Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM

Langlois, Michel; Nordestgaard, Børge G.; Langsted, Anne; Chapman, M. John; Aakre, Kristin Moberg; Baum, Hannsjörg; Borén, Jan; Bruckert, Éric; Catapano, Alberico L.; Cobbaert, Christa; Collinson, Paul; Descamps, Olivier; Duff, Christopher J; Eckardstein, Arnold von; Hammerer-Lercher, Angelika; Kamstrup, Pia R.; Kolovou, Genovefa; Kronenberg, Florian; Mora, Samia; Pulkki, Kari; Remaley, Alan T.; Rifai, Nader; Ros, Emilio; Stanković, Sanja; Stavljenić-Rukavina, Ana; Sypniewska, Grażyna; Watts, Gerald F.; Wiklund, Olov; Laitinen, Päivi

doi:10.1016/j.atherosclerosis.2019.12.005

Cited by 162 publications

(93 citation statements)

References 95 publications

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“…Thus, the initially observed sex differences could be due to the somewhat lower cholesterol concentrations in the male subjects of our study. The median serum cholesterol concentration in our subjects is within the sex-specific reference ranges reported for the age group 66–100 years, which also indicate lower values for men compared to women [ 53 ]. Furthermore, in our study, a lower percentage of men compared to women takes lipid-modifying drugs and suffers from diseases with possible impact on blood lipids.…”

Section: Discussionsupporting

confidence: 78%

Interrelation between Plasma Concentrations of Vitamins C and E along the Trajectory of Ageing in Consideration of Lifestyle and Body Composition: A Longitudinal Study over Two Decades

Jungert

Neuhäuser‐Berthold

2020

Nutrients

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Although the interrelation between vitamins C and E has been demonstrated on an experimental level, its impact on biomarkers in community-dwelling subjects along the trajectory of ageing has not yet been shown. The present longitudinal study investigates the determinants and interrelation of vitamins C and E plasma concentrations in 399 subjects aged ≥60 years with a median follow-up time of 12 years. Linear mixed-effects models were used to analyze the influence of age, sex, body composition, dietary intake, physical activity, smoking and supplement/drug use on plasma vitamin C, plasma α-tocopherol and α-tocopherol/total cholesterol ratio. At baseline, median plasma concentrations of vitamin C and α-tocopherol were 74 and 35 µmol/L. Absolute fat-free mass, physical activity, use of supplements, and plasma α-tocopherol were main determinants of plasma vitamin C in the course of ageing. For the α-tocopherol/total cholesterol ratio, age, use of supplements, use of lipid-modifying drugs, and plasma vitamin C were main determinants. The results reveal a stable positive interrelation between plasma concentrations of vitamins C and E along the trajectory of ageing independent of the other identified determinants. The possible regulatory mechanisms that could explain this robust positive interrelation remain to be elucidated.

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Section: Discussionsupporting

confidence: 78%

Interrelation between Plasma Concentrations of Vitamins C and E along the Trajectory of Ageing in Consideration of Lifestyle and Body Composition: A Longitudinal Study over Two Decades

Jungert

Neuhäuser‐Berthold

2020

Nutrients

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“…Low HDL-cholesterol was defined as < 50 mg/dL in women and < 40 mg/dL in men; and high triglycerides as ≥ 150 mg/dL [ 21 ]. Non-HDL-cholesterol was calculated as total cholesterol minus HDL-cholesterol; and remnant cholesterol as total cholesterol minus HDL-cholesterol minus LDL-cholesterol [ 22 ]. The eGFR was obtained using the Chronic Kidney Disease-Epidemiology Collaboration equation (CKD-EPI) [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Advanced lipoprotein profile disturbances in type 1 diabetes mellitus: a focus on LDL particles

Amor

Castelblanco

Hernández

et al. 2020

Cardiovasc Diabetol

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Background: Lipoprotein disturbances have been associated with increased cardiovascular disease (CVD) risk in type 1 diabetes mellitus (T1DM). We assessed the advanced lipoprotein profile in T1DM individuals, and analysed differences with non-diabetic counterparts. Methods: This cross-sectional study involved 508 adults with T1DM and 347 controls, recruited from institutions in a Mediterranean region of Spain. Conventional and advanced (assessed by nuclear magnetic resonance [NMR] spectroscopy) lipoprotein profiles were analysed. Crude and adjusted (by age, sex, statin use, body mass index and leukocyte count) comparisons were performed. Results: The median (interquartile range) age of the study participants was 45 (38-53) years, 48.2% were men. In the T1DM group, the median diabetes duration was 23 (16-31) years, and 8.1% and 40.2% of individuals had nephropathy and retinopathy, respectively. The proportion of participants with hypertension (29.5 vs. 9.2%), and statin use (45.7% vs. 8.1%) was higher in the T1DM vs. controls (p < 0.001). The T1DM group had a better conventional (all parameters, p < 0.001) and NMR-lipid profile than the control group. Thus, T1DM individuals showed lower concentrations of atherogenic lipoproteins (VLDL-particles and LDL-particles) and higher concentrations of anti-atherogenic lipoproteins (HDL-particles) vs. controls, even after adjusting for several confounders (p < 0.001 for all). While non-diabetic women had a more favourable lipid profile than non-diabetic men, women with T1DM had a similar concentration of LDL-particles compared to men with T1DM (1231 [1125-1383] vs. 1257 [1128-1383] nmol/L, p = 0.849), and a similar concentration of small-LDL-particles to non-diabetic women (672.8 [614.2-733.9] vs. 671.2 [593.5-761.4] nmol/L, respectively; p = 0.790). Finally, T1DM individuals showed higher discrepancies between NMR-LDL-particles and conventional LDLcholesterol than non-diabetic subjects (prevalence of LDL-cholesterol < 100 mg/dL & LDL-particles > 1000 nmol/L: 38 vs. 21.2%; p < 0.001). All these differences were largely unchanged in participants without lipid-lowering drugs (T1DM, n = 275; controls, n = 317).

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“…Considering that Lp(a)-corrected LDL-C (mg/dL) = LDL-C (mg/dL) — [Lp(a) (mg/dL) × 0.30] , Lp(a)-corrected LDL-C is 55−70 mg/dL in a person with an LDL-C concentration of 100 mg/dL and an Lp(a) concentration of 100 mg/dL [ 159 , 160 ]. If LDL-C is expressed in mmol/L the formula is as follows: Lp(a)-corrected LDL-C (mmol/L) = LDL-C (mmol/L)—[Lp(a) (mg/dL) × 0.0078] [ 161 ]. Although the confounding effect of Lp(a) cholesterol on the phenotypic diagnosis of FH in people with hyperlipoproteinemia(a) has been highlighted, to confirm its practical implications for the care of patients requires further studies [ 74 ].…”

Section: Future Perspectives and Conclusionmentioning

confidence: 99%

Lipoprotein(a) Lowering—From Lipoprotein Apheresis to Antisense Oligonucleotide Approach

Greco

Sirtori

Corsini

et al. 2020

JCM

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It is well-known that elevated lipoprotein(a)—Lp(a)—levels are associated with a higher risk of cardiovascular (CV) mortality and all-cause mortality, although a standard pharmacotherapeutic approach is still undefined for patients with high CV risk dependent on hyperlipoproteinemia(a). Combined with high Lp(a) levels, familial hypercholesterolemia (FH) leads to a greater CVD risk. In suspected FH patients, the proportion of cases explained by a rise of Lp(a) levels ranges between 5% and 20%. In the absence of a specific pharmacological approach able to lower Lp(a) to the extent required to achieve CV benefits, the most effective strategy today is lipoprotein apheresis (LA). Although limited, a clear effect on Lp(a) is exerted by PCSK9 antagonists, with apparently different mechanisms when given with statins (raised catabolism) or as monotherapy (reduced production). In the era of RNA-based therapies, a new dawn is represented by the use of antisense oligonucleotides APO(a)Lrx, able to reduce Lp(a) from 35% to over 80%, with generally modest injection site reactions. The improved knowledge of Lp(a) atherogenicity and possible prevention will be of benefit for patients with residual CV risk remaining after the most effective available lipid-lowering agents.

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Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM

Cited by 162 publications

References 95 publications

Interrelation between Plasma Concentrations of Vitamins C and E along the Trajectory of Ageing in Consideration of Lifestyle and Body Composition: A Longitudinal Study over Two Decades

Interrelation between Plasma Concentrations of Vitamins C and E along the Trajectory of Ageing in Consideration of Lifestyle and Body Composition: A Longitudinal Study over Two Decades

Advanced lipoprotein profile disturbances in type 1 diabetes mellitus: a focus on LDL particles

Lipoprotein(a) Lowering—From Lipoprotein Apheresis to Antisense Oligonucleotide Approach

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