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1
Ahmad, Haniah, Shagufta Yousaf, Mubushra Samina, Rehan Asghar Naqvi, Aisha Khan, and Saba Rizwan. "Non-high-density lipoprotein cholesterol: A marker of cardiovascular disease in Type-2 diabetes mellitus." Pakistan Journal of Pathology 36, no. 1 (2025): 1–6. https://doi.org/10.55629/pakjpathol.v36i1.843.
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Objective: To determine association between serum Non-High-Density Lipoprotein cholesterol and cardiovascular disease in Type 2 Diabetes Mellitus patients. Material and Methods: This cross sectional, comparative study was carried out in collaboration with Medical Out Patient Department (OPD) & Pathology Department, Combined Military Hospital Malir Cantt, Karachi from August 2021 to January 2022. The study included 175 Type 2 Diabetic patients (Type 2 DM) with known cardiovascular disease (CVD) or risk of CVD. After verbal informed consent, their medical history and basic anthropometric measurements including BMI & blood pressure were recorded using a pre-designed proforma. Samples were analyzed for glucose, HbA1c & lipid profile. Non-HDL-c was calculated using a formula that subtracted HDL-c from total cholesterol. “Non-HDL-c = Total cholesterol – HDL-c”. Results: - The average age of the total 175 patients was 45.54±10.32 years. Frequency of CVD in Type 2 DM was observed in 49.14% (86/175) patients. There was significantly high association of serum Non-HDL-c levels and CVD in Type 2 DM patients. High Non-HDL-c is present in 96.5% of CVD positive cases and 85.4% of CVD negative cases. Conclusion: Non-HDL cholesterol showed a significant association with CVD in Type 2 DM as compared to CVD negative cases. Non-HDL cholesterol should be considered superior to LDL-c as a marker of screening, treatment monitoring and risk assessment of CVD in Type 2 DM. Keywords: Cholesterol, HDL, Diabetes mellitus, Non-HDL-cholesterol, Cardiovascular disease
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Kolovou, Genovefa, Marianna Stamatelatou, Katherine Anagnostopoulou, et al. "Cholesteryl Ester Transfer Protein Gene Polymorphisms and Longevity Syndrome." Open Cardiovascular Medicine Journal 4, no. 1 (2010): 14–19. http://dx.doi.org/10.2174/1874192401004010014.
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Purpose:High levels of high density lipoprotein (HDL) cholesterol are associated with a decreased risk of coronary heart disease (CHD). Subjects with high levels of HDL cholesterol (>70 mg/dl; 1.79 mmol/l) as well as high levels of low density lipoprotein (LDL) cholesterol, could represent a group with longevity syndrome (LS). Since HDL particles are influenced by cholesteryl ester transfer protein (CETP) activity, it is worth studying the CETP polymorphism. The aim of the study was to detect whether 2 genetic variants of the CETP are associated with the LS.Subjects and Methods:The study population consisted of 136 unrelated men and women with no personal and family history of CHD; 69 met the criteria for LS and 67 did not meet these criteria and had “normal” HDL cholesterol (>40 and <70 mg/dl; >1.03 and <1.79 mmol/l). All patients were genotyped for the TaqIB and I405V polymorphisms.Results:The B2 allele frequency of TaqIB polymorphism was higher in the LS in comparison with the non-LS group (p=0.03) whereas B1 allele frequency was higher in the non-LS group (p=0.03).Conclusions:Gene polymorphisms could help decide whether individuals who have increased levels of both LDL cholesterol and HDL cholesterol require treatment. Some of the prerequisites could include that subjects with LS should not only have very high levels of HDL cholesterol but also favorable gene polymorphisms. However, further investigations with a larger sample and including other gene polymorphisms, are needed.
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Godfrey, Esther, and Julian PJ Halcox. "How Do We Approach Low High-density Lipoprotein Cholesterol in 2011?" European Cardiology Review 7, no. 4 (2011): 257. http://dx.doi.org/10.15420/ecr.2011.7.4.257.
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The prevalence of obesity and of the metabolic syndrome is increasing worldwide, and the management of global cardiovascular disease (CVD) risk requires strategies for the treatment of complex, pro-atherogenic dyslipidaemia. Considerable evidence provides a scientific rationale for the role of high-density lipoprotein (HDL) in atheroprotection. Although HDL function can become altered in pathological states, the quantitative evaluation of HDL cholesterol (HDL-C) in addition to total cholesterol (TC) levels improves the accuracy of CVD risk prediction, and is therefore a component of most global CVD risk assessment models. Non-pharmacological lifestyle interventions, such as diet and exercise for weight loss and smoking cessation, are the mainstay of raising HDL in clinical practice. Several HDL-raising medications are available but, beyond statin therapy, evidence of an incremental clinical benefit is limited. Potent novel HDL therapeutics are emerging that not only increase HDL-C levels but may also improve HDL function. Early data have restored some confidence in the potential of new cholesteryl ester transfer protein (CETP) antagonists in clinical practice. It is essential that clinical trials address vascular burden and patient outcomes, and data from large outcome trials are eagerly awaited.
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Daminelli, Elaine Nunes, Celso Spada, Arício Treitinger, Tatiane Vanessa Oliveira, Maria da Conceição Latrilha, and Raul Cavalcante Maranhão. "Alterations in lipid transfer to High-Density Lipoprotein (HDL) and activity of paraoxonase-1 in HIV+ patients." Revista do Instituto de Medicina Tropical de São Paulo 50, no. 4 (2008): 223–27. http://dx.doi.org/10.1590/s0036-46652008000400007.
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HIV+ patients often develop alterations of the plasma lipids that may implicate in development of premature coronary artery disease. High-density lipoprotein (HDL) has an important role in preventing atherogenesis and the aim of this study was to investigate aspects of HDL function in HIV+ patients. HIV+ patients (n = 48) and healthy control subjects (n = 45) of both sexes with similar age were studied. Twenty-five were not being treated with antiretroviral agents, 13 were under reverse transcriptase inhibitor nucleosidic and non-nucleosidic (NRTI+NNRTI) and 10 were under NRTI + protease inhibitors (NRTI+PI) treatment. Paraoxonase 1 (PON1) activity and the transfer of free and esterified cholesterol, tryglicerides and phospholipids from a lipidic nanoemulsion to HDL were analyzed. In comparison with healthy controls, HIV+ patients presented low PON-1 activity and diminished transfer of free cholesterol and tryglicerides. In contrast, phospholipid transfer was increased in those patients, whereas the transfer of cholesteryl esters was unchanged. NRTI+NNRTI increases the transfer of cholesteryl esters and triglycerides but in NRTI+PI there was no difference in respect to non-treated HIV+ patients. HDL from HIV+ patients has smaller antioxidant properties, as shown by lower PON-1 activity, and the transfer of lipids to this lipoprotein fraction is also altered, suggesting that HDL function is defective in those patients.
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Zhang, Yue, Yanrong Suo, Lin Yang, et al. "Effect of PCSK9 Inhibitor on Blood Lipid Levels in Patients with High and Very-High CVD Risk: A Systematic Review and Meta-Analysis." Cardiology Research and Practice 2022 (April 26, 2022): 1–13. http://dx.doi.org/10.1155/2022/8729003.
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Objectives. We aimed to investigate the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor on blood lipid levels in patients with high and very-high cardiovascular risk. Design. 14 trials (n = 52,586 patients) comparing treatment with or without PCSK9 inhibitors were retrieved from PubMed and Embase updated to 1st Jun 2021. The data quality of included studies was assessed by two independent researchers using the Cochrane systematic review method. All-cause mortality, cardiovascular mortality, and changes in serum low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), lipoprotein (a) (LP (a)), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein A1 (ApoA1) from baseline were analyzed using Rev Man 5.1.0 software. Results. Compared with treatments without PCSK9 inhibitor, addition of PCSK9 inhibitors (evolocumab and alirocumab) had obvious decreasing effects on the levels of LDL-C [MD = −46.86, 95% CI (−54.99 to −38.72), P < 0.00001 ], TC [MD = −31.92, 95% CI (−39.47 to −24.38), P < 0.00001 ], TG [MD = −8.13, 95% CI (−10.48 to −5.79), P < 0.00001 ], LP(a) [MD = −26.69, 95% CI (-27.93 to −25.44), P < 0.00001 ], non-HDL-C [MD = −42.86, 95% CI (−45.81 to −39.92), P < 0.00001 ], and ApoB [MD = −38.44, 95% CI (−42.23 to -34.65), P < 0.00001 ] in high CVD risk patients. Conversely, changes of HDL-C [MD = 6.27, CI (5.17 to 7.36), P < 0.00001 ] and ApoA1 [MD = 4.33, 95% CI (3.53 to 5.13), P < 0.00001 ] from baseline were significantly more in high cardiovascular disease risk patients who received PCSK9 inhibitors treatment. Conclusion. Addition of PCSK9 inhibitors to standard therapy resulted in definite improvement in blood lipid levels compared with therapies that did not include them.
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Sargowo, Djanggan, and Olivia Handayani. "The Association between Cardiovascular Risk and Elevated Triglycerides." Indonesian Biomedical Journal 9, no. 1 (2017): 17. http://dx.doi.org/10.18585/inabj.v9i1.266.
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BACKGROUND: The association between elevated triglycerides and cardiovascular risk has been extensively studied. The elevated level of triglycerides occurs through abnormalities in hepatic very low-density lipoprotein (VLDL) production and intestinal chylomicron synthesis, dysfunctional lipoprotein lipase (LPL)-mediated lipolysis or impaired remnant clearance.CONTENT: Hypertriglyceridemia (HTG) commonly leads to a reduction in high-density lipoprotein (HDL) and increase in atherogenic small dense low-density lipoprotein (LDL) cholesterol, called the atherogenic dyslipidemia (AD). Triglycerides may also stimulate atherogenesis by mechanisms, such excessive release of free fatty acids, and production of pro-inflammatory cytokines, fibrinogen, coagulation factors and impairment of fibrinolysis. Genetic studies strongly support hypertriglyceridemia (HTG) and high concentration of triglyceride-rich lipoprotein (TRL) as causal risk factors for cardiovascular disease. Therefore, lipid management is crucial in reducing cardiovascular risk. Combination of lipid lowering drug therapy may be needed to achieve both LDL and non-HDL cholesterols treatment goal for cardiovascular disease prevention in patients with elevated triglyceride levels, particularly those with triglyceride ≥500 mg/dL.SUMMARY: LDL and non-HDL cholesterol can be a promising target therapy in HTG. Additional clinical outcomes data are needed to provide a more evidence-based rationale for clinical lipid management of hypertriglyceridemic patients.KEYWORDS: hypertriglyceridemia, non-HDL cholesterol, dyslipidemia, CV risk
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Pathak, Urgra Narayan, and D. L. Gurubacharya. "NON-PHARMACOLOGICAL THERAPY OF HYPERLIPIDAEMIA." Journal of Nepal Medical Association 41, no. 142 (2003): 356–60. http://dx.doi.org/10.31729/jnma.770.
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Hyperlipidaemia is one of the major contributors to atherosclerosis and CoronaryHeart Disease (CHD) in our society. Numerous clinical and epidemiological studieshave shown repeatedly that an elevated blood cholesterol level is one of the majormodifiable risk factors associated with the development of CHD. In particular, thesestudies have demonstrated that low- density lipoprotein (LDL) cholesterol is theprimary lipoprotein mediating atherosclerosis. Non-pharmacological therapy especiallydietary therapy and exercise remains the first line of treatment in hyperlipidaemia,with pharmacotherapy reserved for use in patients at high risk of coronary heartdisease or patients who do not respond to non-pharmacological therapyKey Words: Hyperlipidaemia, LDL Cholesterol, HDL Cholesterol, coronary HeartDisease (CHD), Atherosclerosis, National Cholesterol Education Program (NCEP)
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El-Hendy, Yasser Abdel-Monem, Mabrouk Ibrahim Ismail, Maher Mohamed Borai, and Walid Ahmed Ragab Abdelhamid. "Relationship between High-density Lipoprotein Cholesterol and Insulin Resistance in Non-diabetic Chronic Kidney Disease Patients." Saudi Journal of Kidney Diseases and Transplantation 34, no. 4 (2023): 323–30. http://dx.doi.org/10.4103/1319-2442.395448.
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Insulin resistance is linked to cardiovascular disease (CVD), even in non-diabetic patients. Therefore, insulin resistance contributes to the development of CVDs, which are the most important cause of morbidity and mortality in chronic kidney disease (CKD) and patients receiving dialysis replacement therapy. Furthermore, CKD greatly affects the enzyme activities responsible for the metabolism of high-density lipoprotein (HDL), causing an abnormal composition and function of HDL, which results in the loss of the anti-inflammatory effect of HDL and its protective effect against CVD. The study aimed to find the relationship between HDL-C, inflammation, and insulin resistance in nondiabetic CKD patients undergoing different modalities of treatment. This prospective cross-sectional comparative study included 80 subjects divided into the control group (20 healthy participants), Group 1 (15 predialysis CKD patients on conservative treatment), Group 2 (10 peritoneal dialysis patients), and Group 3 (35 hemodialysis patients). A full history, medical examination, and a laboratory investigation were carried out on all subjects from June 2018 to June 2019. The patient groups had significantly lower HDL and higher serum insulin than the control group. HDL was negatively correlated with the Homeostatic Model Assessment of Insulin Resistance. There was a strong negative association between HDL and insulin resistance in CKD patients. Therefore, lifestyle modifications and dyslipidemia treatment in CKD might help to prevent cardiovascular events even in nondiabetic nonobese CKD patients.
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Zambon, Alberto. "Non- high-density lipoprotein cholesterol and cardiovascular disease in patients with diabetic dyslipidaemia." Diabetes mellitus 23, no. 1 (2020): 65–71. http://dx.doi.org/10.14341/dm10351.
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Elevated levels of blood lipids are one of the major risk factors for cardiovascular (CV) disease in patients with type 2 diabetes mellitus. Diabetic dyslipidaemia is characterised by the presence of potentially atherogenic lipids, including high levels of plasma triglycerides (TGs), mild-to-moderately elevated levels of low-density lipoprotein cholesterol (LDL-C), and low levels of high-density lipoprotein cholesterol (HDL-C). Statin therapy to reduce LDL-C levels is the mainstay of treatment practice to reduce CV risk. However, despite achieving targets for LDL-C, patients with diabetic dyslipidaemia remain at a high risk of residual CV events. Hence there is a need to target other components (i.e. elevated TGs) of the atherogenic dyslipidaemia that are not affected by treatment with statins. This review highlights the clinical benefits of using non-HDL-C, a single marker that includes all atherogenic lipoproteins, as a leading treatment target to reduce the residual CV risk.
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Márk, László, and Győző Dani. "Diabeteses dyslipidaemia és atherosclerosis." Orvosi Hetilap 157, no. 19 (2016): 746–52. http://dx.doi.org/10.1556/650.2016.30441.
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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.
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Warnick, G. Russell, Gary L. Myers, Gerald R. Cooper, and Nader Rifai. "Impact of the Third Cholesterol Report from the Adult Treatment Panel of the National Cholesterol Education Program on the Clinical Laboratory." Clinical Chemistry 48, no. 1 (2002): 11–17. http://dx.doi.org/10.1093/clinchem/48.1.11.
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Abstract Background: The US National Cholesterol Education Program has recently released the third report of the Adult Treatment Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Incorporating new evidence and more consistent with other international intervention programs, these more complex guidelines will considerably expand indications for treatment. The implications for clinical laboratories are summarized in this report. Content: LDL-cholesterol (LDL-C) remains the major focus for classification and treatment, whereas diabetes, the presence of multiple risk factors, including the metabolic syndrome, and increased triglycerides (TGs), will now require more intensive management. For screening, a fasting lipoprotein profile is recommended, adding LDL-C and TGs to the previous measurements of total cholesterol and HDL-cholesterol (HDL-C). Lowering the cutpoints defining optimal LDL-C [100 mg/dL (2.58 mmol/L)] and normal TGs [150 mg/dL (1.70 mmol/L)] and raising the cutpoint for low HDL-C to 40 mg/dL (1.03 mmol/L) will select more patients for treatment. A new marker, non-HDL-C, becomes a secondary target in treating high TGs. Conclusions: Laboratories will need to adjust reporting formats and interpretations and can expect more requests for tests to characterize secondary causes of dyslipidemia, e.g., diabetes, and for the so-called “emerging risk factors”, e.g., lipoprotein(a), homocysteine, and C-reactive protein.
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Crandell, James R. "Switching from EPA + DHA (Omega-3-acid Ethyl Esters) to High-Purity EPA (Icosapent Ethyl) in a Statin-Treated Patient with Persistent Dyslipidemia and High Cardiovascular Risk: A Case Study." Clinical Medicine Insights: Cardiology 10 (January 2016): CMC.S38123. http://dx.doi.org/10.4137/cmc.s38123.
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Cardiovascular (CV) risk may remain despite statin treatment, and there is a need to address this risk with add-on therapy. The lipid effects of two different prescription omega-3 fatty acid therapies are described in a 55-year-old statin- and niacin-treated female with severe dyslipidemia and high CV risk. The patient was initially treated with omega-3-acid ethyl esters (eicosapentaenoic acid [EPA] and docosahexaenoic acid) 4 g/day. Due to persistently elevated low-density lipoprotein cholesterol (LDL-C), she was switched to icosapent ethyl (high-purity EPA ethyl ester) 4 g/day. Approximately 28 months after switching to icosapent ethyl, her LDL-C decreased by 69% to 52 mg/dL, triglycerides decreased by 35% to 119 mg/dL, non-high-density lipoprotein cholesterol (non-HDL-C) decreased by 63% to 76 mg/dL, total cholesterol decreased by 44% to 137 mg/dL, and HDL-C increased by 45% to 61 mg/dL. Total and small dense LDL particle concentrations decreased by 60 and 59%, respectively. Treatment was well tolerated, with improvements maintained over two years.
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Lee, Eun-Jae, Sun U. Kwon, Jong-Ho Park, et al. "Changes in High-Density Lipoprotein Cholesterol and Risks of Cardiovascular Events: A Post Hoc Analysis from the PICASSO Trial." Journal of Stroke 22, no. 1 (2020): 108–18. http://dx.doi.org/10.5853/jos.2019.02551.
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Background and purpose Whether pharmacologically altered high-density lipoprotein cholesterol (HDL-C) affects the risk of cardiovascular events is unknown. Recently, we have reported the Prevention of Cardiovascular Events in Asian Patients with Ischaemic Stroke at High Risk of Cerebral Haemorrhage (PICASSO) trial that demonstrated the non-inferiority of cilostazol to aspirin and superiority of probucol to non-probucol for cardiovascular prevention in ischemic stroke patients (clinicaltrials.gov: NCT01013532). We aimed to determine whether on-treatment HDL-C changes by cilostazol and probucol influence the treatment effect of each study medication during the PICASSO study.Methods Of the 1,534 randomized patients, 1,373 (89.5%) with baseline cholesterol parameters were analyzed. Efficacy endpoint was the composite of stroke, myocardial infarction, and cardiovascular death. Cox proportional hazards regression analysis examined an interaction between the treatment effect and changes in HDL-C levels from randomization to 1 month for each study arm.Results One-month post-randomization mean HDL-C level was significantly higher in the cilostazol group than in the aspirin group (1.08 mmol/L vs. 1.00 mmol/L, <i>P</i><0.001). The mean HDL-C level was significantly lower in the probucol group than in the non-probucol group (0.86 mmol/L vs. 1.22 mmol/L, <i>P</i><0.001). These trends persisted throughout the study. In both study arms, no significant interaction was observed between HDL-C changes and the assigned treatment regarding the risk of the efficacy endpoint.Conclusions Despite significant HDL-C changes, the effects of cilostazol and probucol treatment on the risk of cardiovascular events were insignificant. Pharmacologically altered HDL-C levels may not be reliable prognostic markers for cardiovascular risk.
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Giammanco, Antonina, Davide Noto, Carlo Maria Barbagallo, et al. "Hyperalphalipoproteinemia and Beyond: The Role of HDL in Cardiovascular Diseases." Life 11, no. 6 (2021): 581. http://dx.doi.org/10.3390/life11060581.
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Hyperalphalipoproteinemia (HALP) is a lipid disorder characterized by elevated plasma high-density lipoprotein cholesterol (HDL-C) levels above the 90th percentile of the distribution of HDL-C values in the general population. Secondary non-genetic factors such as drugs, pregnancy, alcohol intake, and liver diseases might induce HDL increases. Primary forms of HALP are caused by mutations in the genes coding for cholesteryl ester transfer protein (CETP), hepatic lipase (HL), apolipoprotein C-III (apo C-III), scavenger receptor class B type I (SR-BI) and endothelial lipase (EL). However, in the last decades, genome-wide association studies (GWAS) have also suggested a polygenic inheritance of hyperalphalipoproteinemia. Epidemiological studies have suggested that HDL-C is inversely correlated with cardiovascular (CV) risk, but recent Mendelian randomization data have shown a lack of atheroprotective causal effects of HDL-C. This review will focus on primary forms of HALP, the role of polygenic inheritance on HDL-C, associated risk for cardiovascular diseases and possible treatment options.
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Choi, Hong Y., Isabelle Ruel, Shiwon Choi, et al. "Low-Dose Docetaxel Is Effective in Reducing Atherogenic Lipids and Atherosclerosis." International Journal of Molecular Sciences 26, no. 4 (2025): 1484. https://doi.org/10.3390/ijms26041484.
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High-density lipoprotein (HDL) particles form during cellular cholesterol removal, positioning HDL biogenesis as a potential strategy to combat atherosclerosis. We identified desmocollin 1 (DSC1) as a negative regulator of HDL biogenesis and discovered that docetaxel (DTX) effectively inhibits DSC1 activity. This study assessed the efficacy of DTX in reducing atherosclerosis in ApoE−/− mice. After two weeks on a high-fat diet, mice were divided into baseline, vehicle-treated, and DTX-treated groups. Baseline mice were sacrificed at the end of the two weeks, while the other groups received a vehicle or DTX (1 μg/μL) via subcutaneously implanted osmotic pumps delivering 0.15 μL/h for six weeks, with the high-fat diet continued. The controlled drug delivery system maintained stable DTX blood concentrations (2.7–4.3 nM) over six weeks without hematologic toxicity. DTX treatment significantly reduced circulating atherogenic lipids, including triglycerides, non-esterified fatty acids, low-density lipoprotein cholesterol, and total cholesterol, while increasing the HDL cholesterol/total cholesterol ratio. These improvements were associated with significant reductions in atherosclerotic lesions in the aortic sinus and arch. Notably, these effects occurred without altering circulating inflammatory cytokine levels. These results demonstrate that DTX effectively reduces dyslipidemia-induced atherosclerosis. Its HDL-biogenic and anti-atherosclerotic effects establish DTX as a promising candidate for developing HDL-directed therapies for atherosclerosis.
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Aronow, WS. "Treatment of Hypercholesterolemia in Patients with Diabetes Mellitus." International Journal of Diabetology & Vascular Disease Research 2, no. 3 (2014): 54–56. https://doi.org/10.19070/2328-353X-1400010.
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Numerous studies have shown that statins reduce cardiovascular events including stroke and mortality in diabetics. The American Diabetes Association 2013 guidelines recommend that diabetics at high risk for cardiovascular events should have their serum low-density lipoprotein (LDL) cholesterol reduced to <70 mg/dL with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to < 100 mg/dL. The 2013 American College of Cardiology/American Heart Association lipid guidelines recommend giving high-dose statins to adult diabetics aged ≤75 years with atherosclerotic vascular disease (ASCVD) unless contraindicated with a class I indication and moderate-dose or high-dose statins to diabetics with ASCVD ≥75 years with a class IIa indication. Diabetics ≥ 21 years with a serum LDL cholesterol of ≥190 mg/dL should be treated with high-dose statins with a class I indication. For primary prevention in diabetics aged 40 to 75 years and serum LDL cholesterol between 70 to 189 mg/dL, moderate-dose statins should be given with a class I indication. For primary prevention in diabetics aged 40 to 75 years, a serum LDL cholesterol between 70 to 189 mg/dL, and a 10-year risk of ASCVD of ≥7.5% calculated from the Pooled Heart Equation, high-dose statins should be given with a class IIa indication. For primary prevention in diabetics aged 21 to 39 years or older than 75 years and a serum LDL cholesterol between 70 to 189 mg/dL, moderate-dose statins or high-dose statins should be given with a class IIa indication. There is no additional ASCVD reduction from adding nonstatin therapy to further lower non-high-density lipoprotein (HDL) cholesterol once an LDL cholesterol goal has been reached. Clinical trials have found no lowering of cardiovascular events or mortality in diabetics treated with statins by addition of nicotinic acid, fibric acid derivatives, ezetemibe, or drugs that raise serum HDL cholesterol.
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Xu, Qin, Xia Meng, Hao Li, et al. "The Influence of Non-High-Density Lipoprotein Cholesterol on the Efficacy of Genotype-Guided Dual Antiplatelet Therapy in Preventing Stroke Recurrence." Journal of Stroke 26, no. 2 (2024): 231–41. http://dx.doi.org/10.5853/jos.2024.00367.
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Background and Purpose Non-high-density lipoprotein cholesterol (non-HDL-C), which represents the total cholesterol content of all pro-atherogenic lipoproteins, has recently been included as a new target for lipid-lowering therapy in high-risk atherosclerotic patients in multiple guidelines. Herein, we aimed to explore the relationship between non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing stroke recurrence.Methods This study comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II) trial, from which 5,901 patients with complete data on non-HDL-C were included and categorized by median non-HDL-C levels, using a cutoff of 3.5 mmol/L. The primary efficacy and safety outcomes were recurrent stroke and severe or moderate bleeding within 90 days.Results Ticagrelor-aspirin significantly reduced the risk of recurrent stroke in patients with low non-HDL-C (71 [4.8%] vs. 119 [7.7%]; adjusted hazard ratio [HR] 0.54; 95% confidence interval [CI], 0.40–0.74), but not in those with high non-HDL-C (107 [7.3%] vs. 108 [7.6%]; adjusted HR, 0.88; 95% CI, 0.67–1.16), compared with clopidogrel-aspirin (<i>P</i> for interaction=0.010). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin for recurrent stroke decreased as non-HDL-C levels increased. No significant differences in the treatment assignments across the non-HDL-C groups were observed in terms of the rate of severe or moderate bleeding (5 [0.3%] vs. 8 [0.5%] in the low non-HDL-C group; 4 [0.3%] vs. 2 [0.1%] in the high non-HDL-C group; <i>P</i> for interaction=0.425).Conclusion CHANCE-2 participants with low non-HDL-C levels received more clinical benefit from ticagrelor-aspirin versus clopidogrel-aspirin compared to those with high non-HDL-C, following minor ischemic stroke or transient ischemic attack.
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Guo, Shujuan, Juan Zheng, and Guimei Li. "Effects of growth hormone on lipid metabolism and sexual development in pubertal obese male rats." Open Life Sciences 17, no. 1 (2022): 1531–40. http://dx.doi.org/10.1515/biol-2022-0515.
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Abstract To investigate the effects of growth hormone (GH) on pubertal obese male rats, a rat model of high-fat diet-induced obesity was established in juvenile male rats. The model rats were divided into the treatment group (GH) and the non-treatment group (physiological saline). After 4 weeks, we measured the levels of alanine transaminase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), estrogen (E2), testosterone (T), and insulin-like growth factor (IGF-1). The morphological changes of the liver and testis were assessed, and the expression of aromatase was detected. The levels of ALT, AST, TC, TG, LDL-C, E2, and IGF-1 in the treatment group were significantly lower than in the non-treated model rats (P < 0.001). The levels of HDL-C and T of GH-treated rats were significantly higher than those of the non-treatment group (P < 0.001). Compared with non-treated model rats, GH-treated model rats showed reduced liver steatosis, improved morphological structure of the testicular seminiferous tubules, and an increased number of spermatogenic cells. The treatment group also showed lower expression of aromatase in the liver and testis compared with the non-treatment group. GH partially protected pubertal male rats from obesity-induced lipid metabolic disorder and sexual retardation.
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Soran, Handrean, Safwaan Adam, Zohaib Iqbal, and Paul Durrington. "Mathematical modelling of the most effective goal of cholesterol-lowering treatment in primary prevention." BMJ Open 12, no. 5 (2022): e050266. http://dx.doi.org/10.1136/bmjopen-2021-050266.
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ObjectiveTo compare quantitatively different recommended goals for cholesterol-lowering treatment in the primary prevention of atherosclerotic cardiovascular disease (ASCVD).DesignOutcomes at pretreatment low-density lipoprotein (LDL) cholesterol concentrations from 2 to 5 mmol/L and 10-year ASCVD risk from 5% to 30% were modelled, using the decrease in risk ratio per mmol/L reduction in LDL cholesterol derived from randomised controlled trials (RCTs) of cholesterol-lowering medication.Data sourceSummary statistics from 26 RCTs comparing treatment versus placebo or less versus more effective treatment and 12 RCTs in which statin was compared with a higher dose of the same statin or with a similar statin dose to which an adjunctive cholesterol-lowering drug was added.SettingThe different recommended goals are: (1) LDL cholesterol≤2.6 mmol/L (100 mg/dL); (2) LDL cholesterol≤1.8 mmol/L (70 mg/dL); (3) non-high density lipoprotein (HDL) cholesterol decrease of ≥40%; or (4) LDL cholesterol≤1.8 mmol/L (70 mg/dL) or decreased by ≥50% whichever is lower.ParticipantsRCT participants.InterventionsStatins alone or in combination with ezetimibe or proprotein convertase subtilisin/kexin type 9 inhibitors.Main outcome measuresFor each of the recommended therapeutic goals, our primary outcome was the number of events prevented per 100 people treated for 10 years (N100) and the number of needed to treat (NNT) to prevent one event over 10 years.ResultsAt pretreatment LDL cholesterol 4–5 mmol/L, all four goals provided similar benefit with N100 1.47–16.45 (NNT 6–68), depending on ASCVD risk and pretreatment LDL cholesterol. With initial LDL cholesterol in the range 2–3 mmol/L, the target of 2.6 mmol/L was the least effective with N100 between 0 and 2.84 (NNT 35–infinity). The goal of 1.8 mmol/L was little better. However, reductions in non-HDL cholesterol by ≥40% or of LDL cholesterol to 1.8 mmol/L and/or by 50%, whichever is lower, were more effective, delivering N100 of between 0.9 and 9.33 (NNT 11–111). Percentage decreases in LDL cholesterol or non-HDL cholesterol concentration are more effective targets than absolute change in concentration in people with initial values of <4 mmol/L.ConclusionsThe LDL cholesterol target of 1.8 mmol/L is most effective when initial LDL cholesterol is >4 mmol/L. The time has probably come for the LDL cholesterol goal of <2.6 mmol/L to be abandoned.
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Sidorkiewicz, Malgorzata. "Is microRNA-33 an Appropriate Target in the Treatment of Atherosclerosis?" Nutrients 15, no. 4 (2023): 902. http://dx.doi.org/10.3390/nu15040902.
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The maintenance of cholesterol homeostasis is a complicated process involving regulation of cholesterol synthesis, dietary uptake and bile acid synthesis and excretion. Reverse cholesterol transport, described as the transfer of cholesterol from non-hepatic cells, including foam cells in atherosclerotic plaques, to the liver and then its excretion in the feces is important part of this regulation. High-density lipoproteins are the key mediators of reverse cholesterol transport. On the other hand, microRNA-33 was identified as a key regulator of cholesterol homeostasis. Recent studies indicate the impact of microRNA-33 not only on cellular cholesterol efflux and HDL production but also on bile metabolism in the liver. As proper coordination of cholesterol metabolism is essential to human health, discussion of recent findings in this field may open new perspectives in the microRNA-dependent treatment of a cholesterol imbalance.
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Al-Sabti, Hilal, Ali T. Al-Hinai, Ibrahim Al-Zakwani, et al. "The Achievement of Non-high-density Lipoprotein Cholesterol Target in Patients with Very High Atherosclerotic Cardiovascular Disease Risk Stratified by Triglyceride Levels Despite Statin-controlled Low-density Lipoprotein Cholesterol." Oman Medical Journal 37, no. 2 (2022): e367-e367. http://dx.doi.org/10.5001/omj.2022.79.
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Objectives: We sought to estimate the percentage achievements of non-high-density lipoprotein cholesterol (non-HDL-C) target in patients with very high atherosclerotic cardiovascular diseases (ASCVD) risk stratified by triglyceride (TG) levels despite statin-controlled low-density lipoprotein cholesterol (LDL-C) in the Centralized Pan-Middle East Survey on the under treatment of hypercholesterolemia. Methods: The non-HDL-C target achievement in patients with diabetes mellites (DM) and patients with established ASCVD was defined according to European Society of Cardiology and European Atherosclerosis Society 2019 guidelines for managing dyslipidemia. Patients were stratified to controlled LDL-C defined as < 70 mg/dL (< 1.8 mmol/L) with normal TG < 150 mg/dL (< 1.7 mmol/L) and high TG between 150–400 mg/dL (1.7–4.5 mmol/L). Results: The mean age of our cohort was 58.0±11.0 years, 6.8% (n = 717) were male, 9.7% (104) were smokers, and 48.4% (n = 518) had body mass index of ≥ 30 kg/m2. Those with high TG levels male (76.5% vs. 63.8%; p < 0.001), smokers (16.1% vs. 7.7%; p < 0.001), have metabolic syndrome (77.6% vs. 17.1%; p < 0.001), and low HDL-C levels (79.2% vs. 49.4%; p < 0.001). The majority (93.9%, n = 1008) were on statins (atorvastatin and rosuvastatin) with only 2.2% (n = 24) on the combined statins plus fenofibrate/gemfibrozil. Only 27.4% (n = 294) of patients had non-HDL-C goal attainment. Goal attainment rates in patients with diabetes (3.1% vs. 34,4%; p < 0.001), coronary artery disease (CAD) (2.4% vs. 37.9%; p < 0.001), diabetes plus CAD (0% vs. 40.0%; p < 0.001), and CVD (0% vs. 30.0%; p =0.048) were significantly lower in those with higher TG levels. Conclusions: A large proportion of statin-controlled LDL-C diabetic patients and patients with established ASCVD with high TGs did not achieve the non-HDL-C target. Our study did not demonstrate an association between ASCVD and high TG levels; and therefore, a follow-up study is highly required to assess long-term ASCVD outcomes in this cohort.
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Fogacci, Federica, Marina Giovannini, Antonio Di Micoli, et al. "A Randomized, Double-Blind, Placebo-Controlled Clinical Trial on the Effect of a Dietary Supplement Containing Dry Artichoke and Bergamot Extracts on Metabolic and Vascular Risk Factors in Individuals with Suboptimal Cholesterol Levels." Nutrients 16, no. 11 (2024): 1587. http://dx.doi.org/10.3390/nu16111587.
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The aim of this study was to assess whether dietary supplementation with a nutraceutical blend comprising extracts of bergamot and artichoke—both standardized in their characteristic polyphenolic fractions—could positively affect serum lipid concentration and insulin sensitivity, high-sensitivity C-reactive protein (hs-CRP), and indexes of non-alcoholic fatty liver disease (NAFLD) in 90 healthy individuals with suboptimal cholesterol levels. Participants were randomly allocated to treatment with a pill of either active treatment or placebo. After 6 weeks, the active-treated group experienced significant improvements in levels of triglycerides (TG), apolipoprotein B-100 (Apo B-100), and apolipoprotein AI (Apo AI) versus baseline. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high density lipoprotein cholesterol (Non-HDL-C), and hs-CRP also significantly decreased in the active-treated group compared to both baseline and placebo. At the 12-week follow-up, individuals allocated to the combined nutraceutical experienced a significant improvement in TC, LDL-C, Non-HDL-C, TG, Apo B-100, Apo AI, glucose, alanine transaminase (ALT), gamma-glutamyl transferase (gGT), hs-CRP, several indexes of NAFLD, and brachial pulse volume (PV) in comparison with baseline. Improvements in TC, LDL-C, Non-HDL-C, TG, fatty liver index (FLI), hs-CRP, and endothelial reactivity were also detected compared to placebo (p < 0.05 for all). Overall, these findings support the use of the tested dietary supplement containing dry extracts of bergamot and artichoke as a safe and effective approach for the prevention and management of a broad spectrum of cardiometabolic disorders.
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Frajacomo, Fernando Tadeu Trevisan, Marcelo Marcos Piva Demarzo, Cleverson Rodrigues Fernandes, et al. "The effects of high-intensity resistance exercise on the blood lipid profile and liver function in hypercholesterolemic hamsters." Applied Physiology, Nutrition, and Metabolism 37, no. 3 (2012): 448–54. http://dx.doi.org/10.1139/h2012-008.
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It is well established that atherogenic dyslipidemia, characterized by high levels of triglycerides (TG), total cholesterol (TC), and low-density lipoprotein (LDL) cholesterol and low levels of high-density lipoprotein (HDL) cholesterol, constitutes important risk factors for cardiovascular disease. Regular exercise has been associated with a reduced risk for metabolic diseases. However, studies supporting the concept that resistance exercise is a modifier of blood lipid parameters are often contradictory. The aim of this study was to investigate the effects of high-intensity resistance exercise on the serum levels of TG, TC, HDL and non-HDL cholesterol, glucose, and the liver function enzymes alanine aminotransferase (ALT, EC 2.6.1.2) and aspartate aminotransferase (AST, EC 2.6.1.1) in golden Syrian hamsters (Mesocricetus auratus (Waterhouse, 1839)) fed a hypercholesterolemic diet. Sedentary groups (S) and exercise groups (E) were fed a standard diet (SS and ES) or a cholesterol-enriched diet (standard plus 1% cholesterol, SC and EC). Resistance exercise was performed by jumps in the water, carrying a load strapped to the chest, representing 10 maximum repetitions (10 RM, 30 s rest, five days per week for five weeks). Mean blood sample comparisons were made by ANOVA + Tukey or ANOVA + Kruskal–Wallis tests (p < 0.05) to compare parametric and nonparametric samples, respectively. There were no differences in blood lipids between the standard diet groups (SS and ES) (p > 0.05). However, the EC group increased the glucose, non-HDL, and TC levels in comparison with the ES group. Moreover, the EC group increased the TG levels versus the SC group (p < 0.05). In addition, the ALT levels were increased only by diet treatment. These findings indicated that high-intensity resistance exercise contributed to dyslipidemia in hamsters fed a hypercholesterolemic diet, whereas liver function enzymes did not differ in regards to the exercise protocol.
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Jagroop, I. Anita, Jahm Want Persaud, and Dimitri P. Mikhailidis. "A New Rapid Method to Measure Human Platelet Cholesterol." Clinical and Applied Thrombosis/Hemostasis 17, no. 6 (2011): 578–84. http://dx.doi.org/10.1177/1076029611404213.
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Introduction: Platelet cholesterol (PC) could be used to assess “tissue” cholesterol of patients with vascular disease. However, the methods available so far to measure PC involve a complex extraction process. We developed a rapid method to measure PC and assessed its correlation with serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL-C/HDL-C ratio, triglycerides (TG), and non-HDL-C. Methods: We assessed repeatability (20 times, 3 participants) and reproducibility (8 times, 2 participants). A group of 47 healthy participants was studied. Blood was collected to analyze serum TC, LDL-C, HDL-C, and TG. Citrated blood was used to prepare a platelet pellet. A “clear soup” was produced (by disrupting this pellet using freeze–thaw and sonication cycles) and used to measure PC. Results: Repeatability of PC showed a coefficient of variation (CV) of 4.8%. The reproducibility of PC over a period of 2 months was CV 7.5% and 8.1% (8 measurements for 2 participants). The PC of participants with serum LDL-C >2.6 mmol/L (treatment goal recommended by the National Cholesterol Education Program Adult Treatment Panel III) was 377 ± 120 μmol/10 12 platelets (n = 25). There was a significant correlation (Spearman, correlation coefficient) of PC (n = 25) with serum LDL-C ( rs = 0.45, P = .02), LDL-C/HDL-C ( rs = 0.45, P = .02), TG ( rs = 0.43, P = .03), and non-HDL-C ( rs = 0.53, P = .007). Conclusion: This technique of measuring PC has the advantage of being reproducible, fast, and simpler than previous methods. Thus, it may be useful for multiple sampling when investigating changes in PC in hypercholesterolemic patients. More extensive evaluation is necessary.
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Wratsangka, Raditya, Elly Herwana, Yenny Yenny, Endrico Xavieress, and Aditya Krishnamurti. "High-density Lipoprotein Cholesterol as a Risk Factor of Health-Related Quality of Life in 50–70-Year-Old Community-Dwelling Women." Open Access Macedonian Journal of Medical Sciences 9, E (2021): 1092–96. http://dx.doi.org/10.3889/oamjms.2021.7466.
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BACKGROUND: The prevalence of dyslipidemia, a risk factor of cardiovascular disease, is at present sufficiently high, particularly in the elderly. Health-related quality of life (HRQoL) is also an important outcome in the treatment of dyslipidemia, which is currently more targeted at lowering the low-density lipoprotein cholesterol (LDL-C) concentration. AIM: The aim of this study was to determine the relationship between the high-density lipoprotein cholesterol (HDL-C) concentration and HRQoL in community-dwelling women aged 50–70 years. METHODS: A cross-sectional study involving 137 women aged 50–70 years who underwent blood sampling for determining the concentrations of hemoglobin, total cholesterol (TC), LDL-C, and HDL-C. A questionnaire was given to all subjects regarding data on age, menopausal status, level of education, and also another questionnaire of SF-36 for evaluation HRQoL. Bivariate and multivariate logistic regression analysis was used to identify risk factors associated with HRQoL. RESULTS: In bivariate logistic regression analysis, age, menopausal status, education level, anemia, TC, and LDL-C were found to have non-statistically significant association with HRQoL, but HDL-C was significantly associated with HRQoL (odds ratio = 0.44; 95% Confidence interval [CI] = 0.20–0.97; p = 0.042). In multivariate analysis, menopausal status and education level have a non-statistically significant association with HRQoL, but those normal level of HDL cholesterol was found 0.18 times less likely to be associated with poor HRQoL (Adjusted odds ratio 0.18; 95% CI = 0.03–0.91; p = 0.038). CONCLUSION: This study showed that HDL-C levels were risk factors of HRQoL in women 50–70 years of age.
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Stein, James H., Cynthia M. Carlsson, Kristi Papcke-Benson, Jean A. Einerson, Patrick E. McBride, and Donald A. Wiebe. "Inaccuracy of Lipid Measurements with the Portable Cholestech L·D·X Analyzer in Patients with Hypercholesterolemia." Clinical Chemistry 48, no. 2 (2002): 284–90. http://dx.doi.org/10.1093/clinchem/48.2.284.
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Abstract Background: Although total cholesterol concentrations measured by portable lipid analyzers have acceptable bias and precision in young and middle-aged adults, clinically relevant differences in HDL-cholesterol (HDL-C) and triglyceride values have been described. Furthermore, the accuracy of portable lipid analyzers in older hyperlipidemic individuals, who have a high incidence of coronary heart disease, has not been validated. This study determined the biases and variability in portable lipid measurements in older patients with hypercholesterolemia and related them to National Cholesterol Education Program Adult Treatment Panel III guidelines. Methods: Participants were ≥70 years of age with fasting serum LDL-cholesterol (LDL-C) concentrations &gt;1.40 g/L. Fasting fingerstick samples were analyzed on a Cholestech L·D·X desktop analyzer. Antecubital venous samples were analyzed in a proficiency-certified clinical laboratory. Results: Portable measurements systematically overestimated triglycerides (0.296 g/L; P &lt;0.001) and HDL-C (0.015 g/L; P = 0.026). LDL-C concentrations were underestimated (0.043 g/L; P = 0.046). Total and non-HDL cholesterol calculations based on the portable lipid device provided unbiased estimates, but wide variability was present. Significant variability in lipid determinations limited their clinical usefulness in individual patients, especially because 2 SD of the mean bias between the laboratory and the portable determinations of LDL-C and non-HDL cholesterol exceeded the 0.30 g/L cutoff that defines treatment targets in the current lipid guidelines. Conclusions: Lipid values obtained from portable lipid analyzers may be useful for screening, but they should not be used to make clinical decisions regarding the diagnosis and management of dyslipidemia in individual patients.
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Lui, Matthew, Ross Garberich, Craig Strauss, Thomas Davin, and Thomas Knickelbine. "Usefulness of Lipid Apheresis in the Treatment of Familial Hypercholesterolemia." Journal of Lipids 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/864317.
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Lipid apheresis is used to treat patients with severe hyperlipidemia by reducing low-density lipoprotein cholesterol (LDL-C). This study examines the effect of apheresis on the lipid panel and cardiac event rates before and after apheresis. An electronic health record screen of ambulatory patients identified 11 active patients undergoing lipid apheresis with 10/11 carrying a diagnosis of FH. Baseline demographics, pre- and postapheresis lipid levels, highest recorded LDL-C, cardiac events, current medications, and first apheresis treatment were recorded. Patients completed a questionnaire and self-reported risk factors and interest in alternative treatment. There were significant reductions in mean total cholesterol (−58.4%), LDL-C (−71.9%), triglycerides (−51%), high-density lipoprotein (HDL) cholesterol (−9.3%), and non-HDL (−68.2%) values. Thirty-four cardiac events were documented in 8 patients before apheresis, compared with 9 events in 5 patients after apheresis. Our survey showed a high prevalence of statin intolerance (64%), with the majority (90%) of participants indicating an interest in alternative treatment options. Our results have shown that lipid apheresis primary effect is a marked reduction in LDL-C cholesterol levels and may reduce the recurrence of cardiac events. Apheresis should be compared to the newer alternative treatment modalities in a randomized fashion due to patient interest in alternative options.
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Nandeesha, Hanumanthappa, Purushothaman Pavithran, and T. Madanmohan. "Effect of Antihypertensive Therapy on Serum Lipids in Newly Diagnosed Essential Hypertensive Men." Angiology 60, no. 2 (2008): 217–20. http://dx.doi.org/10.1177/0003319708316167.
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The effect of antihypertensives on serum lipids in newly diagnosed male essential hypertensive patients was studied. The participants (n = 99) were randomly allocated to receive amlodipine, atenolol, enalapril, hydrochlorothiazide, and a combination of amlodipine and atenolol. Lipid parameters were estimated before and after 8 weeks of therapy. The atenolol and thiazide group showed a significant increase in triglycerides (TGs) and very-low-density lipoprotein cholesterol (VLDL-C). High-density lipoprotein cholesterol (HDL-C) and HDL-C to low-density lipoprotein cholesterol (LDL-C) ratio were significantly increased and TC to HDL-C ratio was significantly decreased in the amlodipine and amlodipine–atenolol combination groups. In the enalapril group, we found a significant reduction in TC, TGs, VLDL-C, non-HDL-C, and TG to HDL-C ratio after treatment. It can be concluded from the present study that some drugs have beneficial effects on the lipid status, whereas others adversely affect the lipid status in hypertension.
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Koh, J. H., B. W. Lee, and W. U. Kim. "POS1079 COMPARISON OF CHOLESTEROL PROFILE CHANGES AFTER TREATMENT WITH BIOLOGICS OR JANUS KINASE INHIBITORS IN PATIENTS WITH RHEUMATOID ARTHRITIS." Annals of the Rheumatic Diseases 82, Suppl 1 (2023): 862.2–862. http://dx.doi.org/10.1136/annrheumdis-2023-eular.3636.
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BackgroundJanus kinase inhibitor (JAKi) and tumor necrosis factor inhibitor (TNFi) both effectively reduce inflammation, and both increases serum lipid levels. However, in the recent phase 3b-4 trial, major adverse cardiovascular events were higher with tofacitinib than TNFi. Cholesterol is still primary to the development of atherosclerosis, which collaborates with inflammation. Even in the young population, mildly abnormal lipid levels were associated with an increased future risk of atherosclerotic cardiovascular disease events.ObjectivesTo assess the effects of biological and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) on lipid profiles in patients with moderate-to-severe rheumatoid arthritis (RA).MethodsThis retrospective single-center observational study included patients with RA who initiated and maintained tumor necrosis factor-α inhibitor (TNFi), abatacept, tocilizumab, and Janus kinase inhibitor (JAKi) for at least 6 months. Changes in lipid profile were assessed at months 3 and 6, and associations with clinical efficacy, concomitant medications, and co-morbidities were evaluated.ResultsThis study included 114 patients treated with TNFi, 81 patients with abatacept, 103 patients with tocilizumab, and 89 patients with JAKi. Median percent change from baseline to 6 months in total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and non-HDL-C levels were higher in tocilizumab and JAKi versus TNFi and abatacept recipients (16% and 15% vs 6% and 3%, 19% and 24% vs 8% and 3%, 5% and 9% vs 3% and 0%, 19% and 19% vs 7% and 8%, respectively). The significant change in non-HDL-C was associated with JAKi (versus TNFi, OR, 2.671; 95% CI, 1.44–4.956), tocilizumab (versus TNFi, OR, 1.996; 95% CI, 1.087–3.665), concomitant glucocorticoids (OR, 2.802, 95% CI 1.344–5.843), and statin (OR, 0.419; 95% CI 0.230–0.765), and presence of rheumatoid factor (OR, 3.252, 95% CI, 1.029–10.276). However, the change in disease activity in 28 joints was not associated with a significant non-HDL-C change.ConclusionRegardless of disease activity changes, tocilizumab and JAKi-associated increases in serum non-HDL-C levels were observed. Combination with glucocorticoids may induce elevations in non-HDL-C, whereas statins may decrease in non-HDL-C.References[1] Nurmohamed MT, Heslinga M, Kitas GD. Cardiovascular comorbidity in rheumatic diseases.Nat Rev Rheumatol2015;11:693-704.[2] Robertson J, Peters MJ, McInnes IB, et al.Changes in lipid levels with inflammation and therapy in RA: a maturing paradigm.Nat Rev Rheumatol2013;9:513-23.[3] Brunner FJ, Waldeyer C, Ojeda F, et al.Application of non-HDL cholesterol for population-based cardiovascular risk stratification: results from the Multinational Cardiovascular Risk Consortium.Lancet2019;394:2173-83.AcknowledgementsThis work was supported by National Research Foundation of Korea grants funded by the Ministry of Science, ICT and Future Planning (Grant 2015R1A3A2032927 to W.U. Kim).Disclosure of InterestsNone Declared.
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Hao, Cuijun, Tianhua Hou, Fei Wang, et al. "Efficacy of atorvastatin in the management of atherosclerotic cardiovascular disease (ASCVD)." Tropical Journal of Pharmaceutical Research 24, no. 1 (2025): 39–45. https://doi.org/10.4314/tjpr.v24i1.6.
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Purpose: To investigate the efficacy of atorvastatin in the treatment of atherosclerotic cardiovascular disease (ASCVD) Methods: A total of 158 patients who underwent coronary angiography in the Department of Cardiology, First Affiliated Hospital of Hebei North University, China were divided into acute myocardial infarction (AMI, n = 42), unstable angina pectoris (UAP, n = 70), and control (n = 46) groups. Atorvastatin (40 mg) was administered to the patients in AMI and UAP groups for 40 days. Triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, phospholipase A2 (PLA2), YKL40, and clinical efficacy were evaluated after treatment. Results: Acute myocardial infarction group (AMI) had significantly higher TC, LDL-C, non-HDL-C, PLA2, and YKL40 levels compared to UAP and control (p < 0.05). Also, HDL-C, TG, and TG/HDL-C were significantly higher in AMI and UAP compared to control group (p < 0.05). In coronary heart disease, TG/HDL-C had the highest sensitivity, and LDL-C had the highest specificity. Furthermore, TC, LDL-C, and TG significantly decreased in both AMI and UAP groups (p < 0.05), while HDL-C remained unchanged (p > 0.05). Conclusion: Atorvastatin effectively improves lipid profiles in ASCVD patients, and markers such as PLA2 and YKL40 effectively predict ASCVD risk. Further larger-scale, long-term studies are needed to validate the effectiveness of combining lipid and inflammatory biomarkers for ASCVD risk prediction and management.
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Farnier, Michel, Kjetil Retterstøl, Armin Steinmetz, and Albert Császár. "Comparative efficacy and safety of fenofibrate/pravastatin plus ezetimibe triple therapy and simvastatin/ezetimibe dual therapy in type 2 diabetic patients with mixed hyperlipidaemia and cardiovascular disease." Diabetes and Vascular Disease Research 9, no. 3 (2012): 205–15. http://dx.doi.org/10.1177/1479164111430715.
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Background: This study was designed to compare the efficacy and safety of a fenofibrate/pravastatin 160/40 mg fixed-dose combination plus ezetimibe 10 mg triple therapy and simvastatin 20 mg plus ezetimibe 10 mg dual therapy in patients with type 2 diabetes, mixed hyperlipidaemia and cardiovascular disease. Method: After a 6-week run-in period on simvastatin 20 mg, 273 patients with non-high-density lipoprotein cholesterol (non-HDL-C) ≥ 100 mg/dl or low-density lipoprotein cholesterol (LDL-C) ≥ 70 mg/dl were randomised to receive 12-week treatment with triple therapy or dual therapy, followed by a 12-week safety period during which all patients received the triple therapy. Results: At week 12, similar significant decreases in non-HDL-C were observed with both treatments. The triple therapy has induced a greater decrease in triglycerides (between-treatment difference: −14.6%, p = 0.007) and the dual therapy a greater decrease in LDL-C (between-treatment difference: +5.3%, p = 0.05). Both treatments were generally well tolerated. Conclusion: The fenofibrate/pravastatin plus ezetimibe therapy improves the global atherogenic lipid profile in type 2 diabetic patients with mixed hyperlipidaemia.
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Lee, Yun Jeong, Yunha Choi, Han-Wook Yoo, et al. "Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency." Endocrinology and Metabolism 37, no. 2 (2022): 359–68. http://dx.doi.org/10.3803/enm.2021.1384.
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Background: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period.Methods: This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption.Results: Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates.Conclusion: GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.
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Lee, Yun Jeong, Yunha Choi, Han-Wook Yoo, et al. "Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency." Endocrinology and Metabolism 37, no. 2 (2022): 359–68. http://dx.doi.org/10.3803/enm.2021.1384.
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Background: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period.Methods: This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption.Results: Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates.Conclusion: GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.
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Lee, Yun Jeong, Yunha Choi, Han-Wook Yoo, et al. "Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency." Endocrinology and Metabolism 37, no. 2 (2022): 359–68. http://dx.doi.org/10.3803/enm.2021.1384.
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Background: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period.Methods: This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption.Results: Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates.Conclusion: GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.
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Vally, Muhammed, F. Kathrada, and N. Butkow. "An update on the measurement and management of cholesterol with specific reference to secondary prevention of cardiovascular disease (CVD)." South African Family Practice 60, no. 1 (2018): 15–21. http://dx.doi.org/10.4102/safp.v60i1.4837.
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Cardiovascular disease remains the largest contributor to non-communicable adverse disease outcomes. Treatment and prevention of cardiovascular disease have evolved at a dramatic pace in the last 40 years. Serum-cholesterol has emerged as the dominant risk factor for coronary artery disease and events. The link between serum-cholesterol and arterial atherosclerosis is well documented. The attainment of cholesterol goals has historically concentrated on low-density lipoprotein cholesterol (LDL-C) levels. Current evidence and guidelines have shifted to the attainment of non-HDL-C target levels which represent a more thorough inclusion of small dense atherogenic particles. Methods to reduce serum-cholesterol mainly centre around the use of the HMG CoA-reductase inhibitors also known as the statins. High intensity statins like atorvastatin (80 mg) and rosuvastatin (40 mg) are now the preferred starting therapies to lower cholesterol by at least 40–50% in patients with established cardiovascular disease as secondary prevention. In the event of failure of these medications, evidence suggests that the addition of ezetimibe may enhance the total serum-lowering levels to 50–60%. New therapies aimed at inhibiting PCSK9 revealed exciting new targets for LDL-C lowering, but the high cost of these antibodies could preclude access to this therapeutic intervention. Aggressive pursuit of lower LDL-C or non-high-density lipoprotein cholesterol (non-HDL-C) levels may reduce the incidence of secondary myocardial infarctions, strokes and death from cardiovascular disease.
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Pawłuszewicz, Patrycja, Paweł Andrzej Wojciak, Aleksander Łukaszewicz, et al. "Assessment of Lipid Balance Parameters after Laparoscopic Sleeve Gastrectomy in 1-Year Observation." Journal of Clinical Medicine 12, no. 12 (2023): 4079. http://dx.doi.org/10.3390/jcm12124079.
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Introduction: Currently, the increase in the percentage of obese people observed along with the development of civilization, reaching the level of a global pandemic, has forced a search for methods of effective and permanent obesity treatment. Obesity is a multifactorial disease; it coexists with many disease entities and requires multidisciplinary treatment. Obesity leads to metabolic changes in the form of metabolic syndromes, which include, among others, atherogenic dyslipidemia. The proven relationship between dyslipidemia and cardiovascular risk enforces the need to effectively improve the lipid profile of obese patients. Laparoscopic sleeve gastrectomy is a method of surgical treatment of morbid obesity which improves bariatric and metabolic parameters. The aim of the study was to assess the effectiveness of laparoscopic sleeve gastrectomy (LSG) at improving lipid profile parameters upon a 1-year follow up. Material and Methods: Bariatric parameters of 196 patients who underwent laparoscopic sleeve gastrectomy as well as the lipid profile of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), non-NDL, and triglycerides (TG) in a 1-year observation were analyzed. Results: Improvements in bariatric parameters were observed in patients after LSG. Total cholesterol, low-density lipoprotein (LDL), triglycerides and non-HDL level decreases were observed along with an increase in high-density lipoprotein (HDL) cholesterol levels. Conclusions: Sleeve gastrectomy is an effective method of treating obesity and improving the lipid profile in obese patients.
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Bastaki, Khaled Mahmoud, Jamie Maurice Roy Tarlton, Richard James Lightbody, Annette Graham, and Patricia Esther Martin. "Homo Sapiens (Hsa)-microRNA (miR)-6727-5p Contributes to the Impact of High-Density Lipoproteins on Fibroblast Wound Healing In Vitro." Membranes 12, no. 2 (2022): 154. http://dx.doi.org/10.3390/membranes12020154.
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Chronic, non-healing wounds are a significant cause of global morbidity and mortality, and strategies to improve delayed wound closure represent an unmet clinical need. High-density lipoproteins (HDL) can enhance wound healing, but exploitation of this finding is challenging due to the complexity and instability of these heterogeneous lipoproteins. The responsiveness of primary human neonatal keratinocytes, and neonatal and human dermal fibroblasts (HDF) to HDL was confirmed by cholesterol efflux, but promotion of ‘scrape’ wound healing occurred only in primary human neonatal (HDFn) and adult fibroblasts (HDFa). Treatment of human fibroblasts with HDL induced multiple changes in the expression of small non-coding microRNA sequences, determined by microchip array, including hsa-miR-6727-5p. Intriguingly, levels of hsa-miR-6727-5p increased in HDFn, but decreased in HDFa, after exposure to HDL. Delivery of a hsa-miR-6727-5p mimic elicited repression of different target genes in HDFn (ZNF584) and HDFa (EDEM3, KRAS), and promoted wound closure in HDFn. By contrast, a hsa-miR-6727-5p inhibitor promoted wound closure in HDFa. We conclude that HDL treatment exerts distinct effects on the expression of hsa-miR-6727-5p in neonatal and adult fibroblasts, and that this is a sequence which plays differential roles in wound healing in these cell types, but cannot replicate the myriad effects of HDL.
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Murad, Shah, Zafar H. Tanveer, Abdul Qudoos, et al. "Apricots Contain Vitamin A, Beta-Carotene, Potassium and Phytosterols: Treatment for Oxidative Stress." South Asian Research Journal of Pharmaceutical Sciences 6, no. 01 (2024): 1–4. http://dx.doi.org/10.36346/sarjps.2024.v06i01.001.
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Just look at regular intake of two fruits ie; apple and apricot may help to escape patients from sufferings related to hyperlipidemia. These two fruits have had been researched by scientist for treatment of hyperlipidemia by decreasing low density lipoprotein cholesterol (LDL-C) and increasing high density lipoprotein cholesterol (HDL-C). It was placebo based research work conducted at General Hospital Lahore from January to April 2022. 100 already diagnosed patients of primary/secondary hyperlipidemia were enrolled in research study with (written/explained and approved) consent. Inclusion criteria was their age (20-70 years), gender (male and female) and patients not on any hypolipidemic allopathic medicines. Exclusion criteria was smokers, alcoholic addictives, and patients of thyroid, liver, lung, and severe heart related diseases. Grouping: They were divided in four equal groups including 25 patients in each group. Group-one was on apple half kg per day for the period of three months. Group-two was on apricot half kg per day for the period of three months. Group-three was on apple ½ kg plus apricot ½ kg for the period of three months. Group-four was placebo group and they were advised to take any fruit except these two fruits ie; apple and apricot. Method: Their name/age/gender/occupation/address/cell number was kept in separate folder for research record. Their base line lipid profile was determined at pathology/biochemistry laboratory of the hospital. Fortnightly visit was advised to them. After three months therapy their lipid profile was re-determined. Mean values of their LDL-C and HDL-C ± SEM was analyzed biostatistically by applying paired t-test. P-values >0.05 was regarded as non-significant, p-values <0.01 and <0.001 were regarded as significant and highly significant changes in tested parameters respectively. Results: After three months therapy it was observed that apple reduced LDL-cholesterol 23.77 mg/dl and increased HDL-cholesterol 3.3 mg/dl. Apricot reduced LDL-cholesterol 7.5 mg/dl and increased HDL-cholesterol 5.3 mg/dl. Combination of both fruits decreased LDL-cholesterol 16.1 mg/dl and increased HDL-cholesterol 6.6 mg/dl in three months therapy. Conclusion: It was concluded from results of this research work that apple and apricot given separately or in combination, have remarkable effect on LDL-C and HDL-C in patients suffering from primary/secondary hyperlipidemia.
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Tony, Darsi Eswar, M. Uday Kiran, Md Abu Saleha, et al. "A Comparative Research between Pharmacological and Non-Pharmacological Profile of Anti-Hyperlipidemic Activity on Rodents." Journal of Drug Delivery and Therapeutics 11, no. 5 (2021): 65–70. http://dx.doi.org/10.22270/jddt.v11i5.5016.
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The condition of hyperlipidemia is found to be a great establisher for all the negative health consequences which may lead to cardiac complications. Continuous usage of medication alone is not permanent remedy but also need physical exercise. The same situation was established in animals to assess the performance of pharmacological and non-pharmacological profile by standardized screening using In-vivo methods. The high-cholesterol diet caused a significant increase in total lipids, total cholesterol (TC), total triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and the atherogenic index, whereas the level of high-density lipoprotein cholesterol (HDL-C) was significantly decreased for the treatment groups intended for physical exercise. This article enables the importance of health benefited by physical performance by depicting the biochemical parameters.
 Keywords: Hyperlipidemia, Triglycerides, low-density lipoprotein, activity wheel, Physical exercise, Cardiac performance.
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Myrou, Athena, Konstantinos Barmpagiannos, Erofili Papathanasiou, Vasileios Kachtsidis, Christina Kiouli, and Konstantinos Tziomalos. "Association Between Lipid Profile and COVID-19 Severity: Insights from a Single-Center Cross-Sectional Study in Northern Greece." Journal of Clinical Medicine 14, no. 12 (2025): 4082. https://doi.org/10.3390/jcm14124082.
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Objective: To examine the relationship between lipid profile components—including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides—and clinical outcomes in hospitalized COVID-19 patients in Northern Greece. Methods: A retrospective analysis was performed using data from 208 COVID-19 patients. Lipid profiles [including LDL (low-density lipoprotein cholesterol), HDL (high-density lipoprotein cholesterol), and triglycerides], prior antilipidemic treatment, and clinical outcomes were evaluated. Statistical analysis was conducted using SPSS version 19. Patients: A total of 208 COVID-19 patients from Northern Greece. Results: The mean LDL level was 84.12 mg/dL, with no significant differences observed between survivors and non-survivors. Prior antilipidemic treatment did not significantly affect outcomes. Elevated triglyceride levels were noted in obese patients (BMI ≥ 30 kg/m2) and lower HDL levels were associated with higher CRP (C-reactive protein) levels. Although LDL levels declined over time in non-survivors, this decrease was not statistically significant. Longitudinal analysis showed normalization of LDL levels post-recovery, while HDL levels remained persistently low. Conclusions: Despite observable alterations in lipid profiles, their prognostic significance in this cohort was limited. These findings highlight the need for further investigation into the role of lipid metabolism in the pathophysiology of COVID-19.
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Ishchenko, Alla, M. Van Mechelen, Lies Storms, et al. "Low apolipoprotein A1 and high apolipoprotein B levels indicate specific lipid changes in treatment naïve early psoriatic arthritis." RMD Open 11, no. 1 (2025): e005174. https://doi.org/10.1136/rmdopen-2024-005174.
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ObjectivesTo investigate serum lipid profile in early, treatment-naïve psoriatic arthritis (PsA) and to determine whether changes in classical lipids or apolipoproteins are specific to PsA.MethodsTotal cholesterol, non-high-density lipoprotein cholesterol (non-HDL-c), low-density lipoprotein cholesterol (LDL-c), HDL-c, triglycerides, apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) were compared in newly diagnosed untreated PsA patients (n=75) to sex- and age-matched controls (healthy control (HC)) (n=61) and early untreated rheumatoid arthritis (RA) patients (n=50).ResultsAmong classical lipid measurements, HDL-c levels were lower in PsA than in HC and RA (df 2, χ210, p=0.006, PsA vs HC p=0.013). Significant differences in ApoA1 and ApoB levels were observed between PsA, RA and controls. ApoB was higher in PsA than in RA patients but lower than in controls (df2, χ243.8; p<0.001). ApoA1 was markedly lower in PsA patients compared with both RA and controls (df2, χ2118.9; p<0.001). In regression models, the levels of ApoA1, adjusted for additional factors, were predictive of PsA diagnosis with 90.6% accuracy. In receiver operating characteristic analysis, ApoA1 was predictive of the diagnosis of PsA with a specificity of 82.4% and a sensitivity of 83.8% at an optimal cut-off value of 1403 µg/mL (area under the curve (95% CI), 0.886 (0.83 to 0.941)).ConclusionEarly, treatment-naïve PsA patients exhibit a distinct pro-atherogenic lipid profile, characterised by decreased ApoA1 and increased ApoB levels, distinguishing them from early RA patients and healthy controls. These findings highlight the potential of apolipoprotein measurements to serve as more accurate indicators of lipid disturbances in PsA than traditional serum lipids and as aid to diagnosis of patients presenting with early arthritis.
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Dullaart, Robin P. F., Frank Perton, Wim J. Sluiter, Rindert de Vries, and Arie van Tol. "Plasma Lecithin: Cholesterol Acyltransferase Activity Is Elevated in Metabolic Syndrome and Is an Independent Marker of Increased Carotid Artery Intima Media Thickness." Journal of Clinical Endocrinology & Metabolism 93, no. 12 (2008): 4860–66. http://dx.doi.org/10.1210/jc.2008-1213.
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Context: Lecithin:cholesterol acyltransferase (LCAT), which esterifies free cholesterol to cholesteryl esters, is required for normal plasma lipoprotein structure and is instrumental in high density lipoprotein (HDL) remodeling, but the relationship of variation in plasma LCAT activity with subclinical atherosclerosis is unclear. Objectives: The aim of the study was to determine the effect of the metabolic syndrome (MetS) on plasma LCAT activity and its relationship with carotid artery intima media thickness (IMT). Setting: The study was conducted at the vascular laboratory of a university medical center. Methods: In 74 subjects with MetS and 90 subjects without MetS (National Cholesterol Education Program Adult Treatment Panel III criteria), mean carotid artery IMT, plasma lipids, LCAT activity (exogenous substrate method), high-sensitive C-reactive protein, and homeostasis model assessment insulin resistance (HOMAir) were documented. Results: IMT was greater (P = 0.01) and plasma LCAT activity was higher (P &lt; 0.001) in subjects with MetS compared to subjects without MetS. Similar increases in IMT and LCAT were found in MetS subjects without type 2 diabetes mellitus. Multiple linear regression analysis demonstrated that plasma LCAT activity was independently and positively related to HOMAir, plasma triglycerides, non-HDL cholesterol, and HDL cholesterol (all P &lt; 0.001). After adjustment for age and sex, IMT was positively associated with LCAT activity (P &lt; 0.01), independently of the presence of MetS (or alternatively of plasma lipids), HOMAir, and high-sensitive C-reactive protein. Conclusions: Plasma LCAT activity is elevated in MetS and may be a marker of subclinical atherosclerosis. Our findings do not support the contention that strategies to elevate LCAT are necessarily beneficial for cardioprotection.
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San Mauro Martín, Ismael, Elena Garicano Vilar, Sara Sanz Rojo, et al. "Gene Influence in the Effectiveness of Plant Sterols Treatment in Children: Pilot Interventional Study." Nutrients 11, no. 10 (2019): 2538. http://dx.doi.org/10.3390/nu11102538.
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Cardiovascular disease is linked to high serum low density lipoprotein (LDL)-cholesterol levels. Cardiovascular risk may be indirectly influenced by genetic load. Serum LDL-cholesterol levels may be reduced by the consumption of food enriched with plant sterols (PS). The aim was to test a plant sterol treatment on cholesterol levels according to different genetic polymorphisms. A pilot interventional trial was performed in 26 children (n = 16 girls, n = 10 boys). Seven hundred milliliters/day of commercial skimmed milk with added plant sterols delivering 2.2 g plant sterols were ingested for three weeks. Blood draws were performed at the baseline and end of the study. Significant modifications of non-high density lipoprotein (HDL)-cholesterol (p = 0.010; p = 0.013) and LDL-cholesterol (p = 0.004; p = 0.013) levels appeared in the genes LIPC C-514T and PPAR-α L162V carriers. No statistically significant differences were observed for other genes. LIPC C-514T and PPAR-alpha L162V carriers could benefit from a plant sterol supplement to ameliorate hypercholesterolemia.
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Yoshida, H., R. Kusukawa, N. Watanabe, G. Ohtsuki, T. Sakamoto, and R. Haranaka. "The Effects of Ba-wei-wan (Hachimijiogan) on Plasma Levels of High Density Lipoprotien-cholesterol and Lipoperoxide in Aged Individuals." American Journal of Chinese Medicine 13, no. 01n04 (1985): 71–76. http://dx.doi.org/10.1142/s0192415x85000113.
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Ba-wei-wan was administered for 7 months to 24 aged, non-hospitalized subjects. Laboratory examinations showed an improvement in serum or plasma levels of total lipid, LPO and HDL-C. Other blood examinations were shown to be unaffected by the treatment. To reconfirm the effects of Ba-wei-wan on lipid metabolism, the three step adiminstration of the drug was employed. The elevation of HDL-C levels and the decrease of LPO levels were obtained by this treatment. The discontinuation of this drug induced the converse effect on the plasma levels; decreased HDL-C and increased LPO. It could be concluded from these results that Ba-wei-wan administration improved the lipid metabolism in the aged subjects.
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Dr, Aqsa Choudhary Dr Masooma Batool Dr Muntaha Munawar. "A DESCRIPTIVE RESEARCH TO ASSESS THE LIPID PROFILE AMONG PATIENTS DIAGNOSED WITH HYPERTENSION AT MAYO HOSPITAL, LAHORE." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES o6, no. 04 (2019): 8548–55. https://doi.org/10.5281/zenodo.2652822.
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<strong><em>Objective: </em></strong><em>The purpose of this study was to see the lipid profile in hypertension cases.</em> <strong><em>Methods: </em></strong><em>This descriptive study held at Mayo Hospital, Lahore from April 2017 to August 2018. A total of 100 patients admitted with hypertension were the participants of the study. The patients are in the range of 40-80 years. Both known hypertensive patients who were on treatment for a varying time and newly diagnosed hypertensive patients participated in the study.</em> <strong><em>Results: </em></strong><em>Serum TC, LDL/ HDL, VLDL, TGL, TC/HDL, LDL, were much higher within the hypertensive group in comparison with healthy controls. HDL serum was deficient within patients of hypertension in comparison with controls, and the LDL was high within obese in comparison with non-obese patient value for both HDL and LDL was statistically significant. It was definitely found that LDL /HDL and TC/ HDL were high within obese patients, TC was high in the group of CVA, LDL was high in the IHD group, TC was high in the IHD group, LDL was high in the CVA group, and LDL/ HDL along with TC/ HDL was high in the CVA group in comparison with non-CVA group.</em> <strong><em>Conclusion: </em></strong><em>There was significant variation of lipid profile within hypertensive patients in comparison with controls. LDL cholesterol, triglycerides, total cholesterol, LDL/HDL, TC/HDL, and VLDL ratios were high within patients of hypertension. HDL was reduced in hypertensive patients. Hyperlipidemia was often observed in most cases of patients with Type IIa pattern. Mean TC /HDL, TC, LDL/ HDL, LDL were found high within obese. Average TC, TC/ HDL, LDL/ HDL, and LDL ratios are raised in a group of CVA. The average TC and LDL were high in the group of IHD. </em> <strong><em>Keywords</em></strong><em>: Hypertension; TC; LDL; HDL; VLDL; TGL; Cerebrovascular accident; Ischemic heart diseases; Obesity.</em>
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Islam, Syed, Raghava Danwada, Minoti Ganguli, Ramon Espaillat, Michael Jarvis, and H. Peter Bacher. "Evaluation of Lipid Profile and Residual Cardiovascular Risk in Patients Prior to Initiation of Niaspan Therapy." Journal of Pharmacy Technology 34, no. 1 (2017): 3–8. http://dx.doi.org/10.1177/8755122517745650.
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Background: Despite significant impact of statins, there are a number of patients with residual risk of cardio vascular disease who have optimally controlled low-density lipoprotein cholesterol (LDL-C). Niaspan (extended-release nicotinic acid or niacin-ER) is indicated for its use as monotherapy for the treatment of very high triglyceride (TG) levels and for the raising of high-density lipoprotein cholesterol (HDL-C) representing those residual risk populations. The patient characteristics and lipid profile, prior to initiation of therapy, in the real-world clinical setting has not been well documented. Objectives: This study evaluated lipid levels among patients initiating Niaspan in real-world clinical practice. Methods: Patients with a first prescription of Niaspan were identified using electronic medical record data from GE. Lipid values were categorized into optimal and nonoptimal TG or HDL-C levels. Results: There were 89 091 new users. Most patients had nonoptimal TG, HDL-C, TG/HDL-C ratio, LDL-C, and non-HDL-C levels. Among those with nonoptimal TG and HDL, the ratio of TG to HDL-C was higher among younger age groups (mean ratio 12.0 in males; 10.58 in females aged 18 to <40 years). TG was significantly correlated with non-HDL-C (0.41, P < .001) but not with LDL-C. Among those with LDL-C <100 mg/dL, 64.3% had nonoptimal TG/HDL-C ratio and approximately 70% had non-HDL-C ≥130 mg/dL. More than a third of the patients had diagnosis of coronary heart disease or coronary heart disease risk equivalent. Conclusion: Majority of Niaspan users had nonoptimal TG and/or HDL-C. The correlation of nonoptimal TG levels with non-HDL-C levels further support that Niaspan was targeted to population with residual risk for cardiovascular disease.
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Braet, Drew J., Kian Pourak, Vibav Mouli, et al. "Non-high-density lipoprotein cholesterol and treatment targets in vascular surgery patients." Vascular, September 15, 2022, 170853812211262. http://dx.doi.org/10.1177/17085381221126232.
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Introduction Low-density lipoprotein cholesterol (LDL) is a known contributing factor to atherosclerotic cardiovascular disease (ASCVD) and a primary therapeutic target for medical management of ASCVD. Non-high-density lipoprotein cholesterol (non-HDL) has recently been identified as a secondary therapeutic target but is not yet widely used in vascular surgery patients. We sought to assess if vascular surgery patients were undertreated per non-HDL therapeutic guidelines. Methods This was an observational study that used a single-center database to identify a cohort of adult patients who received care from a vascular surgery provider from 01/2001 to 07/2021. ICD-9/10-CM codes were used to identify patients with a medical history of hyperlipidemia (HLD), coronary artery disease (CAD), cerebrovascular occlusive disease (CVOD), peripheral artery disease (PAD), hypertension (HTN), or diabetes mellitus (DM). Patient smoking status and medications were also identified. Lab values were obtained from the first and last patient encounter within our system. Primary outcomes were serum concentrations of LDL and non-HDL, with therapeutic thresholds defined as 70 mg/dL and 100 mg/dL, respectively. Results The cohort included 2465 patients. At first encounter, average age was 59.3 years old, 21.4% were on statins, 8.4% were on a high-intensity statin, 25.7% were diagnosed with HLD, 5.2% with CAD, 15.3% with PAD, 26.3% with DM, 18.6% with HTN, and 2.1% with CVOD. At final encounter, mean age was 64.8 years, 23.5% were on statins with 10.1% on high-intensity statin. Diagnoses frequency did not change at final encounter. At first encounter, nearly two-thirds of patients were not at an LDL <70 mg/dL (62.3%) or non-HDL <100 mg/dL (66.0%) with improvement at final encounter to 45.2 and 40.5% of patients not at these LDL or non-HDL treatment thresholds, respectively. Patients on statins exhibited similar trends with 51.1 and 50.1% of patients not at LDL or non-HDL treatment thresholds at first encounter and 39.9 and 35.4% not at LDL or non-HDL treatment thresholds at last encounter. Importantly, 6.9% of patients were at LDL but not non-HDL treatment thresholds. Discussion Among vascular surgery patients, over half did not meet non-HDL targets. These results suggest that we may be vastly under-performing adequate medical optimization with only about one-fourth of patients on a statin at their final encounter and approximately one-tenth of patients being treated with a high-intensity statin. With recent evidence supporting non-HDL as a valuable measurement for atherosclerotic risk, there is potential to optimize medical management beyond current high-intensity statin therapy. Further investigation is needed regarding the risk of adverse events between patients treated with these varied therapeutic targets.
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Plakogiannis, Roda, Joseph J. Saseen, and Abraham Stefanidis. "Pharmacists’ Utilization of Non-HDL-C Levels in Managing Patients With Lipid Disorders." Hospital Pharmacy, March 6, 2020, 001857872091038. http://dx.doi.org/10.1177/0018578720910380.
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Background: Since 2013 there have been cholesterol guideline changes impacting pharmacists’ clinical practice in managing lipid disorders. For more than a decade, cholesterol management was based on the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol Adult Treatment Panel III guideline, highlighting non-high-density lipoprotein cholesterol (non-HDL-C) as a secondary target in persons with triglycerides ≥200 mg/dL, after low-density lipoprotein cholesterol goal attainment. The 2013 American College of Cardiology and American Heart Association (ACC/AHA) guideline differed from the traditional management of dyslipidemia, in part no longer emphasizing the utilization of non-HDL-C levels. Objective: To measure pharmacists’ attitudes and behavior regarding utilization of non-HDL-C level calculation before and after the inception of the 2013 ACC/AHA cholesterol guideline. Methods: Pharmacists in the American College of Clinical Pharmacy ambulatory care listserv participated in an electronic survey in November 2013, before the inception of the 2013 ACC/AHA guideline, and again in October 2018. Results: We collected 391 usable responses from participants; 212 responses in 2013 and 179 responses in 2018. The before and after comparison revealed that respondents in 2013 reported significantly higher frequency of calculating non-HDL-C levels (mean = 1.88, SD = 0.80) than respondents in 2018 (mean = 1.66, SD = 0.79) ( P ≤ .001). Also, the frequency that non-HDL-C level calculation alters decisions regarding course of treatment was lower in the 2018 (mean = 3.50, SD = 1.06) in comparison with 2013 (mean = 3.77, SD = 0.88) ( P ≤ .05). Furthermore, pharmacists were more favorable toward the inclusion of non-HDL-C level calculation in 2018 (mean = 3.77, SD = 1.05) than in 2013 (mean = 3.13, SD = 1.33) ( P ≤ .001). Conclusion and Relevance: Clinical pharmacists’ utilization of non-HDL-C levels in the clinical management of patients with hypercholesterolemia has decreased, highlighting the need for further education on the importance of evaluating non-HDL-C levels in the very high-risk atherosclerotic cardiovascular disease population.
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"Repositioning of the global epicentre of non-optimal cholesterol." Nature 582, no. 7810 (2020): 73–77. http://dx.doi.org/10.1038/s41586-020-2338-1.
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AbstractHigh blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
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Elshazly, Mohamed B., Seth S. Martin, Parag H. Joshi, Michael J. Blaha, Krishnaji R. Kulkarni, and Steven R. Jones. "Abstract 401: Relative Population Percentiles of LDL Cholesterol, Non-HDL Cholesterol and Total Cholesterol to HDL Cholesterol Ratio: The Very Large Database of Lipids Study (VLDL-2)." Arteriosclerosis, Thrombosis, and Vascular Biology 33, suppl_1 (2013). http://dx.doi.org/10.1161/atvb.33.suppl_1.a401.
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Background Non-HDL cholesterol (non-HDL-C) and the total cholesterol to HDL cholesterol ratio (TC/HDL-C) are alternatives to LDL cholesterol (LDL-C) in risk assessment and decision-making for lipid-lowering therapy. Methods We assigned population percentiles to non-HDL-C, TC/HDL-C and LDL-C in 1,340,614 U.S. adults from the Very Large Database of Lipids (VLDL). The distributions of TC, HDL-C, LDL-C and TG in the VLDL were nearly identical to those in the NHANES 2007-2008 survey. Lipids were measured by ultracentrifugation (Atherotech; Birmingham, AL). LDL-C was estimated by the Friedewald method, excluding patients with TG ≥400 mg/dL (2.3% of sample). We examined the relative values of these lipid markers across equivalent population percentiles. Results Spearman correlation (ρ) between non-HDL-C and LDL-C percentiles was high overall, ρ=0.94 but lower in patients with LDL-C <70 mg/dL, ρ=0.51; similar for TC/HDL-C and LDL-C percentiles, ρ=0.56; lower in patients with LDL-C<70 mg/dL ρ=0.13. The equivalent non-HDL-C percentile to LDL-C of 70 mg/dL was 93 mg/dL (guidelines recommend 100 mg/dL); equivalent TC/HDL-C of 2.6, the 15 th percentile. Similarly, the equivalent non-HDL-C percentile to LDL-C of 100 mg/dL was 125 mg/dL (guidelines recommend 130 mg/dL); equivalent TC/HDL-C of 3.3, the 44th percentile (Table). Conclusion Selection of treatment targets based on consistent population percentiles may have implications in risk stratification and selection of guideline target values.