Is non-HDL cholesterol a risk marker for cardiovascular atherosclerotic disease in diabetes mellitus?

Authors

  • Solange Houssay José María Ramos Mejía Hospital, Autonomous City of Buenos Aires, Argentina
  • Carolina Gómez Martín Comprehensive Center of Endocrinology and Diabetes (CENDIA), Concordia, Entre Ríos, Argentina
  • Bárbara Arinovich University of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Eva López González Argentine Nutrition Society, Autonomous City of Buenos Aires, Argentina
  • Melina Saban British Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Silvio Daniel Schraier University of Buenos Aires, Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v56i2Sup.537

Keywords:

non-HDL colesterol, statins, residual cardiovascular risk

Abstract

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.

Author Biographies

Solange Houssay, José María Ramos Mejía Hospital, Autonomous City of Buenos Aires, Argentina

University Specialist in Nutrition and Medical Clinic; Staff Physician, Nutrition and Diabetes Unit, Department of Medicine, José María Ramos Mejía Hospital; Associate professor of the Nutrition Chair, University of Buenos Aires (UBA); Coordinator of the Committee on Arterial Hypertension and cardiovascular risk factors, Argentine Diabetes Society (SAD)

Carolina Gómez Martín, Comprehensive Center of Endocrinology and Diabetes (CENDIA), Concordia, Entre Ríos, Argentina

Specialist in Internal Medicine, University of Buenos Aires (UBA), specialized in Diabetes, Argentine Diabetes Society (SAD); Co-director of the Comprehensive Center for Endocrinology and Diabetes (CENDIA)

Bárbara Arinovich, University of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Specialist in Internal Medicine, University of Buenos Aires (UBA), Nutrition (UBA), specialized in Diabetes, Argentine Diabetes Society (SAD)

Eva López González, Argentine Nutrition Society, Autonomous City of Buenos Aires, Argentina

Specialist in Nutrition and Medical Clinic, Argentine Nutrition Society (SAN); Diploma in Nutrition

Melina Saban, British Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Endocrinology Specialist; Staff of the Endocrinology, Nutrition, Diabetes and Metabolism Service

Silvio Daniel Schraier, University of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Medical specialist in Nutrition and Diabetes; Professor of Internal Medicine and Nutrition, University of Buenos Aires (UBA); Director of the Specialization Course in Nutrition (UBA-HIBA headquarters); Vice Director of the Specialization Course (University Institute of Health Sciences, Barceló Foundation); Lipid Expert (Argentine Lipid Society); Diploma in Scientific, Medical and Environmental Communication (UFP); Scientific Coordinator of the Argentine Council on Food Safety and Nutrition

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.

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Published

2022-08-01

How to Cite

Houssay, S., Gómez Martín, C., Arinovich, B., López González, E., Saban, M., & Schraier, S. D. (2022). Is non-HDL cholesterol a risk marker for cardiovascular atherosclerotic disease in diabetes mellitus?. Journal of the Argentine Society of Diabetes, 56(2Sup), 44–47. https://doi.org/10.47196/diab.v56i2Sup.537

Issue

Vol. 56 No. 2Sup (2022): May/Agost 2022

Section

Recommendations

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