Is non-HDL cholesterol a risk marker for cardiovascular atherosclerotic disease in diabetes mellitus?
DOI:
https://doi.org/10.47196/diab.v56i2Sup.537Keywords:
non-HDL colesterol, statins, residual cardiovascular riskAbstract
Type 2 diabetes (T2D) is a major cardiovascular risk
factor (CVRF). Diabetes confers two to four times more
cardiovascular risk (CVR). The risk is even higher in patients
with T2D who have suffered an acute myocardial infarction
(AMI) or cerebrovascular accident (CVA). The dyslipidemia
of T2D consists of high fasting triglycerides, with greater postprandial excursion, low levels of HDLc and qualitative alterations of LDLc and HDLc. Appropriate glycemic control in T2D greatly improves lipoprotein abnormalities. Lipid-lowering therapy is key to reducing CVR in T2D. The CVR reduction achieved with statins is based on the reduction of LDLc. In patients who persist with an altered lipid profile despite highdose statins, the addition of other lipid-lowering agents to reduce atherogenic lipoproteins may be considered.
References
I. Fox CS, Coady S, Sorlie PD, Levy D, Meigs JB, D’Agostino RB Sr, Wilson PWF, Savage PJ. Trends in cardiovascular complications of diabetes. JAMA 2004;292:2495–2499.
II. Laakso M. Cardiovascular disease in type 2 diabetes: challenge for treatment and prevention. J Intern Med 2001;249:225-235.
III. Liu J, Sempos C, Donahue RP, Dorn J, Trevisan M, Grundy SM. Joint distribution of non-HDL and LDL cholesterol and coronary heart disease risk prediction among individuals with and without diabetes. Diabetes Care 2005;28:1916-192.
IV. Sniderman AD, Scantlebury T, Cianflone K. Hypertriglyceridemic hyperapo B: the unappreciated atherogenic dyslipoproteinemia in type 2 diabetes mellitus. Ann Intern Med 2001;135:447-459.
V. Turner RC, Millns H, Neil HAW, Stratton IM, Manley SE, Matthews DR, Holman RR; for the United Kingdom Prospective Diabetes Study Group. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus (UKPDS 23). BMJ 1998;316:823-828.
VI. Lu W, Resnick HE, Jablonski KA, Jones KL, Jain AK, Howard WJ, Robbins DC, Howard BV. Non-HDL cholesterol as a predictor of cardiovascular disease in type 2 diabetes: the Strong Heart Study. Diabetes Care 2003;26:16-23.
VII. Austin MA, King M-C, Vranizan KM, Krauss RM. Atherogenic lipoprotein phenotype: a proposed genetic marker for coronary heart disease risk. Circulation 1990;82:495-506.
VIII. Vijan S, Hayward RA. Pharmacologic lipid lowering therapy in type 2 diabetes mellitus: background paper for the American College of Physicians. Ann Intern Med 2004;140:650-658.
IX. Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005;366:1267-1278.
X. The Expert Panel. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): final report. Circulation 2002;106:3143-3421.
XI. Davidson MH, Maki KC, Pearson TA, Pasternak RC, Deedwania PC, McKenney JM, Fonarow GC, Maron DJ, Ansell BJ, Clark LT, Ballantyne CM. Results of the National Cholesterol Education (NCEP) Program Evaluation Project Utilizing Novel E-technology (NEPTUNE) II survey and implications for treatment under the recent NCEP Writing Group recommendations. Am J Cardiol 2005;96:556-563.
XII. Brunner FJ, Waldeyer Ch, Ojeda F, et al.; on behalf of the Multinational Cardiovascular Risk Consortium. Application of non-HDL cholesterol for population-based cardiovascular risk stratification: results from the Multinational cardiovascular Risk Consortium. Lancet 2019; 394:2173-83.
XIII. Cafferata A, Lorenzatti A, Corral P, et al; en nombre del Grupo de trabajo de la Sociedad Argentina de Lípidos. Consenso de Riesgo Residual cardiovascular en Lípidos. www.lipidos.org.ar. Acceso: 28/03/22.
XIV. MacLaughlin T, Reaven G, Abbasi F, et al. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am J Cardiol 2005;96(3):399-404.
XV. Soutelo J, Graffigna, Honfi M, et al. Índice triglicéridos/HDL colesterol en una población de adolescentes sin factores de riesgo cardiovascular. ALAN (Archivos Latinoamericanos de Nutrición 2012; 62 (2). Disponible en: www.alanrevista.org. Acceso:28/03/22
XVI. Salim S Virani. Non-HDL cholesterol as a metric of good quality of care. Tex Heart Inst J. 2011;8(2):160-162.
XVII. Castillo-Nuñez Y, Aguilar-Salinas CA, Mendivil-Anaya CO, Rodríguez M, Ruy L. Consenso del Grupo de Tareas de la Asociación Latinoamericana de Diabetes (ALAD) sobre el manejo de la dislipidemia diabética. Rev ALAD 2018;8:118-40.
XVIII. Elikir G, Cúneo C, et al; en nombre del Consejo de Consensos y Normas (CCN) de la Sociedad Argentina de Lípidos. Guía de Práctica Clínica de la Sociedad Argentina de Lípidos sobre diagnóstico y tratamiento de las dislipemias en adultos 2019. Disponible en: www.sociedadargentinadelipidos.com.ar. Guías y consensos SAL. Guía de práctica clínica 2019.pdf. Acceso: 28/03/22.
XIX. Piepoli M, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart j 2016;137(29):2315-2381. doi: 10.1093/eurheartj/ehw106.
XX. Área de Consensos y Normas de la Sociedad Argentina de Cardiología. Actualización del Consenso de Prevención Cardiovascular de la Sociedad Argentina de Cardiología. Rev Argent Cardiol 2016;84(sup.2):1-17.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 on behalf of the authors. Reproduction rights: Argentine Diabetes Society
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.
La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.
Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.
