Journal of Clinical Lipidology via MedWorm.com

News from the NLA

Journal of Clinical Lipidology — Fri, 06 Jan 2012 05:00:00 +0100

The Nominating Committees of the NLA Board of Directors and the regional Boards of Directors are seeking nominations. Each year, the term of approximately one-third of each Board expires. New Board members are elected each May at the NLA Annual Scientific Sessions. Please go to http://www.lipid.org/about/committees to nominate a colleague. (Source: Journal of Clinical Lipidology)

Journal of Clinical Lipidology — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Journal of Clinical Lipidology)

Editorial Board

Journal of Clinical Lipidology — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Journal of Clinical Lipidology)

From the Editor: Five Years of Growth for the Journal

Journal of Clinical Lipidology — Mon, 12 Dec 2011 05:00:00 +0100

This issue marks the end of our fifth year as a professional publication focusing on clinical lipidology. The Journal began with the first issue in March of 2007 as an initiative of the National Lipid Association (NLA) and is the property of this Association. Having our own journal was stated as a long-term goal by the leadership of the Association at the time of its birth in 2002. Most of us did not believe that it would be possible within 5 years of the founding of the NLA, but with the very positive attitude of the Board and an excellent administrative staff, this task was undertaken successfully. I have been honored by being appointed Editor and by the tremendous support given with enthusiasm by the Associate Editors, the Editorial Board, the NLA, and our contracted publisher, Elsevier...

High HDL and ATD

Journal of Clinical Lipidology — Mon, 21 Nov 2011 05:00:00 +0100

The article by Costacou et al on the link between very high levels of high-density lipoprotein (HDL) cholesterol (80 mg/dL and greater) and atherothrombotic disease (ATD) in patients with type I diabetes prompted me to review my database of ATD patients, focusing on those with similar HDL levels. The subject matter is important because of the continuing controversy regarding “dysfunctional” HDL. (Source: Journal of Clinical Lipidology)

Measurement of cholesterol and triglycerides from a dried blood spot in an Indian Council of Medical Research–World Health Organization multicentric survey on risk factors for noncommunicable diseases in India

Journal of Clinical Lipidology — Mon, 14 Nov 2011 05:00:00 +0100

Conclusion: In conclusion, dried blood would be a good method for collection of blood for measurement of cholesterol and triglycerides for population health surveys. However, the benefits of blood spot analysis should be weighed against potential sources of errors attributable to sampling and other factors, such as temperature and humidity, in a country like India. (Source: Journal of Clinical Lipidology)

Benefits associated with achieving optimal risk factor levels for the primary prevention of cardiovascular disease in older men

Journal of Clinical Lipidology — Wed, 09 Nov 2011 05:00:00 +0100

Conclusion: Control of 4 treatable risk factors (nonsmoking, control of non-high density lipoprotein cholesterol and blood pressure, and aspirin use) was associated with substantial protection against incident cardiovascular events in older men even after adjustment for competing causes of mortality. (Source: Journal of Clinical Lipidology)

Non–high-density lipoprotein cholesterol calculation and goal awareness among physicians-in-training

Journal of Clinical Lipidology — Wed, 09 Nov 2011 05:00:00 +0100

Conclusions: At least one-third of physicians-in-training could not calculate non-HDL-C from a standard lipid panel, and a large number were not aware of ATP III treatment goals pertaining to non-HDL-C. This area represents one for improvement if non-HDL-C is to be retained as a treatment target in the forthcoming ATP-IV guidelines. (Source: Journal of Clinical Lipidology)

Unraveling HDL-Associated Risk: Current Challenges and Future Directions

Journal of Clinical Lipidology — Mon, 07 Nov 2011 05:00:00 +0100

High-density lipoprotein (HDL) cholesterol is gaining more attention as an important risk factor and as important biomarker in cardiovascular disease (CVD). This Journal of Clinical Lipidology open-source eCME activity (accessed at http://multimedia.lipidjournal.com/2011/HDL) summarizes the many issues that this raises: the unacceptably high variance in direct HDL assays; the importance of considering low-density lipoprotein (LDL) particle number in the evaluation of HDL cholesterol-associated residual risk; the conflicting CVD risk factor associations, depending on whether measuring serum HDL cholesterol levels or HDL particles in models that include LDL-P; and assessment of HDL “functionality.” The article concludes with reference to the recently published article that attempts to es...

Measuring HDL: The Effect of Current HDL-Raising Therapies on HDL Levels and Subfractions

Journal of Clinical Lipidology — Mon, 07 Nov 2011 05:00:00 +0100

Although lacking prospective controlled clinical trial evidence to prove the hypothesis, nevertheless it has been firmly established observationally that there is both a substantial gradient of risk associated with low HDL levels and a degree of protection associated with high HDL levels. However, whereas LDL particles present a relatively simplistic size spectrum, ranging from large, buoyant and less harmful, to the small, dense, and readily oxidized and infiltrative into the arterial wall and atherosclerotic plaques, the spectrum of HDL particle sizes is rather more complex, although in one dimension the size spectrum can be considered as simply the amount of cholesterol that has accumulated to fill the HDL particle. In line with this analysis, this Journal of Clinical Lipidology open-so...

The Current Status and Future Development of CETP Inhibitors

Journal of Clinical Lipidology — Mon, 07 Nov 2011 05:00:00 +0100

Although difficult to test prospectively (because proof would require enrollment of large numbers of patients who fail maximal lowering of low-density lipoprotein [LDL] cholesterol to (Source: Journal of Clinical Lipidology)

HDL Proteomics and Lipidomics

Journal of Clinical Lipidology — Mon, 07 Nov 2011 05:00:00 +0100

Recent research has shown that the spectrum of HDL particles is far more complex than the simple array of LDL particles. As with LDL particles, the spectrum of HDL particles can be characterized by size and density, as a measure of the quantity of cholesterol they distribute; this categorization is based chiefly on the early analytic methods, however, and it fails to recognize that unlike LDL particles, the different HDL particles perform qualitatively different biologic functions, depending on their composition. This diversity is caused by both the protein components of the particle’s structure, the proteome, and the lipid contents of the particle, the lipidome. This Journal of Clinical Lipidology open-source eCME activity (accessed at http://multimedia.lipidjournal.com/2011/HDL) examin...

HDL Functionality: How Do We Measure It and Is It Relevant for Everyday Clinical Practice?

Journal of Clinical Lipidology — Mon, 07 Nov 2011 05:00:00 +0100

It is an often-repeated axiom that high-density lipoprotein (HDL) cholesterol is protective, whereas low-density lipoprotein (LDL) cholesterol is causative, of the pathologic consequences of excess serum cholesterol, resulting in development of atherosclerotic plaques and coronary heart disease (CHD). Measurement of circulating LDL cholesterol has been well studied and correlated with CHD risk. HDL cholesterol levels, however, although correlated epidemiologically with reduction of CHD risk, have remained less-well defined as a biomarker. This Journal of Clinical Lipidology open-source eCME activity (accessed at http://multimedia.lipidjournal.com/2011/HDL) presentation details a simple laboratory measure of the degree of risk-reduction that a given patient’s HDL cholesterol should provid...

Translating HDL Science to Clinical Practice

Journal of Clinical Lipidology — Mon, 07 Nov 2011 05:00:00 +0100

To provide an enduring record of the most important contents from the live HDL Highlights Symposium: Translating HDL Science to Clinical Practice, held in New York City in May 2011, the National Lipid Association has partnered with Elsevier to publish an open-access, journal-indexed Internet activity, with optional CME/CE credit, presented as a slide-driven narrative with edited text for each figure interpolated from the audio presentations. This online publication from the Journal of Clinical Lipidology provides the opportunity to access the contents visually, acoustically, and via the peer-reviewed text, as presented during this key opinion leader symposium. (Source: Journal of Clinical Lipidology)

Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: A review

Journal of Clinical Lipidology — Fri, 04 Nov 2011 04:00:00 +0100

Abstract: In this exploratory, hypothesis-generating literature review, we evaluated potentially differential effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and non-HDL-C in published studies of ω-3 fatty acid supplementation or prescription ω-3 fatty acid ethyl esters. Placebo-adjusted changes in mean lipid parameters were compared in randomized, controlled trials in subjects treated for ≥4 weeks with DHA or EPA. Of 22 studies identified, 6 compared DHA with EPA directly, 12 studied DHA alone (including 14 DHA–treated groups), and 4 examined EPA alone. In studies directly comparing EPA with DHA, a net increase in LDL-C of 3.3% was observed with DHA...

Familial Hypercholesterolemia: Management Issues in Adults

Journal of Clinical Lipidology — Fri, 04 Nov 2011 04:00:00 +0100

This article reviews the clinical application of recommended therapeutic strategies, from lifestyle modifications to high-potency statin therapy, combination therapies for patients intolerant or insufficiently responsive to statin therapy, and ultimately, for patients unresponsive to 6 months of maximum tolerated drug therapy, plasma apheresis or even liver transplantation. Ito MK. J Clin Lipidol. 2011; 5(6). Accessible at http://www.lipidjournal.com. (Source: Journal of Clinical Lipidology)

Familial Hypercholesterolemia: Prevalence, Genetics, Diagnosis and Screening

Journal of Clinical Lipidology — Fri, 04 Nov 2011 04:00:00 +0100

Familial hypercholesterolemia (FH) is an autosomal-dominant genetic disorder associated with mutations in the low-density lipoprotein (LDL) receptors expressed on the surface of hepatocytes. This Journal of Clinical Lipidology open-source eCME activity (accessed at http://multimedia.lipidjournal.com/2011/HDL) reviews public awareness, medical diagnosis, and current evidence-based treatment for FH. The expression of functionally intact LDL receptors helps to ensure clearance of LDL cholesterol from the systemic circulation. Patients with FH have significant elevations in their serum LDL cholesterol levels, which results in increased risk for coronary heart disease that is the same as it would be for any adult with severe dyslipidemia except that this coronary heart disease risk manifests m...

Familial Hypercholesterolemia: Pediatric Aspects (eCME Multimedia Activity)

Journal of Clinical Lipidology — Fri, 04 Nov 2011 04:00:00 +0100

People with the genetic mutation that causes familial hypercholesterolemia (FH) either totally lack (homozygous FH) or lack about half (heterozygous FH) the receptors for low-density lipoprotein (LDL) cholesterol that are needed for the metabolic step that removes LDL cholesterol from circulation. In this Journal of Clinical Lipidology open-source eCME activity (accessed at http://multimedia.lipidjournal.com/2011/HDL) public awareness, medical diagnosis, and current evidence-based treatment of FH are reviewed. The principal fact of the extremely high serum levels of LDL cholesterol, with the subsequent greatly increased risk of cardiovascular disease (CHD) and premature CHD events. For adults this is a very serious condition, but physicians have the opportunity to recognize and treat it...

Treatment of Adults with Familial Hypercholesterolemia

Journal of Clinical Lipidology — Fri, 04 Nov 2011 04:00:00 +0100

The National Lipid Association has published new recommendations for the screening, diagnosis, and treatment of adults with familial hypercholesterolemia (FH). This Journal of Clinical Lipidology open-source eCME activity (accessed at http://multimedia.lipidjournal.com/2011/HDL) reviews public awareness, medical diagnosis, and current evidence-based treatment for FH, followed by discussion of the public awareness, medical diagnosis, and current evidence-based treatment of FH. The 4 most important recommendations that physicians should be aware of and follow when presented with a possible case of FH in an adult, to ensure the proper differential diagnosis, are presented. In addition, this report highlights the urgency that evidence-based treatment of FH requires, including initiation of tr...

Future Issues, Public Policy, and Public Awareness of Familial Hypercholesterolemia

Journal of Clinical Lipidology — Fri, 04 Nov 2011 04:00:00 +0100

In May 2011 the National Lipid Association (NLA) issued new recommendations for the treatment of familial hypercholesterolemia (FH). This Journal of Clinical Lipidology open-source eCME activity (accessed at http://multimedia.lipidjournal.com/2011/HDL) reviews public awareness, medical diagnosis, and current evidence-based treatment for FH. FH is caused by genetic mutations that affect the function of low-density lipoprotein (LDL) cholesterol receptors. Elevated serum LDL cholesterol is the lipid most associated with increased risk of atherosclerotic cardiovascular disease (CVD). Because of the genetic mutations, the distinguishing characteristic of patients with FH is extraordinarily high levels of serum LDL cholesterol, typically 350−550 mg/dL in patients with heterozygous FH (inherita...

NLA Recommendations for the Diagnosis and Management of Familial Hypercholesterolemia in Children and Adults

Journal of Clinical Lipidology — Fri, 04 Nov 2011 04:00:00 +0100

This activity will provide important contents from the live FH Highlights Symposium, held in New York City in May 2011. The National Lipid Association has partnered with Elsevier to create an open-access, journal-indexed internet CME/CE activity based on slide highlights. (Source: Journal of Clinical Lipidology)

Keyword Index to Volume 5

Journal of Clinical Lipidology — Tue, 01 Nov 2011 04:00:00 +0100

ABCB1, 91 Ablation, 18 (Source: Journal of Clinical Lipidology)

Author Index to Volume 5

Journal of Clinical Lipidology — Tue, 01 Nov 2011 04:00:00 +0100

Ackermann D, 188 Afonso L, 82 (Source: Journal of Clinical Lipidology)

Journal of Clinical Lipidology — Tue, 01 Nov 2011 04:00:00 +0100

(Source: Journal of Clinical Lipidology)

Editorial Board

Journal of Clinical Lipidology — Tue, 01 Nov 2011 04:00:00 +0100

(Source: Journal of Clinical Lipidology)

News from the NLA

Journal of Clinical Lipidology — Fri, 28 Oct 2011 04:00:00 +0100

The NLA is pleased to announce that it has joined the NHLBI Coordinating Committee of the National Program to Reduce Cardiovascular Risk (NPRCR), a program aimed at reducing the risk of cardiovascular disease through implementation of evidence-based clinical practice guidelines and interventions to control cardiovascular risk factor in clinical practice settings. Terry Jacobson, MD, FNLA, who currently serves as Secretary for the NLA Board of Directors and President for the Southeast Lipid Association, will represent the NLA on the NPRCR Coordinating Committee. The inaugural meeting of the Coordinating Committee was held in October of 2011, with a follow-up meeting scheduled in the spring of the 2012. (Source: Journal of Clinical Lipidology)

From the Editor

Journal of Clinical Lipidology — Mon, 24 Oct 2011 04:00:00 +0100

The addition of omega-3 fatty acids to our diet via the ingestion of more fish and certain vegetable products has been touted for many years. The authors of two large clinical trials documenting reduced cardiovascular events with relatively small doses (0.85 grams per day in the Gissi II trial and 1.8 grams per day in the JELIS study) have provided the strongest evidence for supplements if necessary to assure the consumption of 0.5 to 1 gram per day for all adults. We now have various preparations of omega-3 fatty acids that provide such doses in one or two capsules per day. One omega-3 preparation has been approved as a prescription agent in the case of ethyl esters of eicosapentanoic acid and docosahexaenoic acid derived from fish. The only specific indication for this preparation is red...

Remembering William B. Kannel, MD, MPH (1923–2011)

Journal of Clinical Lipidology — Wed, 05 Oct 2011 04:00:00 +0100

The Framingham Heart Study started in 1948 under the auspices of the National Heart Institute and was originally planned to track 5000 middle-aged adults older than 20 years of age. Bill Kannel was involved with the study from the beginning and the early research questions asked were relatively simple in comparison with the types of investigations that are performed today. He was a leader in the development of more sophisticated approaches for the analysis of risk relationships and helped develop the field of modern cardiovascular epidemiology. Bill’s legacy concerning how we think about cardiovascular disease risk has been summarized in articles, interviews, and special journal articles. (Source: Journal of Clinical Lipidology)

Using omega-3 fatty acids in the practice of clinical lipidology†

Journal of Clinical Lipidology — Tue, 04 Oct 2011 04:00:00 +0100

W. Virgil Brown, MD: Increasing the quantity of dietary omega-3 fatty acids appears to offer significant health benefits. The American Heart Association suggests an additional 0.5 to 1 g of omega-3 fats daily from fish and other dietary sources. The reduction of blood triglyceride concentrations with much larger doses has led to the use of these fats as pharmacologic agents. I have asked three clinical lipidologists, Drs. Harold Bays, William Harris and Michael Miller, each with considerable research experience, to join me in a Roundtable discussion on the use of these agents in the management of lipoprotein disorders. (Source: Journal of Clinical Lipidology)

Biographical notes on Ancel Keys and Salim Yusuf: Origins and significance of the Seven Countries Study and the INTERHEART Study

Journal of Clinical Lipidology — Fri, 23 Sep 2011 04:00:00 +0100

Abstract: Ancel Keys and Salim Yusuf are both pioneers in preventive cardiology. Each overcame significant obstacles to demonstrate, through large international studies, how culture and environment influence cardiovascular disease. This paper will explore the origins and outcomes of their landmark studies: the Seven Countries Study, a prospective cohort model, and the INTERHEART Study, a case-control model. Each study advanced our understanding of the interplay between lifestyle, culture, and heart disease. (Source: Journal of Clinical Lipidology)

Efficacy and tolerability of once-weekly rosuvastatin in patients with previous statin intolerance

Journal of Clinical Lipidology — Thu, 22 Sep 2011 04:00:00 +0100

We congratulate Kennedy et al on publishing the first randomized controlled trial that investigated the use of once-weekly rosuvastatin in patients with previous myalgia on statins. Some additional comments may be of interest. It would be useful to document factors that may increase the risk of statin myopathy (eg, impaired renal function, hypothyroidism or ethnicity). More specifically, did the patients who did not tolerate rosuvastatin once a week have any of these characteristics? An additional factor to consider is vitamin D deficiency. There is evidence suggesting that vitamin D replacement in deficient patients decreases their risk of developing statin-related myalgia. (Source: Journal of Clinical Lipidology)

Management of familial hypercholesterolemia during pregnancy: Case series and discussion

Journal of Clinical Lipidology — Thu, 22 Sep 2011 04:00:00 +0100

Abstract: With an occurrence of approximately 1 in 500 individuals worldwide, the heterozygous form of familial hypercholesterolemia is not uncommon. With statins being contraindicated in pregnancy (Category X), the management of pregnant women who carry this diagnosis has not been clearly defined. This case series describes five pregnant women seen at the Emory Center for Heart Disease Prevention between 2004 and 2010 who carried this diagnosis, their treatment, and subsequent outcomes. The article concludes with treatment options for clinicians in dealing with such individuals. (Source: Journal of Clinical Lipidology)

Reduced cellular cholesterol efflux and low plasma high-density lipoprotein cholesterol in a patient with type B Niemann-Pick disease because of a novel SMPD-1 mutation

Journal of Clinical Lipidology — Thu, 15 Sep 2011 04:00:00 +0100

Conclusion: In summary, we identified a unique point mutation in a patient with type B NPD that was associated with various clinical findings, including a low plasma HDL-C level. This reduced cellular cholesterol efflux may be implicated, at least in part, in low plasma HDL levels. (Source: Journal of Clinical Lipidology)

Antisense therapy and emerging applications for the management of dyslipidemia

Journal of Clinical Lipidology — Thu, 15 Sep 2011 04:00:00 +0100

Conclusion: Antisense therapy represents a potentially effective and well-tolerated emerging treatment modality for numerous diseases. In the treatment of hypercholesterolemia, the antisense therapy mipomersen may provide a possible treatment option for patients with treatment-resistant dyslipidemia. (Source: Journal of Clinical Lipidology)

The differential effect of statins on oxidative stress and endothelial function: Atorvastatin versus pravastatin

Journal of Clinical Lipidology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusion: In hyperlipidemic subjects with metabolic syndrome, atorvastatin is associated with a greater reduction in lipid markers of oxidation compared with pravastatin. Whether these effects are responsible for the outcome differences in trials comparing these agents needs further investigation. (Source: Journal of Clinical Lipidology)

Evidence of dependence of lipoprotein(a) on triglyceride and high-density lipoprotein metabolism

Journal of Clinical Lipidology — Wed, 14 Sep 2011 04:00:00 +0100

In this study, we investigated the relationship of Lp(a) to other lipoproteins at high and normal levels of serum triglycerides (TGs). We measured serum lipid and Lp(a) particle concentrations in 148 unselected primary- and secondary-prevention patients. Subjects with TG > 200 mg/dL were classified as having high TG in accordance with National Cholesterol Education Program Adult Treatment Panel III guidelines. Our analysis revealed mean TG levels of 100 and 270 mg/dL in the normal and high TG groups, respectively. Lp(a)-C, Lp(a)-P, and Lp(a) cholesterol content per particle [Lp(a)-C/Lp(a)-P] did not differ between groups. At normal TG levels, stepwise multiple linear regression revealed that Lp(a)-P correlated with Lp(a)-C (P < 10−6), ApoAI (P = .0001), the high-density lipoprotein chol...

Evaluation of the incidence and risk factors for development of fenofibrate-associated nephrotoxicity

Journal of Clinical Lipidology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusion: This observational study suggests fenofibrate-associated nephrotoxicity occurs more frequently than previously reported, particularly in patients with renal disease and in those receiving high-dose fenofibrate or concomitant calcium channel blockers. (Source: Journal of Clinical Lipidology)

Effects of prescription omega-3-acid ethyl esters, coadministered with atorvastatin, on circulating levels of lipoprotein particles, apolipoprotein CIII, and lipoprotein-associated phospholipase A2 mass in men and women with mixed dyslipidemia

Journal of Clinical Lipidology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusion: This analysis supports the view that LDL-P concentration is not increased by POM3 plus atorvastatin, relative to atorvastatin monotherapy, and is associated with potentially favorable shifts in LDL-P subfractions, Apo CIII and lipoprotein-associated phospholipase A2 in mixed dyslipidemia. (Source: Journal of Clinical Lipidology)

Clinical utility of inflammatory markers and advanced lipoprotein testing: Advice from an expert panel of lipid specialists

Journal of Clinical Lipidology — Thu, 01 Sep 2011 04:00:00 +0100

This report describes the consensus view of an expert panel convened by the National Lipid Association to evaluate the use of selected biomarkers [C-reactive protein, lipoprotein-associated phospholipase A2, apolipoprotein B, LDL particle concentration, lipoprotein(a), and LDL and HDL subfractions] to improve risk assessment, or to adjust therapy. These panel recommendations are intended to provide practical advice to clinicians who wrestle with the challenges of identifying the patients who are most likely to benefit from therapy, or intensification of therapy, to provide the optimum protection from CV risk. (Source: Journal of Clinical Lipidology)

Journal of Clinical Lipidology — Thu, 01 Sep 2011 04:00:00 +0100

(Source: Journal of Clinical Lipidology)

Editorial Board

Journal of Clinical Lipidology — Thu, 01 Sep 2011 04:00:00 +0100

(Source: Journal of Clinical Lipidology)

News from the NLA

Journal of Clinical Lipidology — Mon, 29 Aug 2011 04:00:00 +0100

The campaign FH: It’s Relative—Know Your Family Cholesterol History continues to build momentum, particularly in the realm of the media. Since its launch in May, the campaign has garnered the following results: (Source: Journal of Clinical Lipidology)

From the Editor

Journal of Clinical Lipidology — Mon, 29 Aug 2011 04:00:00 +0100

The concept of risk factors, as derived from the Framingham Heart Study and confirmed by many other community-based population assessments, has given the clinician a firm basis for assignment of cardiovascular risk in our patients. However, this approach is well recognized to be limited in its positive predictive power to separate those who are very likely to have a myocardial infarction or stroke from those at low risk. During the past 20 years, a number of additional measures have been reported to add to the efficacy of classical risk assessment. Some of these have come from basic science and animal studies of the pathogenesis of arteriosclerosis. Others have been derived from prospective observational studies and clinical trials. Earlier this year, the National Lipid Association commiss...

Homozygous lecithin:cholesterol acyltransferase (LCAT) deficiency due to a new loss of function mutation and review of the literature

Journal of Clinical Lipidology — Wed, 24 Aug 2011 04:00:00 +0100

Conclusions: In our view the most important aspects of therapy to prevent the kidney disease that these patients develop is careful control of blood pressure and lifestyle measures to optimize non HDL lipoproteins. In the future replacement therapy by gene transfer or other methods may become available. (Source: Journal of Clinical Lipidology)

Remnant-like particle cholesterol and serum amyloid A–low-density lipoprotein levels in obese subjects with metabolic syndrome

Journal of Clinical Lipidology — Tue, 16 Aug 2011 04:00:00 +0100

Background: Although the circulating levels of remnant-like particle cholesterol (RLP-C) or serum amyloid A–low-density lipoprotein (SAA-LDL) can individually be increased in subjects with metabolic syndrome (MetS), the correlation between the two markers has not yet been previously studied. In the present study, we aimed to investigate the correlation between RLP-C and SAA-LDL in obese subjects with MetS in comparison to those without MetS.Methods: A total of 436 obese subjects were divided into groups with MetS and without MetS (male/female 75/143, mean age 49 years, current smokers 16% in both groups) by applying the age-, gender-, and smoking habit-matching method based on the database in the multicenter Japan Obesity and Metabolic Syndrome Study (JOMS). The data, including RLP-C and...

The association of apolipoprotein E polymorphism and lipid levels in children with a family history of premature coronary artery disease

Journal of Clinical Lipidology — Mon, 01 Aug 2011 04:00:00 +0100

Conclusions: Tc levels are influenced by apoE genotypes in childhood. Also, the frequency of the ɛ4 allele is greater in children with family history of premature CAD. The ɛ4 allele may be associated with an increased risk for development of atherosclerosis by elevated levels of Tc in children with family history of CAD. The evaluation of apoE gene polymorhisms may contribute to the assessment of cardiovascular risk in children with a family history of CAD. (Source: Journal of Clinical Lipidology)

Erratum

Journal of Clinical Lipidology — Mon, 01 Aug 2011 04:00:00 +0100

In the August 2010 issue (4/4) of Journal of Clinical Lipidology, in the article by Maurizio Averna and colleagues titled ‘‘Ezetimibe/simvastatin 10/20 mg versus simvastatin 40 mg in coronary heart disease patients’’ (2010;4:272–278; doi:10.1016/j.jacl.2010.05.002), two professor’s names were inadvertently omitted from the Acknowledgments of the original manuscript as submitted to the journal. Please recognize Prof. Cesare Sirtori and Dr. Pablo Werba as part of the Acknowledgments, and see the Acknowledgments in its entirety below: (Source: Journal of Clinical Lipidology)

Low-density lipoprotein particle number predicts coronary artery calcification in asymptomatic adults at intermediate risk of cardiovascular disease

Journal of Clinical Lipidology — Fri, 15 Jul 2011 04:00:00 +0100

Conclusion: Small LDL-P was a strong, independent predictor of the presence of CAC. Large prospective studies are needed to examine the effect of LDL particle number and size on coronary artery calcification. (Source: Journal of Clinical Lipidology)

Letter to the Editor

Journal of Clinical Lipidology — Mon, 04 Jul 2011 04:00:00 +0100

I would like to make you and the readership of the Journal aware of an unexpected problem we have recently encountered in our studies of the effects of different dietary fatty acids on atherosclerosis in experimental animals. We typically use commercial preparations of oils with known fatty acid compositions to construct our diets. We have identified fatty acids that protect against atherosclerosis to be both n-3 and n-6 polyunsaturated fatty acids. In contrast, saturated and monounsaturated fatty acids promote atherosclerosis in monkeys and mice. The diets we feed are mixed in our diet kitchen under the careful guidance of a technician with more than 20 years of experience in diet preparation. Nevertheless, aliquots of all batches of diet are typically put through quality control assays b...

News from the NLA

Journal of Clinical Lipidology — Sun, 03 Jul 2011 23:00:00 +0100

Join your colleagues in Florida for a 2-day intensive learning experience. The Summer Clinical Lipid Update features the theme, “The Lipid Consultant: Consultative Challenges and Practical Answers—A Case-based Approach” and will be held August 26–28 at the Hilton Bonnet Creek in Orlando. In these cutting-edge sessions, thought leaders will present cases and discuss the latest research, guidelines, controversies, and clinical strategies. In addition to the sessions, make sure you make plans to attend one of the many preconference workshops that will take place before the start of the sessions: (Source: Journal of Clinical Lipidology)

Journal of Clinical Lipidology — Thu, 30 Jun 2011 23:00:00 +0100

(Source: Journal of Clinical Lipidology)

Editorial Board

Journal of Clinical Lipidology — Thu, 30 Jun 2011 23:00:00 +0100

(Source: Journal of Clinical Lipidology)

Relationships between cholesterol efflux and high-density lipoprotein particles in patients with type 2 diabetes mellitus

Journal of Clinical Lipidology — Wed, 29 Jun 2011 04:00:00 +0100

Conclusion: In patients with moderately controlled type 2 diabetes mellitus, cholesterol efflux from macrophages incubated with apolipoprotein B–depleted plasmas correlated significantly and positively with the concentration of total and medium-sized HDL and not with that of the smallest particles. (Source: Journal of Clinical Lipidology)

3-hydroxyl-3-methylglutaryl coenzyme A reductase inhibitor use in chronic liver disease: A therapeutic controversy

Journal of Clinical Lipidology — Wed, 29 Jun 2011 04:00:00 +0100

Conclusions: Available clinical data suggest that statin therapy in nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and hepatitis C virus is a safe option in the management of dyslipidemia. (Source: Journal of Clinical Lipidology)

A novel mutation of apolipoprotein B in a French Canadian family with homozygous hypobetalipoproteinemia

Journal of Clinical Lipidology — Wed, 29 Jun 2011 04:00:00 +0100

We describe the case of a young woman who is homozygous for an APOB gene mutation that encodes a severely truncated apo B protein. Although ABL has been previously described in French Canadians, homozygous FHBL has not yet been reported for this population. (Source: Journal of Clinical Lipidology)

Effects of combination therapy with rosuvastatin and fenofibric acid in patients with mixed dyslipidemia and high-sensitivity C-reactive protein (≥2 mg/L)

Journal of Clinical Lipidology — Wed, 29 Jun 2011 04:00:00 +0100

Background: Elevated levels of high-sensitivity C-reactive protein (hsCRP) correlate with an increased risk for cardiovascular events. Combination therapy with a statin and a fibrate may be more effective than statin monotherapy for reducing hsCRP, especially in patients with mixed dyslipidemia.Objective: To characterize the treatment effects of rosuvastatin and fenofibric acid combination therapy compared with individual monotherapies in mixed dyslipidemic patients with baseline hsCRP ≥2 mg/L versus (Source: Journal of Clinical Lipidology)

High-density lipoprotein cholesterol in diabetes: Is higher always better?

Journal of Clinical Lipidology — Wed, 29 Jun 2011 04:00:00 +0100

Conclusion: The increased CAD risk in women for an HDL-C >80 mg/dL in type 1 diabetes merits further study. Gender specificity could not be determined as only two men had HDL-C >80 mg/dL. (Source: Journal of Clinical Lipidology)

A survey on blood lipid levels among newborns and healthy inhabitants in urban Shanghai (2008–2009)

Journal of Clinical Lipidology — Wed, 29 Jun 2011 04:00:00 +0100

Conclusion: Currently, hypertriglyceridemia and low HDL-C in middle-aged men older than 30 years of age have become a growing problem. (Source: Journal of Clinical Lipidology)

The surprising AIM-HIGH results are not surprising when viewed through a particle lens

Journal of Clinical Lipidology — Wed, 29 Jun 2011 04:00:00 +0100

The early stopping of the Atherothrombosis Intervention in Metabolic syndrome with low HDL/high triglycerides: impact on Global Health outcomes (AIM-HIGH) trial because of the lack of efficacy was a surprise and disappointment to many clinicians whose clinical experience with niacin is positive, because the drug favorably impacts several lipoprotein abnormalities believed to contribute to residual cardiovascular disease (CVD) risk beyond low-density lipoprotein (LDL). Personally, as someone taking niacin for a completely different reason, I was neither surprised nor disappointed nor dissuaded from continuing this regimen. The reason is the differing perspective one obtains from viewing lipoproteins and their clinical management through a particle lens rather than the traditional cholestero...

Statins and their influence on brain cholesterol

Journal of Clinical Lipidology — Fri, 24 Jun 2011 04:00:00 +0100

Conclusion: Better understanding of the effects of statins on brain metabolism becomes more important because many studies bring evidence of a possible link between cholesterol and neurodegeneration. (Source: Journal of Clinical Lipidology)

Lipoprotein (a): Perspectives from a lipid-referral program

Journal of Clinical Lipidology — Thu, 23 Jun 2011 04:00:00 +0100

Conclusion: High-risk levels of Lp(a) are associated with female gender, African- American race, and CHD. 19% of moderate and high risk patients would be candidates for treatment with niacin if the indication is a cutpoint Lp(a) ≥50mg/dL. (Source: Journal of Clinical Lipidology)

Interview with Dr. Scott Grundy during AHA EPI/NPAM Meeting in March 2011

Journal of Clinical Lipidology — Thu, 23 Jun 2011 04:00:00 +0100

This is an interview with Dr. Scott Grundy, who was one of the original founding members of the Nutrition, Physical Activity and Metabolism (NPAM) Council of the American Heart Association (AHA). Dr. Grundy served for several years as Chairman of the Nutrition Committee, and, with other members of the AHA, recognized that a Scientific Council was necessary for the AHA to effectively advance research and education in the areas that involve the lifestyle of our population. This Council now is the driving force for improvement in interventions that are most commonly applied in our population and that are proving successful in changing the risk of vascular disease in the United States and throughout the world. The interview took place during the combined Scientific Sessions of the Epidemiology...

Achievement of specified low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol apolipoprotein B, and high-sensitivity C-reactive protein levels with ezetimibe/simvastatin or atorvastatin in metabolic syndrome patients with and without atherosclerotic vascular disease (from the VYMET study)

Journal of Clinical Lipidology — Fri, 17 Jun 2011 04:00:00 +0100

Background: Metabolic syndrome (MetS) and atherosclerotic vascular disease (AVD) are associated with increased coronary heart disease risk.Objective: To assess percent change from baseline in lipids and high-sensitivity C-reactive protein (hs-CRP) levels and the proportion of subjects reaching specified low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C) and apolipoprotein B (Apo B) single, dual, and triple targets and hs-CRP (Source: Journal of Clinical Lipidology)

Impact of lipid profile and high blood pressure on endothelial damage

Journal of Clinical Lipidology — Fri, 17 Jun 2011 04:00:00 +0100

Conclusion: Impaired endothelial function was associated with increased total-C/HDL-C values, possibly as the result of increased vascular oxidative stress and inflammation. In the early stages of atherosclerosis, the impact of both total-C/HDL-C and BP may be similar in terms of endothelial damage. (Source: Journal of Clinical Lipidology)

From the Editor

Journal of Clinical Lipidology — Sun, 12 Jun 2011 23:00:00 +0100

This study used a combination of simvastatin and ezetimibe to produce a highly significant reduction in nonfatal myocardial infarction and coronary death, revascularization, and ischemic stroke. One-half of the 9438 patients were assigned randomly to placebos or the lipid-lowering regimen. Of this group, some 3000 patients were on dialysis, and only a trend toward a benefit in these end points was recorded. The findings of this study confirm several earlier trials in which the authors found the use of statins to have a weak effect in reducing end points directly attributable to coronary artery disease in dialysis patients. The Roundtable discussion in this issue of the Journal involves three experts in both chronic renal disease and in cardiovascular disease prevention. I believe the reade...

Concordance between plasma apolipoprotein B levels and cholesterol indices among patients receiving statins and nonstatin treatment: Post-hoc analyses from the U.K. InPractice study

Journal of Clinical Lipidology — Thu, 09 Jun 2011 23:00:00 +0100

Conclusion: We showed that the association between ApoB and LDL-C is similar across different lipid-lowering treatment regimes, which suggests that the use of different lipid-lowering agent confers similar ability to predict ApoB levels. When determining CVD risk at an individual patient level, limitation exists when using LDL-C or nonHDL-C per se as risk markers. In the absence of ApoB measurement, we believe that information from both LDL-C and nonHDL-C should be used together to improve the estimation of residual CVD risk among patients who are already receiving lipid lowering therapy. (Source: Journal of Clinical Lipidology)

Clinical and laboratory phenotype of patients experiencing statin intolerance attributable to myalgia

Journal of Clinical Lipidology — Thu, 09 Jun 2011 23:00:00 +0100

Conclusions: Statin intolerance attributable to myalgia is a significant barrier to effective treatment of hyperlipidemia. Conventional clinical risk factors for myositis do not appear to predictive of statin-associated myalgia. These findings underscore the need to better define the pathophysiology of statin-induced myalgia and develop methodologies to guide treatment of statin-intolerant patients. (Source: Journal of Clinical Lipidology)

Reliability of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B measurement

Journal of Clinical Lipidology — Thu, 26 May 2011 23:00:00 +0100

Abstract: There is little understanding of the reliability of laboratory measurements among clinicians. Low-density lipoprotein cholesterol (LDL-C) measurement is the cornerstone of cardiovascular risk assessment and prevention, but it is fraught with error. Therefore, we have reviewed issues related to accuracy and precision for the measurement of LDL-C and the related markers non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B. Despite the widespread belief that LDL-C is standardized and reproducible, available data suggest that results can vary significantly as the result of methods from different manufacturers. Similar problems with direct HDL-C assays raise concerns about the reliability of non-HDL-C measurement. The root cause of method-specific bias relates to ...

Fatal cardiac atherosclerosis in a child 10 years after liver transplantation: A case report and a review

Journal of Clinical Lipidology — Tue, 24 May 2011 23:00:00 +0100

Abstract: We hereby review liver transplantation for homozygous familial hypercholesterolemia and report the case of a 14-year-old girl presenting with severe bilateral coronary ostial stenosis and tight supra-valvular aortic narrowing 10 years after liver transplantation. Despite normalization of the lipids after liver transplantation, the patient showed evidence of severe cardiac atherosclerosis 10 years later and died of apparent sepsis. (Source: Journal of Clinical Lipidology)

Persisting thrombin activity in elderly patients with atrial fibrillation on oral anticoagulation is decreased by anti-inflammatory therapy with intensive cholesterol-lowering treatment

Journal of Clinical Lipidology — Tue, 24 May 2011 23:00:00 +0100

Conclusion: Intensive cholesterol lowering significantly reduced inflammation and was accompanied by reduced thrombin generation. Larger clinical studies should determine which inflammatory markers are most specific and sensitive for estimating the inflammatory burden in these patients and at which corresponding thrombin activity level it is beneficial and safe to add intensive cholesterol lowering therapy even if normal cholesterol levels are present. (Source: Journal of Clinical Lipidology)

Assessment and management of vascular disease risk in patients with chronic kidney disease†

Journal of Clinical Lipidology — Tue, 24 May 2011 23:00:00 +0100

W. Virgil Brown, MD: The Roundtable this month involves discussion of the management of one of the most recalcitrant of all risk factors, chronic kidney disease (CKD), with reduction of the glomerular filtration rate (GFR). This condition is associated with an acceleration of vascular disease, and the mechanisms of the enhanced event rates have been difficult to ascertain. Furthermore, the treatment modalities that benefit persons with more-normal renal function have not provided expected event reduction in CKD. I am joined today by three known experts in management of patients with all degrees of renal compromise and with a special interest in reducing the vascular sequelae. (Source: Journal of Clinical Lipidology)

Multiple lipoprotein and electrolyte laboratory artifacts caused by lipoprotein X in obstructive biliary cholestasis secondary to pancreatic cancer

Journal of Clinical Lipidology — Wed, 18 May 2011 23:00:00 +0100

We present a patient with severe obstructive cholestasis secondary to pancreatic cancer leading to very high Lp-X concentrations resulting in pseudohyponatremia, pseudohypokalemia, pseudohypochloremia and interference with the selective micellary solubilization direct low density lipoprotein cholesterol assay. These spurious laboratory anomalies impeded the initial clinical management of the patient including the attempted correction of the electrolyte abnormalities. After relief of obstruction following biliary stent placement, the patient’s lipid levels normalized. Clinicians must be wary of laboratory artifacts and remember to correlate the laboratory values with the clinical presentation of the patient. Assays employing direct ion-selective electrodes such as those in blood gas analy...

Efficacy and tolerability of once-weekly rosuvastatin in patients with previous statin intolerance

Journal of Clinical Lipidology — Sun, 15 May 2011 23:00:00 +0100

Conclusion: Once-weekly low-dose rosuvastatin is an effective and well-tolerated lipid-lowering therapy option for patients not at LDL goal and previously unable to tolerate statins because of a history of myalgias. (Source: Journal of Clinical Lipidology)

The relationship between body mass index and the variation in plasma levels of triglycerides after short-term red wine consumption

Journal of Clinical Lipidology — Sun, 15 May 2011 23:00:00 +0100

Conclusions: Individuals with higher BMI, although nonobese, might be at greater risk for elevation in plasma TG levels and the TG/HDL-cholesterol ratio after short-term red wine consumption. (Source: Journal of Clinical Lipidology)

Serum fatty acids, antioxidants, and treatment response in hepatitis C infection: Greater polyunsaturated fatty acid and antioxidant levels in hepatitis C responders

Journal of Clinical Lipidology — Sun, 15 May 2011 23:00:00 +0100

Conclusion: SFA profiles and antioxidant status in female CHC patients differ markedly from those of healthy controls, a phenomenon which is possibly related with their effect of HCV replication. (Source: Journal of Clinical Lipidology)

Extended-release niacin/laropiprant lowers serum phosphorus concentrations in patients with type 2 diabetes

Journal of Clinical Lipidology — Sun, 15 May 2011 23:00:00 +0100

Background: Niacin compounds lower serum phosphorus concentrations in patients with end-stage renal disease.Methodology: We evaluated the impact of extended release niacin, given in fixed-dose combination with laropiprant, a specific inhibitor of prostaglandin-mediated, niacin-induced flushing, versus placebo, on serum phosphorus concentrations measured serially (at weeks 0, 4, 8, 12, 18, 24, 30, and 36) during a 36-week randomized, controlled trial. All subjects had a confirmed diagnosis of type 2 diabetes (n = 446 niacin/laropiprant; n = 339 placebo). Estimated glomerular filtration rate ranged from 36 to 184 mL/min/1.73 m2, with n = 111 (14.1%) having a value (Source: Journal of Clinical Lipidology)

Can conclusions that seem discordant be concordant after all?

Journal of Clinical Lipidology — Sun, 15 May 2011 23:00:00 +0100

In the March issue of the Journal of Clinical Lipidology, two articles relating lipoprotein particles to the risk of vascular disease were published. On the face of it, to put it bluntly, they contradicted each other: in one, by Manickam et al, the authors concluded that lipoprotein particle number is not a more accurate index of the lipoprotein-associated risk of vascular disease, whereas in the other, by Otvos et al, the authors concluded that it is. Their conclusions were “discordant.” That alone is not noteworthy: after all, disagreement among investigators is far from exceptional in science. However, the fact that these two studies are based on the same database should capture our attention. How frustrating. Scientific experiments should turn out more like cookies from a cookie c...

A Limited Role for the LDL Receptor Pathway in Regulation of Cholesterol Homeostasis in the Liver