Association between Very Low-Density Lipoprotein Cholesterol (VLDL-C) and Carotid Intima-Media Thickness in Postmenopausal Women Without Overt Cardiovascular Disease and on LDL-C Target Levels

Abstract

Background: atherosclerotic process inexorably advances in patients reaching low-density lipoprotein cholesterol (LDL-C) targets. An attractive hypothesis is that lipoprotein particles (very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL)), could contribute to residual risk. The present study aims to investigate the relationship between carotid intima-media thickness (IMT) and different lipoprotein subfractions in a cohort of healthy postmenopausal women. Methods: 75 postmenopausal women, at LDL-C target levels without overt cardiovascular disease, underwent biochemical analyses (including subfraction assay of plasma lipoproteins) and carotid ultrasound examination. Results: a statistically significant correlation between VLDL and carotid IMT (p < 0.001) was found. No significant correlation was found between carotid IMT and LDL-C (p = 0.179), IDL-C (p = 0.815), high-density lipoprotein (HDL) (p = 0.855), and LDL score (p = 0.240). Moreover, IMT is significantly correlated to LDL particle diameter (p = 0.044). After adjusting for age, systolic blood pressure, body mass index, smoking habits, glucose plasma concentration, and Lipoprotein(a) (Lpa) levels, multivariate analysis showed that women in the third tertile of VLDL-C, compared with those in the first tertile, were significantly associated to the highest IMT (p = 0.04). Conclusions: in this cohort of postmenopausal women, VLDL-C was significantly associated to carotid IMT, independent of main cardiovascular risk factors. These findings pave the way for targeting circulating concentrations of VLDL-C to reduce cardiovascular events in patients with target LDL-C levels.

Estimating the Effect of Aerobic Exercise Training on Novel Lipid Biomarkers: A Systematic Review and Multivariate Meta-Analysis of Randomized Controlled Trials

“…For RCTs with a study quality score ≥ 10, AET reduced the combined biomarker Apo B100 + VLDL-C by the statistically significant amount of 0.08 mmol/L. Such a decrease in atherogenic lipoproteins and sub-fractions is also associated with a similar reduction in coronary heart disease [105][106][107]. Our results reinforce the prescription of AET as a central tool in lipid management.…”

Prevalence, patterns and predictors of metabolic abnormalities in Nigerian hypertensives with hypertriglyceridemic waist phenotype: A cross sectional study

“…Cardiovascular disease events occur in the scenario of on-target or even low levels of LDL-c and/or statin therapy in some individuals, a phenomenon referred to as residual cardiovascular risk [37]. Triglyceride-rich lipoproteins (especially VLDL) and their cholesterol content could partially explain this residual risk [38]. These lipoproteins are novel biomarkers driving residual cardiovascular risk in our contemporary era of high burden of obesity, diabetes, and PLOS GLOBAL PUBLIC HEALTH metabolic syndrome [38,39].…”

“…Triglyceride-rich lipoproteins (especially VLDL) and their cholesterol content could partially explain this residual risk [38]. These lipoproteins are novel biomarkers driving residual cardiovascular risk in our contemporary era of high burden of obesity, diabetes, and PLOS GLOBAL PUBLIC HEALTH metabolic syndrome [38,39]. The JUPITER trial demonstrated that VLDL-c, particularly the smallest remnant subclass, was associated with cardiovascular disease risk when LDL was low [40].…”

Carotid Atherosclerosis, Ultrasound and Lipoproteins

“…The study of Iannuzzi et al [ 10 ] on the association between subfractions of atherosclerotic lipoproteins and carotid atherosclerosis showed that in post-menopausal women cholesterol contained in VLDL and in IDL was significantly associated with carotid plaques, even after correction for other significant cardiovascular risk factors. In particular, the association between subclinical carotid atherosclerosis in women with higher levels of VLDL cholesterol was present even in patients without other cardiovascular disease and with normal or low levels of LDL cholesterol [ 11 ]. Among the least studied of the routinely investigated lipid parameters is small-dense LDL-C (sd-LDL-C), which is a group of LDLs with a density between 1044 g/mL and 1063 g/mL.…”