Journal of the Endocrine Society · 2019
Calculated Non-HDL Cholesterol Includes Cholesterol in Larger Triglyceride-Rich Lipoproteins in Hypertriglyceridemia.
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Sun Cathy J, McCudden Christopher, Brisson Diane, Shaw Julie, Gaudet Daniel, Ooi Teik C
Аннотация
CONTEXT: Calculated non-high-density lipoprotein (HDL) cholesterol (non-HDLC) should selectively include cholesterol from atherogenic lipoproteins to be a reliable risk marker of cardiovascular disease. In hypertriglyceridemia (HTG), there is increased abundance of larger and less atherogenic triglyceride-rich lipoproteins (TRL), namely, larger very-low-density lipoproteins (VLDL), and chylomicrons.
OBJECTIVE: We aim to demonstrate that serum triglyceride (TG) level has a substantial impact on non-HDLC's ability to represent cholesterol from atherogenic lipoproteins, even though TG is not part of the calculation for non-HDLC.
DESIGN: Analysis of lipid profile data.
SETTINGS: Lipid Clinic patient cohort, and Biochemistry Laboratory patient cohort.
PATIENTS OR OTHER PARTICIPANTS: 7,492 patients in the Lipid Clinic cohort with baseline lipid profiles documented prior to starting lipid-lowering medications and 156,311 lipid profiles from The Ottawa Hospital Biochemistry Laboratory cohort.
INTERVENTION: None.
MAIN OUTCOME MEASURE: Our modeling process includes derivation of TG-interval-specific lipoprotein composition factor (LCF) for TRL, which represents the mass ratio of cholesterol to TG in TRL. A high LCF indicates that the TRLs are mainly the cholesterol-rich atherogenic remnant lipoproteins. A low LCF indicates that the TRLs are mainly the TG-rich larger VLDL and chylomicrons.
RESULTS: As serum TG increases, there is progressive decline in the LCF for TRL, which indicates that the calculated non-HDLC level reflects progressive inclusion of cholesterol from larger TRL. This is shown in both cohorts.
CONCLUSIONS: Calculated non-HDLC is influenced by TG level. As TG increases, non-HDLC gradually includes more cholesterol from larger TRL, which are less atherogenic than LDL and remnant lipoproteins.
OBJECTIVE: We aim to demonstrate that serum triglyceride (TG) level has a substantial impact on non-HDLC's ability to represent cholesterol from atherogenic lipoproteins, even though TG is not part of the calculation for non-HDLC.
DESIGN: Analysis of lipid profile data.
SETTINGS: Lipid Clinic patient cohort, and Biochemistry Laboratory patient cohort.
PATIENTS OR OTHER PARTICIPANTS: 7,492 patients in the Lipid Clinic cohort with baseline lipid profiles documented prior to starting lipid-lowering medications and 156,311 lipid profiles from The Ottawa Hospital Biochemistry Laboratory cohort.
INTERVENTION: None.
MAIN OUTCOME MEASURE: Our modeling process includes derivation of TG-interval-specific lipoprotein composition factor (LCF) for TRL, which represents the mass ratio of cholesterol to TG in TRL. A high LCF indicates that the TRLs are mainly the cholesterol-rich atherogenic remnant lipoproteins. A low LCF indicates that the TRLs are mainly the TG-rich larger VLDL and chylomicrons.
RESULTS: As serum TG increases, there is progressive decline in the LCF for TRL, which indicates that the calculated non-HDLC level reflects progressive inclusion of cholesterol from larger TRL. This is shown in both cohorts.
CONCLUSIONS: Calculated non-HDLC is influenced by TG level. As TG increases, non-HDLC gradually includes more cholesterol from larger TRL, which are less atherogenic than LDL and remnant lipoproteins.