Abstract
This study intended to determine the impact of HDL-c and/or TGs levels on patients with average LDL-c concentration, focusing on lipidic, oxidative, inflammatory, and angiogenic profiles. Patients with cardiovascular risk factors (n = 169) were divided into 4 subgroups, combining normal and low HDL-c with normal and high TGs patients. The following data was analyzed: BP, BMI, waist circumference and serum glucose, Total-c, TGs, LDL-c, oxidized-LDL, total HDL-c and HDL subpopulations, paraoxonase-1 (PON1) activity, hsCRP, uric acid, TNF-α, adiponectin, VEGF, and iCAM1. The two populations with increased TGs levels, regardless of the normal or low HDL-c, presented obesity and higher waist circumference, Total-c, LDL-c, Ox-LDL, and uric acid. Adiponectin concentration was significantly lower and VEGF was higher in the population with cumulative low values of HDL-c and high values of TGs, while HDL quality was reduced in the populations with impaired values of HDL-c and/or TGs, viewed by reduced large and increased small HDL subfractions. In conclusion, in a population with cardiovascular risk factors, low HDL-c and/or high TGs concentrations seem to be associated with a poor cardiometabolic profile, despite average LDL-c levels. This condition, often called residual risk, is better evidenced by using both traditional and nontraditional CV biomarkers, including large and small HDL subfractions, Ox-LDL, adiponectin, VEGF, and uric acid.
Highlights
Dyslipidemia is recognized as one of the major risk factors for the development of cardiovascular disease (CVD), which remains the leading cause of death across Europe [1].The 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors, known as statins, are the first-line lipid-lowering agents for CVD patients and have transformed the treatment of dyslipidaemia
At five years, and reducing low density lipoprotein cholesterol (LDL-c) by 40 mg/dL (1 mmol/L) with statin therapy leads to a 20% reduction in risk for coronary events [2, 3]; for every mmol/L reduction in LDL-c, the risk of coronary heart disease (CHD) mortality decreases by 19% and overall mortality decreases by 12% [2, 4]
The present study aimed to evaluate the influence of low high density lipoprotein cholesterol (HDL-c) and/or elevate TGs levels and the relative relevance of each one alone and combined on the cardiometabolic profile of patients with cardiovascular risk factors but average LDL-c contents, using both traditional and new nontraditional markers, including HDL subpopulations, oxidized LDL (Ox-LDL), and inflammatory and angiogenesis mediators
Summary
Dyslipidemia is recognized as one of the major risk factors for the development of cardiovascular disease (CVD), which remains the leading cause of death across Europe [1].The 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors, known as statins, are the first-line lipid-lowering agents for CVD patients and have transformed the treatment of dyslipidaemia. Dyslipidemia is recognized as one of the major risk factors for the development of cardiovascular disease (CVD), which remains the leading cause of death across Europe [1]. At five years, and reducing low density lipoprotein cholesterol (LDL-c) by 40 mg/dL (1 mmol/L) with statin therapy leads to a 20% reduction in risk for coronary events [2, 3]; for every mmol/L reduction in LDL-c, the risk of coronary heart disease (CHD) mortality decreases by 19% and overall mortality decreases by 12% [2, 4]. It is apparent that a greater number of residual cardiovascular events occur than are prevented with statin therapy; the RCVR remains elevated even in clinical trials in which LDL-c levels have been aggressively reduced [11,12,13]. There has been an increased focus on elevated triglycerides (TGs) and decreased high density lipoprotein cholesterol (HDL-c) levels and their significant contributions to RCVR even when LDL-c levels are well controlled [14, 15]
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