Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024

Journal of clinical lipidology, Journal Year: 2024, Volume and Issue: 18(3), P. e320 - e350

Published: April 24, 2024

BACKGROUNDThis joint expert review by the Obesity Medicine Association (OMA) and National Lipid (NLA) provides clinicians an overview of pathophysiologic clinical considerations regarding obesity, dyslipidemia, cardiovascular disease (CVD) risk.METHODSThis is based upon scientific evidence, perspectives authors, peer OMA NLA leadership.RESULTSAmong individuals with adipose tissue may store over 50% total body free cholesterol. Triglycerides represent up to 99% lipid species in tissue. The potential for expansion accounts greatest weight variance among most individuals, percent fat ranging from less than 5% 60%. While population studies suggest a modest increase blood low-density lipoprotein cholesterol (LDL-C) levels excess adiposity, adiposopathic dyslipidemia pattern often described adiposity includes elevated triglycerides, reduced high density (HDL-C), increased non-HDL-C, apolipoprotein B, LDL particle concentration, small, dense particles.CONCLUSIONSObesity increases CVD risk, at least partially due promotion adiposopathic, atherogenic profile. also worsens other cardiometabolic risk factors. Among patients interventions that reduce improve outcomes are generally associated improved levels. Given improvement LDL-C reduction overweight or early treat both (LDL-C and/or non-HDL-C) priorities reducing CVD. This risk. leadership. particles.

Language: Английский

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Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024

Obesity Pillars, Journal Year: 2024, Volume and Issue: 10, P. 100108 - 100108

Published: March 12, 2024

This joint expert review by the Obesity Medicine Association (OMA) and National Lipid (NLA) provides clinicians an overview of pathophysiologic clinical considerations regarding obesity, dyslipidemia, cardiovascular disease (CVD) risk. is based upon scientific evidence, perspectives authors, peer OMA NLA leadership. Among individuals with adipose tissue may store over 50% total body free cholesterol. Triglycerides represent up to 99% lipid species in tissue. The potential for expansion accounts greatest weight variance among most individuals, percent fat ranging from less than 5% 60%. While population studies suggest a modest increase blood low-density lipoprotein cholesterol (LDL-C) levels excess adiposity, adiposopathic dyslipidemia pattern often described adiposity includes elevated triglycerides, reduced high density (HDL-C), increased non-HDL-C, apolipoprotein B, LDL particle concentration, small, dense particles. increases CVD risk, at least partially due promotion adiposopathic, atherogenic profile. also worsens other cardiometabolic risk factors. patients interventions that reduce improve outcomes are generally associated improved levels. Given improvement LDL-C reduction overweight or early treat both (LDL-C and/or non-HDL-C) priorities reducing CVD.

Language: Английский

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Triglyceride-Rich Lipoprotein Metabolism: Key Regulators of Their Flux

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(13), P. 4399 - 4399

Published: June 29, 2023

The residual risk for arteriosclerotic cardiovascular disease after optimal statin treatment may amount to 50% and is the consequence of both immunological lipid disturbances. Regarding disturbances, role triglyceride-rich lipoproteins (TRLs) their remnants has come forefront in past decade. Triglycerides (TGs) stand as markers catabolism TRLs that tend contain twice much cholesterol compared LDL. accumulation circulating partially lipolyzed derivatives, known “remnants”, caused mainly by ineffective triglyceride catabolism. These cholesterol-enriched remnant particles are hypothesized contribute atherogenesis. aim present narrative review briefly summarize main pathways TRL metabolism, bringing newly discovered apolipoproteins, key physiological function lipoprotein lipase its regulators, importance fluxes these post-prandial period, catabolic rates apo CIII angiopoietin-like proteins partition during fast-fed cycle. Finally, we provide a succinct summary new old therapeutic armamentarium outcomes current trials with final outlook on different methodological approaches measuring remnants, still search gold standard.

Language: Английский

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Lipid-based insulin-resistance markers predict cardiovascular events in metabolic dysfunction associated steatotic liver disease

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: May 20, 2024

Insulin resistance (IR) is the cornerstone of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD), pathophysiologically being key link between MASLD, metabolic disorders, and cardiovascular (CV) diseases. There are no prospective studies comparing predictive values different markers insulin in identifying presence MASLD associated risk events (CVEs).

Language: Английский

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The chylomicron saga: time to focus on postprandial metabolism

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 14

Published: Jan. 18, 2024

Since statins have had such tremendous therapeutic success over the last three decades, field of atherosclerosis has become somewhat LDL-centric, dismissing relevance triglycerides (TG), particularly chylomicrons, in atherogenesis. Nonetheless, 50% patients who take are at risk developing atherosclerotic cardiovascular disease (ASCVD) and unable to achieve their goal LDL-C levels. This residual is mediated, part by triglyceride rich lipoproteins (TRL) remnants. Following his seminal investigation on subject, Zilversmit proposed that a postprandial event 1979 (1–4). In essence, concept suggests remnant cholesterol-rich chylomicron (CM) very-low density lipoprotein (VLDL) particles play role Given foregoing, this narrative review addresses most recent improvements our understanding dyslipidemia. The primary metabolic pathways chylomicrons discussed, emphasizing critical physiological lipase apoCIII, importance these particles’ fluxes period, catabolic rate, complexities testing metabolism, angiopoietin-like proteins partition CM during fed cycle. rounded out dysregulation lipid metabolism insulin resistance states consequent CVD risk, clinical evaluation dyslipidemia, current research limits, potential future study directions.

Language: Английский

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Longitudinal changes in remnant cholesterol and the risk of cardiovascular disease

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: Jan. 2, 2025

Language: Английский

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Cumulative residual cholesterol predicts the risk of cardiovascular disease in the general population aged 45 years and older

Lipids in Health and Disease, Journal Year: 2024, Volume and Issue: 23(1)

Published: Jan. 19, 2024

Abstract Background Numerous studies have affirmed a robust correlation between residual cholesterol (RC) and the occurrence of cardiovascular disease (CVD). However, current body literature fails to adequately address link alterations in RC CVD. Existing focused mainly on individual values. Hence, primary objective this study is elucidate association cumulative (Cum-RC) morbidity Methods The changes were categorized into high-level fast-growth group (Class 1) low-level slow-growth 2) by K-means cluster analysis. To investigate relationship combined exposure multiple lipids CVD risk, weighted quantile sum (WQS) regression analysis was employed. This involved calculation weights for total (TC), low-density lipoprotein (LDL), high-density (HDL), which used effectively RC. Results Among cohort 5,372 research participants, considerable proportion 45.94% consisted males, with median age 58. In three years follow-up, 669 participants (12.45%) had Logistic revealed that Class 2 individuals significantly reduced risk developing compared 1. probability having increased 13% every 1-unit increase Cum-RC according continuous variables. restricted cubic spline (RCS) showed linearly related ( P nonlinearity = 0.679). WQS results nonsignificant trend toward an index incidence but overall positive trend, greatest contribution from TC (weight 0.652), followed LDL 0.348). Conclusion positively strongly suggesting addition focusing traditional lipid markers, early intervention patients may further reduce

Language: Английский

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Association of remnant cholesterol with coronary heart disease and severity of coronary artery stenosis in non-dialysis patients with stage 3-5 chronic kidney disease

Nutrition Metabolism and Cardiovascular Diseases, Journal Year: 2025, Volume and Issue: unknown, P. 103852 - 103852

Published: Jan. 1, 2025

Language: Английский

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Remnant Cholesterol and Residual Risk of Atherosclerotic Cardiovascular Disease

Reviews in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 26(2)

Published: Feb. 20, 2025

Remnant cholesterol (RC) is increasingly recognized as a key target in the treatment of atherosclerotic cardiovascular disease (ASCVD), addressing much residual risk that persists despite standard therapies. However, integrating RC into clinical practice remains challenging. Key issues, such development accessible measurement methods, identification safe and effective medications, determination optimal levels, creation RC-based stratification strategies, require further investigation. This article explores complex role ASCVD development, including its definition, metabolic pathways, association with both overall primary secondary prevention. It also examines effect current lipid-lowering therapies on levels their influence outcomes. Recent research has highlighted promising advancements aimed at lowering RC, which show potential for reducing major adverse events (MACEs). Inhibitors angiopoietin-like protein 3 (ANGPTL3), apolipoprotein C-III (apoCIII), proprotein convertase subtilisin/kexin type 9 (PCSK9) have demonstrated ability to modulate reduce MACEs by targeting specific proteins involved synthesis metabolism. There pressing need larger randomized controlled trials clarify relevant patient populations. The targeted RC-lowering holds promise significantly high rates morbidity mortality associated ASCVD.

Language: Английский

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Association of obesity and LDL subfractions evaluated by body mass index, waist circumference, and diabetes status: the ELSA-Brasil study

Diabetology & Metabolic Syndrome, Journal Year: 2025, Volume and Issue: 17(1)

Published: March 6, 2025

Low-density lipoproteins (LDL) comprise a pool of particles with different densities that may have variable impact on atherogenesis. Studies suggest obese individuals elevated body mass index (BMI) and waist circumference (WC) increased small dense LDL subfractions (sdLDL-c). It is unclear if diabetes (T2D) insulin resistance (IR) modify this association. We included 4,111 (50.4 ± 8.6 years age, 45.5% men) neither prior cardiovascular disease nor use lipid-lowering medications. Total LDL-c its (LDL1-c, LDL2-c, LDL3-c, LDL4-c) were measured by vertical zonal ultracentrifugation. considered the LDL1-c LDL2-c as large buoyant (lbLDL-c) LDL3-c LDL4-c sdLDL-c. analyzed association between subclasses, BMI WC using linear regression analysis stratified presence T2D IR. For sdLDL-c, direct hypertension, T2D, fasting plasma glucose, total cholesterol, LDL-c, triglycerides was observed. In multivariate analysis, after adjustment for sex, race triglycerides, strong sdLDL-c (β 95% CI 0.16 (0,13-0,19)) 0.22 (0.19-0.26)) persisted. After stratification, present only in those or diabetes. showed smaller than strongly associated subfractions. Further, modified status.

Language: Английский

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