Abstract
Background: Elevated fasting remnant cholesterol (REM-C) levels have been associated with an increased cardiovascular risk in patients with metabolic syndrome (Mets) and Non-Alcoholic Fatty Liver Disease (NAFLD). We aimed to estimate the effect of different diets on REM-C levels in patients with MetS, as well as the association between NAFLD and REM-C. Methods: This is a secondary analysis of the MEDIDIET study, a parallel-arm Randomized Clinical Trial (RCT). We examined 237 people with MetS who underwent Liver Ultrasound (LUS) to assess the NAFLD score at baseline, 3-, and 6-months follow-up. Subjects were randomly assigned to the Mediterranean diet (MD), Low Glycemic Index diet (LGID), or Low Glycemic Index Mediterranean diet (LGIMD). REM-C was calculated as [total cholesterol–low density lipoprotein cholesterol (LDL-C)–high density lipoprotein cholesterol (HDL-C)]. Results: REM-C levels were higher in subjects with moderate or severe NAFLD than in mild or absent ones. All diets had a direct effect in lowering the levels of REM-C after 3 and 6 months of intervention. In adherents subjects, this effect was stronger among LGIMD as compared to the control group. There was also a significant increase in REM-C levels among Severe NAFLD subjects at 3 months and a decrease at 6 months. Conclusions: fasting REM-C level is independently associated with the grade of severity of NAFLD. LGIMD adherence directly reduced the fasting REM-C in patients with MetS.
Highlights
Hyperlipidemia is a condition characterized by elevated levels of serum lipids
As no studies of the impact of diet on the relationship between remnant cholesterol (REM-C) and metabolic syndrome (MetS) have yet been reported, we aimed to estimate the effect of different diets on REM-C levels in patients with MetS, as well as the association between Non-Alcoholic Fatty Liver Disease (NAFLD) and REM-C in patients enrolled in the Randomized Clinical Trial (RCT), by performing a secondary analysis [29]
All diets had a direct effect in lowering the levels of REM-C after 3 and 6 months of intervention in subjects with MetS
Summary
Hyperlipidemia is a condition characterized by elevated levels of serum lipids. Excess lipids in the blood commonly accumulate in the walls of arteries and several studies have established the central role of hyperlipidemia in the development of cardiovascular diseases (CVD) [1,2]. Even after a reduction of LDL-C to the recommended concentrations, there is still a considerable residual risk of recurrent cardiovascular events, so lowering LDL-C levels alone is insufficient [8]. Some of this residual risk may be attributed to elevated remnant cholesterol (REM-C). Elevated fasting remnant cholesterol (REM-C) levels have been associated with an increased cardiovascular risk in patients with metabolic syndrome (Mets) and Non-Alcoholic. All diets had a direct effect in lowering the levels of REM-C after 3 and 6 months of intervention In adherents subjects, this effect was stronger among
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