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Dyslipidemia
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Susan Halli-Demeter, Lynne T. Braun
A Mediterranean diet pattern consists of unprocessed fruits and vegetables, minimal red meat, and use of monounsaturated fatty acids (MUFAs). The PREDIMED Study showed the increased use of MUFAs may lower cardiovascular risk and triglyceride levels, especially when substituting olive oil for other vegetable oils or incorporating a serving of nuts (Sofi et al., 2018; Wojda et al., 2021). When the PREDIMED cohort was reanalyzed post hoc, those in the top two quintiles with the highest vegetarian score had a significant 41% reduction in mortality (Arnett et al., 2019). A study by Gomez Marin et al. (2018) revealed that participants with type 2 diabetes who followed a Mediterranean diet rich in olive oil for three years had a significant triglyceride reduction of 17.3% area under the curve (AUC) (p=0.003) compared to baseline with improvement in postprandial lipemia and remnant cholesterol. Another study also noted a reduction in triglycerides in addition to an increase in HDL-C in patients with type 2 diabetes following the Mediterranean diet and found it to be the most effective in overall reduction of diabetic dyslipidemia (Neuenschwander et al., 2019). Adherence to the Mediterranean diet had an inverse association with cardiometabolic disorders and polypharmacy in over 500 Italian adults aged 50–89 years in one study (Vicinanza et al., 2018). Subjects with low to moderate adherence to a Mediterranean diet had a higher prevalence of arterial hypertension, dyslipidemia, and diabetes compared to those with high adherence (p < 0.001). Conversely, a review of 30 randomized controlled trials (over 12,000 patients) evaluating the benefit of the Mediterranean diet in primary and secondary prevention of cardiovascular disease events and risk factors found some uncertainty regarding its effects (Rees et al., 2019). They found low to moderate quality of evidence supporting the benefits of the Mediterranean diet in cardiovascular risk factors in primary prevention and low quality evidence in reduction of cardiovascular and total mortality (Rees et al., 2019).
Association of metabolic dysfunction-associated fatty liver disease with chronic kidney disease: a Chinese population-based study
Published in Renal Failure, 2022
Qian Hu, Yao Chen, Ting Bao, Yan Huang
Remnant cholesterol is defined as triglyceride-rich lipoprotein cholesterol and is calculated as total cholesterol minus HDL-C and LDL-C. Recent studies have confirmed that remnant cholesterol, not HDL-C or LDL-C, is significantly associated with an increased risk of CVD [17,18]. A higher level of remnant cholesterol was also related to the prevalence of CKD in a general middle-aged population [19] and was predictive of all-cause, cardiovascular-related, and cancer-related mortality in individuals with MAFLD [20]. In our study, we demonstrated that remnant cholesterol was independently related to an increased risk of CKD in all subjects after PSM, as well as in individuals with MAFLD with DM or prediabetes, which suggests that elevated serum remnant cholesterol might contribute to the development of CKD in subjects with MAFLD. According to these findings, screening and evaluation of remnant cholesterol can more accurately identify a high risk of CKD and prevent prevalent CKD. Further studies are needed to elucidate the value of remnant cholesterol monitoring in MAFLD management.
Coronary atherosclerotic plaque progression: contributing factors in statin-treated patients
Published in Expert Review of Cardiovascular Therapy, 2020
Donald Clark, Rishi Puri, Steven E. Nissen
Remnant cholesterol is calculated from the standard lipid profile as TC – HDL-C – LDL-C, representing atherogenic triglyceride-rich lipoproteins (TGRLs) including remnants of very-low-density lipoprotein cholesterol, intermediate-density lipoprotein, and chylomicrons. Mendelian randomization data suggest that remnant cholesterol is causally related to ischemic heart disease, and a post hoc analysis of the Treating to New Targets (TNT) trial demonstrated that increased remnant cholesterol levels are associated with greater cardiovascular risk among statin-treated patients [44,45]. Complimentary findings were reported in a pooled IVUS analysis among 5,754 patients with coronary artery disease showing that remnant cholesterol was associated with atheroma progression regardless of on-treatment conventional lipid parameters, C-reactive protein, or clinical risk factors [46]. Collectively, these data support further investigation into remnant cholesterol-lowering interventions to target residual cardiovascular risk among statin-treated patients.
Age- and sex-specific reference values for non-HDL cholesterol and remnant cholesterol derived from the Nordic Reference Interval Project (NORIP)
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2019
Peter Ridefelt, Emil Hagström, Maria K. Svensson, Torbjörn Åkerfeldt, Anders Larsson
Cardiovascular diseases (CVD) are a worldwide leading cause of death, especially in developed countries [1]. Traditionally patients with CVD are monitored with regard to lipids with total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and triglycerides with an emphasis on LDL-C values [2]. LDL-C does not include the participation of other lipoprotein fractions such as lipoprotein a (Lp (a)) and the triglyceride rich very low-density lipoprotein (VLDL) cholesterol which have been suggested to be involved in and contribute to the development of atherosclerosis. Further, the prevalence of patients being obese, having the metabolic syndrome and type 2 diabetes mellitus are increasing. These are all conditions known to increase the proportion of triglyceride rich lipoproteins (TRLs). Over the last decade there has, therefore, been an increased interest in and use of non-HDL-C and remnant cholesterol (remnant-C) as both causal for atherosclerosis and risk markers for CVD and all-cause mortality [3,4].