A New Start for Triglycerides and Remnant Cholesterol-Nonfasting.

Abstract

Featured Article: Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA 2007;298:299–308.3 My first independent scientific project was to understand why patients with lipoprotein lipase (LPL) deficiency, the chylomicronemia syndrome, and severely increased plasma triglycerides did not develop cardiovascular disease. At the time this was a great mystery, one that led to the belief that triglycerides, unlike cholesterol, were not important for the development of atherosclerosis and cardiovascular disease. This belief was supported by studies by George Lyman Duff and others, published in the late 1940s, showing that the alloxan-diabetic, cholesterol-fed rabbit with severely increased triglycerides likewise did not develop atherosclerosis. I started my studies in the mid-1980s at the University of Copenhagen together with Dr. and later Professor Steen Stender, and continued in the laboratory of Professor Donald Zilversmit at Cornell University in New York. Using the alloxan-diabetic, cholesterol-fed rabbit we showed that, at severely increased triglycerides, most lipoproteins were chylomicron-like with diameters above 75 nm and that these lipoproteins were unable to enter into the arterial intima, explaining the lack of atherosclerosis development …