, respectively. Results: In the cross-sectional analysis, compared to subjects in the low BPA tertile, those in the high BPA tertile showed a higher level of LDL cholesterol (108.1 ± 24.4 mg/dL versus 119.5 ± 26.9 mg/dL; P<.05) and a lower level of HDL cholesterol (46.2 ± 11.7 mg/dL versus 39.5 ± 7.5 mg/dL; P<.05). In multivariable linear regression models, Z-transformed BPA was positively associated with LDL cholesterol (β= 0.13, P = .002) and negatively associated with HDL cholesterol (β= −0.28; P<.001). After cross-sectionally adjusting for confounders, subjects in higher BPA exposure was associated with a higher prevalence of low-HDL-cholesterolemia. Longitudinally, in subjects without low-HDL-cholesterolemia at baseline, each SD increment in baseline BPA was associated with a higher incidence of low-HDL-cholesterolemia after adjustment for confounders (odds ratio [95% confidence interval; CI] 2.76, 95% CI 1.21, 6.29). Conclusion: Cross-sectionally, higher BPA exposure is associated with a higher prevalence of low-HDL-cholesterolemia. Longitudinally, baseline BPA is an independent predictor of the 5-year incidence of low-HDL-cholesterolemia. Abbreviations: BMI = body mass index; BPA = bisphenol A; CI = confidence interval; CVD = cardiovascular disease; EIMDS = environment, inflammation and metabolic diseases study; HDL = high density lipoprotein; LDL = low density lipoprotein; OR = odds ratio; PPAR = peroxisome proliferator-activated receptor; SBP = systolic blood pressure; TG = triglyceride; Z-BPA = Z-transformed bisphenol A

scholarly journals Inclisirán as an alternative treatment for Hypercholesterolemia

2021 ◽  
Vol 12 (3) ◽  
pp. 517-521
Author(s):  
Jorge Andrés Ojeda Villota ◽  
Javier Alfredo Pérez Martínez ◽  
Luis Alberto Burgos de Moya ◽  
Rodrigo Alfonso Chavez Vega ◽  
Roxana Rivera Valencia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density ◽  
Pcsk9 Inhibitors ◽  
Cholesterol Levels ◽  
Lowering Therapy

Hypercholesterolemia (CH) is defined as the elevation of serum cholesterol levels, especially low-density lipoprotein (LDL) cholesterol, which is considered to be one of the most relevant risk factors for triggering cardiovascular disease, for This is vitally important to start treatment, there are several highly useful pharmacological groups for lipid-lowering therapy, among them we highlight the PCSK9 inhibitors, among the molecules that are part of this group we find inclisirán, this being a structure that promises a lot in regarding the management of hypercholesterolemia.

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