Moving beyond the “LDL hypothesis”

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 333-340 ◽  
Author(s):  
Christian Werner ◽  
Ulrich Laufs
Keyword(s):  
Ldl Cholesterol ◽  
Causal Relation ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Clinical Trial Data ◽  
Randomised Clinical Trial ◽  
Trial Data ◽  
Low Density Lipoprotein Cholesterol ◽  
Genetic Studies ◽  
Statin Drug

Abstract. Summary: The term “LDL hypothesis” is frequently used to describe the association of low-density lipoprotein cholesterol (LDL-cholesterol, LDL-C) and cardiovascular (CV) events. Recent data from genetic studies prove a causal relation between serum LDL-C and CV events. These data are in agreement with mechanistic molecular studies and epidemiology. New randomised clinical trial data show that LDL-C lowering with statins and a non-statin drug, ezetimibe, reduces CV events. We therefore believe that the “LDL-hypothesis” has been proven; the term appears to be outdated and should be replaced by “LDL causality”.

scholarly journals Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis

Biomedicines ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. 254 ◽  
Author(s):  
Chih-Sheng Chu ◽  
Shi Hui Law ◽  
David Lenzen ◽  
Yong-Hong Tan ◽  
Shih-Feng Weng ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Clinical Significance ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Exercise Stress ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

Despite the numerous risk factors for atherosclerotic cardiovascular diseases (ASCVD), cumulative evidence shows that electronegative low-density lipoprotein (L5 LDL) cholesterol is a promising biomarker. Its toxicity may contribute to atherothrombotic events. Notably, plasma L5 LDL levels positively correlate with the increasing severity of cardiovascular diseases. In contrast, traditional markers such as LDL-cholesterol and triglyceride are the therapeutic goals in secondary prevention for ASCVD, but that is controversial in primary prevention for patients with low risk. In this review, we point out the clinical significance and pathophysiological mechanisms of L5 LDL, and the clinical applications of L5 LDL levels in ASCVD can be confidently addressed. Based on the previously defined cut-off value by receiver operating characteristic curve, the acceptable physiological range of L5 concentration is proposed to be below 1.7 mg/dL. When L5 LDL level surpass this threshold, clinically relevant ASCVD might be present, and further exams such as carotid intima-media thickness, pulse wave velocity, exercise stress test, or multidetector computed tomography are required. Notably, the ultimate goal of L5 LDL concentration is lower than 1.7 mg/dL. Instead, with L5 LDL greater than 1.7 mg/dL, lipid-lowering treatment may be required, including statin, ezetimibe or PCSK9 inhibitor, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Since L5 LDL could be a promising biomarker, we propose that a high throughput, clinically feasible methodology is urgently required not only for conducting a prospective, large population study but for developing therapeutics strategies to decrease L5 LDL in the blood.

scholarly journals Variability in cholesterol measurements: comparison of calculated and direct LDL cholesterol determinations

1996 ◽  
Vol 42 (5) ◽  
pp. 732-737 ◽  
Author(s):  
G Schectman ◽  
M Patsches ◽  
E A Sasse
Keyword(s):  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density Lipoprotein Cholesterol ◽  
Lipid Disorder ◽  
Total Variability ◽  
Friedewald Equation ◽  
C Value ◽  
Hypercholesterolemic Subjects

Abstract Calculated low-density lipoprotein cholesterol (LDL-C) concentrations determined from the Friedewald equation have a large intraindividual CV, in part because the calculation incorporates the variability of cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglyceride measurements. We studied whether a new assay that measures LDL-C directly will reduce this variability and reduce the need for averaging serial specimens. Four blood samples were obtained 1 week apart from 35 mildly hypercholesterolemic subjects and analyzed for total cholesterol, triglycerides, and HDL-C. LDL-C was calculated by the Friedewald equation, and was also measured directly with a commercially available direct LDL-C assay. The intraindividual CV for the direct and calculated LDL-C assays were similar [CV of direct LDL-C assay (mean +/- SE): 6.8 +/- 0.5% vs calculated LDL-C: 7.3 +/- 0.6%; difference 0.44%, 95% confidence interval: -0.7-1.5%]. For both assays, at least two blood tests were required from each subject to reduce total variability of LDL-C to less than or equal to 5%. We conclude that the direct LDL-C assay did not reduce the variability in LDL-C compared with the conventional LDL-C calculation. However, it may have a specific role in lipid disorder evaluation and (or) monitoring when triglycerides are increased or the LDL-C value alone is needed.

scholarly journals Validation of the Modified Friedewald’s Formula to Calculate Low-density Lipoprotein Cholesterol in Bangladeshi Population

2012 ◽  
Vol 30 (3) ◽  
pp. 141-144
Author(s):  
Mimi Parvin ◽  
Muhammad Saiedullah ◽  
Aminul Haque Khan ◽  
Muhammad Rezwanur Rahman ◽  
Md Saiful Islam
Keyword(s):  
Correlation Coefficient ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Bangladeshi Population ◽  
Modified Formula

Objective: A modification of Friedewald’s formula was proposed to calculate LDL cholesterol in Bangladeshi population up to serum triglyceride concentration of 1000 mg/dL. The aim of this study was to validate the modification of Friedewald’s formula in Bangladeshi population.Methods: Serum total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol concentrations were measured in specimens obtained form 314 adult Bangladeshi subjects selected conveniently. LDL cholesterol concentrations were also calculated by modified Friedewald’s formula and original Friedewald’s formula. Results were expressed as mean ± SD and calculated LDL cholesterol was compared with measured LDL cholesterol by two-tailed paired t test and Pearson’s correlation coefficient (r).Results: The mean ± SD of measured LDL cholesterol was 138.3 ± 54.58 mg/dL. LDL cholesterol calculated by modified Friedewald’s formula and original Friedewald’s formula were 135.9 ± 59.26 mg/dL (P>0.05) and 123.5 ± 65.75 mg/dL (P<0.001) respectively. Compared to measured LDL cholesterol, calculated LDL cholesterol were 2.47 mg/ dL and 17.20 mg/dL lower for modified formula and original formula respectively. The correlation coefficient (r) with measured LDL cholesterol was 0.8601 (P<0.0001) for LDL cholesterol calculated by the modified Friedewald’s formula and 0.8565 (P<0.0001) for the LDL cholesterol calculated by the original Friedewald’s formula.Conclusion: The study validates the modified Friedewald’s formula to calculate LDL cholesterol in Bangladeshi    population. DOI: http://dx.doi.org/10.3329/jbcps.v30i3.12463 J Bangladesh Coll Phys Surg 2012; 30: 141-144

PEDIATRIC FAMILIAL TYPE II HYPERLIPOPROTEINEMIA: THERAPY WITH DIET AND CHOLESTYRAMINE RESIN

PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 669-679
Author(s):  
C. J. Glueck ◽  
R. Fallat ◽  
R. Tsang
Keyword(s):  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Type Ii ◽  
Drug Adherence ◽  
Low Density Lipoprotein Cholesterol ◽  
Familial Type ◽  
Low Cholesterol

Effects of a low cholesterol (&lt;300 mg/day), polyunsaturate rich (P:S 1.5/1) diet and cholestyramine (12 gm active resin/day) were studied in 36 children with familial type II hyperlipoproteinemia. In 11 children after six months on diet alone, cholesterol and low density lipoprotein cholesterol (LDL) were reduced to normal levels. Twenty of the 25 children whose cholesterol and LDL remained elevated on diet received 12 gm of cholestyramine per day in addition to diet. Ten of these 20 children had good drug adherence. Cholesterol and LDL cholesterol fell to normal or near normal levels in six of these ten children on cholestyramine and diet for 6 and 12 months. Ten of the 20 children had fair drug adherence (8 gm of cholestyramine taken per day) and none sustained notable decrements in cholesterol or LDL after 6 and 12 months of cholestyramine and diet. Overall, there were reductions of LDL cholesterol to normal or near normal levels in 11 of 38 children (31%) with diet alone, and in six of ten children (60%) with diet and added cholestyramine.

scholarly journals Correlation of Small Dense LDL Cholesterol and Apolipoprotein B with LDL Cholesterol and its Clinical Significance in Overweight, Type 2 Diabetes Mellitus and Coronary Artery Disease

2016 ◽  
Vol 14 (2) ◽  
pp. 36-40 ◽  
Author(s):  
Arabinda Mohan Bhattarai ◽  
HS Batra ◽  
Suchit Bandyopadhyay ◽  
Pratibha Misra ◽  
Manushri Sharma ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Apolipoprotein B ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Apo B ◽  
Artery Disease

Introduction: Atherosclerotic Coronary Artery Disease (CAD) is fundamentally related to disorders of lipid metabolism. Health problems like obesity, glucose intolerance and metabolic syndrome increase atherosclerotic CAD risk.  A fraction of Low density lipoprotein cholesterol (LDL) is called small dense low density lipoprotein cholesterol (sdLDL). These particles are more atherogenic because they are taken up more easily by arterial wall, readily oxidized and not easily cleared from plasma. Every LDL particle contain an Apo B molecule.Methods: In this cross sectional study we recruited 100 known cases each of CAD, type 2 diabetes, overweight and 100 age and sex matched healthy controls. We took a detailed case summary along with anthropometric measurements. We measured sdLDL by heparin magnesium precipitation method followed by direct estimation of the LDL in the supernatant.Result: Linear regressive analysis showed positive correlation between sdLDL and Apolipoprotein B (Apo B) with LDL cholesterol (r=0.61, p=0.004), (r=0.754, p=0.0034) respectively. Multiple Comparisons after Kruskalwallis test of sdLDL and Apo B levels of  type 2 diabetes, CAD and overweight with controls were significant (p<0.001).Conclusion: Our findings suggest that the estimation of sdLDL and Apo B provide a complimentary benefit in assessment of cases with CAD, type 2 diabetes and overweight.

scholarly journals Lipids Changes After Switch from TDF to TAF in the OPERA Cohort: LDL-cholesterol and Triglycerides

2021 ◽  
Author(s):  
Patrick W G Mallon ◽  
Laurence Brunet ◽  
Jennifer S Fusco ◽  
Girish Prajapati ◽  
Andrew Beyer ◽  
...  
Keyword(s):  
Generalized Estimating Equations ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
People Living With Hiv ◽  
Low Density Lipoprotein Cholesterol ◽  
Before And After ◽  
Tenofovir Alafenamide ◽  
Living With Hiv ◽  
Linear Splines

Abstract Background Increases in lipids have been observed in people living with HIV (PLWH) switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF). We assessed changes in low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) following a switch from TDF to TAF. Methods Adults with ≥1 lipid measure before and after switch from TDF-to-TAF were identified in the OPERA® cohort. Multivariable linear regression using generalized estimating equations were used to estimate predicted changes in lipids over time on TAF, modeled flexibly with linear splines. Results 6,451 PLWH switched from TDF-to-TAF, of whom 4,328 maintained all other agents. LDL-C increased significantly by 1.40 mg/dL/month over the first 3 months on TAF, by 0.33 mg/dL/month between 3-9 months and plateaued beyond 9 months. TG increased significantly by 3.52 mg/dL/month over the first 3 months of TAF, by 0.91 mg/mL/month between 3-9 months, and by 0.72 mg/mL/month between 9-16 months but decreased thereafter. Similar patterns were observed in analyses restricted to PLWH who switched from TDF-to-TAF but maintained all other agents. Discussion TDF-to-TAF switch was associated with LDL-C and TG increases over the first 9 to 16 months on TAF. The dynamic patterns observed cannot be attributed to changes in other agents.

scholarly journals DESCRIPTION OF LEVELS LOW DENSITY LIPOPROTEIN CHOLESTEROL (LDL) IN THE BRAHMA KUMARIS LACTO VEGETARIAN COMMUNITY ON DENPASAR CITY

2017 ◽  
Vol 4 (1) ◽  
pp. 29-38
Author(s):  
Ni Putu Yuliartini ◽  
I Putu Oka Dharmawan ◽  
Putu Ayu Parwati
Keyword(s):  
Coronary Heart Disease ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Vegetarian Diet ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Main Factors ◽  
Vegetables And Fruits ◽  
Brahma Kumaris

Coronary Heart Disease (CHD) is one of the main factors of cardiovascular disiase (Heart and blood vassel disease) one the leading cause of death in developed an developing country. One barometer in orther to know the risk factor for CHD is the lipid profile, inkluding Low Density Lipoprotein (LDL) cholesterol. This causes many people to switch to adopt a vegetarian diet. Lacto vegetarians consume foods from vegetable, vegetables and fruits, this type of vegetarians consume milk but don’t consume eggs. The goal of this study is to know the level of Low Density Lipoprotein (LDL) on lacto vegetarian in Brahma Kumaris community. The type of study is descriptive and using puposive sampling tecnique. Sampling was done in the Lacto Vegetarian Brahma Kumaris community. LDL examination results obtained from 30 respondents, this is 28 people (93.4%) with optimal levels, 1 person (3.3%) with levels close to optimal, and 1 person (3.3%) with alarming levels.

Sign in / Sign up

Export Citation Format

Share Document