Abstract
Low-density lipoprotein (LDL-C) concentrations are a standard of care in the prevention of cardiovascular disease and are influenced by different factors. This study compared the LDL-C concentrations estimated by two different equations and determined their associations with inflammatory status, oxidative stress, anthropometric variables, food intake and DNA methylation levels in the LPL, ADRB3 and MTHFR genes. A cross-sectional population-based study was conducted with 236 adults (median age 37.5 years) of both sexes from the municipality of João Pessoa, Paraíba, Brazil. The LDL-C concentrations were estimated according to the Friedewald and Martin equations. LPL, ADRB3 and MTHFR gene methylation levels; malondialdehyde levels; total antioxidant capacity; ultra-sensitive C-reactive protein, alpha-1-acid glycoprotein, homocysteine, cobalamin, and folic acid levels; usual dietary intake; and epidemiological variables were also determined. For each unit increase in malondialdehyde concentration there was an increase in the LDL-C concentration from 6.25 to 10.29 mg/dL (p <0.000). Based on the Martin equation (≥70 mg/dL), there was a decrease in the DNA methylation levels in the ADRB3 gene and an increase in the DNA methylation levels in the MTHFR gene (p <0.05). There was a positive relation of homocysteine and cholesterol intake on LDL-C concentrations estimated according to the Friedewald equation and of waist circumference and age based on the two estimates. It is concluded the LDL-C concentrations estimated by the Friedewald and Martin equations were different, and the Friedewald equation values were significantly lower than those obtained by the Martin equation. MDA was the variable that was most positively associated with the estimated LDL-C levels in all multivariate models. Significant relationships were observed based on the two estimates and occurred for most variables. The methylation levels of the ADRB3 and MTHFR genes were different according to the Martin equation at low LDL-C concentrations (70 mg/dL).
Highlights
Worldwide guidelines focus on low-density lipoprotein cholesterol (LDL-C) cut-off values as evidence-based standards for the prevention and treatment of cardiovascular disease (CVD)
The LDL-C concentrations estimated by the Friedewald and Martin equations were different, and the Friedewald equation values were significantly lower than those obtained by the Martin equation
MDA was the variable that was most positively associated with the estimated LDL-C levels in all multivariate models composed of variables associated with LPL, ADRB3 and methylenetetrahydrofolate reductase (MTHFR) gene methylation levels, oxidative stress, inflammation, abdominal obesity, food intake and epidemiological variables
Summary
Worldwide guidelines focus on low-density lipoprotein cholesterol (LDL-C) cut-off values as evidence-based standards for the prevention and treatment of cardiovascular disease (CVD). Many of these guidelines attribute the highest level of evidence (class 1) to LDL-C treatment goals [1,2,3,4,5]. In this context, the usefulness of treatment goals depends on the accuracy of the estimation used to assess LDL-C values. The Martin equation has been applied in studies with individuals undergoing treatment due to high cardiovascular risk, having as a therapeutic goal the reduction in LDL-C to
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