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Defined as the total cholesterol minus high-density lipoprotein (HDL), non-HDL cholesterol has been increasingly acknowledged as a measure of risk estimation for developing atherosclerotic cardiovascular diseases (ASCVD). Comprising of apolipoprotein B100-containing cholesterols (very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), intermediate-density lipoprotein (IDL), and lipoprotein (a) (Lp(a))), and apolipoprotein B48-containing lipoproteins (chylomicrons and its remnants), elevated serum levels of non-HDL cholesterol in early adolescence has been strongly linked with the development of ASCVD in adulthood. This article reviews the evidence from longitudinal studies, which demonstrate the cumulative risk of ASCVD in relation to the elevated levels of non-HDL cholesterol earlier in life.

The atherogenic role of triglycerides (TG) as an independent cardiovascular risk factor has been discussed for many years, largely because hypertriglyceridaemia (HTG) is a complex metabolic entity of multiple aetiology involving processes of diverse nature. In this chapter, a discussion will be presented on the current recommendations for the management of mild-moderate hypertriglyceridaemia (150-880mg/dL). The aim of the interventions used is to decrease the LDL-cholesterol (c-LDL) and control the HTG. This entails reducing apoprotein B (ApoB) levels, the number of remaining TG-rich lipoproteins (LRP), non-HDL-cholesterol (c-non-HDL), and increasing HDL-cholesterol (c-HDL). The management strategy includes healthy lifestyle recommendations, and subsequent use of lipid-lowering drugs, including statins, fibrates, n-3 fatty acids and PCSK9 inhibitors.

Objective To reveal the relationship between uric acid level and carotid atherosclerotic plaques in hypertensive subjects in randomized urban population according to 10-years prospective study. Design and methods A 10-years prospective study included 3,500 randomized individuals living in the district of Vitebsk (2007/2008 - 2017/2018). The coverage of the survey was 97,9% (3427 participants). There was revealed 2170 persons with normal blood pressure. 1862 of them were examined on the second stage in 2012/2013 (coverage of the survey was 85,8%). 286 new cases of hypertension were revealed and they had significant positive relationship with the IV quartile of uric acid level (≥339 μmol/l). A 10-years prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed on the second stage of the study. Specially developed registration form was filled in for all the participants and it included socio-demographic data, standard questionnaires for detection of cardiovascular risk factors, anthropometry, blood pressure measurements, electrocardiography, blood chemistry, ultrasound examination of brachiocephalic arteries and echocardiography. Results According to the results of 10-years prospective study serum uric acid level ≥339 μmol/l, revealed at the start of the study, is a predictor of the detection of carotid atherosclerotic plaques in 2017/2018 in subjects with new cases of hypertension (df=1; χ2 Wald=6,63; p Conclusions Serum uric acid level ≥339 μmol/l predicted detection of carotid atherosclerotic plaques in patients with new cases of hypertension in 10-years prospective study. The most significant factors, regardless of age and gender, associated with serum uric acid levels in these patients were level of triglycerides, alcohol abuse, body mass index, apoB/apoA1 ratio and level of high-sensitivity C-reactive protein. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Republican Scientific and Practical Centre of Cardiology

BACKGROUND: Associations between increased dietary fat and decreased carbohydrate intake with circulating HDL and non-HDL cholesterol have not been conclusively determined. OBJECTIVE: We assessed these relations in 8 European observational human studies participating in the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) using harmonized data. METHODS: Dietary macronutrient intake was recorded using study-specific dietary assessment tools. Main outcome measures were lipoprotein cholesterol concentrations: HDL cholesterol (mg/dL) and non-HDL cholesterol (mg/dL). A cross-sectional analysis on 5919 participants (54% female) aged 13-80 y was undertaken using the statistical platform DataSHIELD that allows remote/federated nondisclosive analysis of individual-level data. Generalized linear models (GLM) were fitted to assess associations between replacing 5% of energy from carbohydrates with equivalent energy from total fats, SFAs, MUFAs, or PUFAs with circulating HDL cholesterol and non-HDL cholesterol. GLM were adjusted for study source, age, sex, smoking status, alcohol intake and BMI. RESULTS: The replacement of 5% of energy from carbohydrates with total fats or MUFAs was statistically significantly associated with 0.67mg/dL (95% CI: 0.40, 0.94) or 0.99mg/dL (95% CI: 0.37, 1.60) higher HDL cholesterol, respectively, but not with non-HDL cholesterol concentrations. The replacement of 5% of energy from carbohydrates with SFAs or PUFAs was not associated with HDL cholesterol, but SFAs were statistically significantly associated with 1.94mg/dL (95% CI: 0.08, 3.79) higher non-HDL cholesterol, and PUFAs with -3.91mg/dL (95% CI: -6.98, -0.84) lower non-HDL cholesterol concentrations. A statistically significant interaction by sex for the association of replacing carbohydrates with MUFAs and non-HDL cholesterol was observed, showing a statistically significant inverse association in males and no statistically significant association in females. We observed no statistically significant interaction by age. CONCLUSIONS: The replacement of dietary carbohydrates with fats had favorable effects on lipoprotein cholesterol concentrations in European adolescents and adults when fats were consumed as MUFAs or PUFAs but not as SFAs.

Background: Dyslipidemia contributes to the development and progression of cardiovascular disease. However, the potential association between non-high-density lipoprotein-cholesterol-to-high-density lipoprotein-cholesterol (nonHDLc/HDLc) ratio and mortality in septic patients is unclear.Methods: This was a retrospective cohort study of patients with sepsis in the eICU Collaborative Research Database (eICU-CRD) from 208 distinct ICUs across the United States between 2014 and 2015. All-cause mortality within 28-days after ICU admission. A multivariable logistic regression model was used to estimate the risk of death.Result: Of the 724 patients with a median age of 68 years, 43 (5.94%) died within 28 days after ICU admission. The association between the nonHDLc/HDLc ratio and the risk of all cause mortality was J shaped, and a high level was associated with increased risk of all cause mortality. The mortality rate increased when the nonHDLc/HDLc ratio higher than the turning point (≥3.41) with an adjusted odds ratio (OR) of 1.34 (95% CI: 1.07–1.67, P=0.010) for every 1 increment of nonHDLc/HDLc ratio. With the per-SD increase in the nonHDLc/HDLc ratio, the OR of mortality was 1.79 (95% CI: 1.15–2.80, P=0.010) when the nonHDLc/HDLc ratio was ≥3.41. The trend of sensitivity analysis was consistent with the main analysis.Conclusion: For patients with sepsis, the association between the nonHDLc/HDLc ratio and the 28-day mortality risk was J shaped. A higher level of nonHDLc/HDLc ratio was associated with an increased risk of 28-day mortality. These findings need to be confirmed in other studies.

To explore whether non-high-density-lipoprotein cholesterol (non-HDL-c) is associated with depression, a total of 26 819 Canadians aged 45–85 from the Canadian Longitudinal Study on Aging (CLSA) were included in analysis. Non-HDL-c, the difference between total-c and HDL-c, was categorized into five levels, i.e.

Background: Metabolic syndrome over decades has undergone multiple diagnostic criteria announced by National Cholesterol Education Program (NCEP), WHO, International Diabetic Federation (IDF) and certain regional criteria. Recently, Soldatovic et al. have provided a mathematical model for evaluating metabolic syndrome. We aimed to compare siMS score among subjects with and without metabolic syndrome and other biochemical risks including insulin resistance. Methods: The study was conducted at PNS HAFEEZ hospital from July-2017 to Jan-2019. A comparative cross-sectional analysis was carried out among 232 subjects to evaluate siMS score among metabolic syndrome and those without metabolic syndrome. Pearson’s correlation was performed for siMS score with other anthropometric and biochemical measures. Finally ROC curve analysis was performed to evaluate various biomarkers along with siMS score for diagnosis of metabolic syndrome. Results: Insulin resistance between subjects was higher among subjects with metabolic syndrome [Mean = 3.27 ± 4.45] than non-metabolic syndrome subjects [Mean = 2.10 ± 1.89] (p = 0.012). Differences in siMS score was higher in subjects with metabolic syndrome (Mean = 3.58 ± 0.725, N = 121) than subjects without metabolic syndrome (Mean = 2.83 ± 0.727, N = 108). AUC for various biochemical parameters was highest for sdLDL cholesterol and siMS score. Conclusion: siMS score has shown better performance than HOMAIR, sdLDL cholesterol, non-HDL cholesterol, HbA1c, and fasting plasma glucose in diagnosing metabolic syndrome.

Background: India has seen an ever increasing number of diabetic patients and in turn rise in cardiovascular diseases. Many studies have shown diabetic patients to have dyslipidemia, with certain common patterns early in the disease. Aims and Objective: The current study was done to identify pattern of dyslipidemia and prevalence of ADD in treatment naïve diabetic patients. Material and Methods: Fasting lipid profile was analysed in treatment naïve diabetic patients at a tertiary care teaching hospital. Various factors influencing the results were analysed statistically. Results: Prevalence of dyslipidemia was 89.2%, whereasatherogenic diabetic dyslipidemia was seen in 34.2% and raised non-HDL cholesterol in 73.3%. Conclusion: Our study showed a high prevalence of dyslipidemia in newly diagnosed diabetics indicating the importance of screening for dyslipidemia in newly diagnosed cases and implementation of timely lipid lowering therapy to prevent CVD. It also highlights the importance of pattern of dyslipidemia called Atherogenic diabetic dyslipidemia and raised Non-HDL cholesterol in diabetic patients.

Background Extended elevations of non–high-density lipoprotein cholesterol (non–HDL-C) across a lifespan are associated with increased risk of cardiovascular disease (CVD). However, optimal testing intervals to identify individuals with high lipid-related CVD risk are unknown. Objectives This study determined the extent to which lipid levels in young adulthood predict future lipid trajectories and associated long-term CVD risk. Methods A sample of 2,516 Framingham Offspring study participants 25 to 40 years of age free of CVD and diabetes had their non–HDL-C progression modeled over 8 study examinations (mean follow-up 32.6 years) using group-based methods. CVD risk based on 25 to 30 years of follow-up was evaluated using Kaplan-Meier analyses for those with mean non–HDL-C ≥160 mg/dl (“high”) and Results The trajectories of the lipid levels were generally stable over the 30-year life course; mean non–HDL-C measured in young adulthood were highly predictive of levels later in life. Individuals could be reliably assigned to high and low non–HDL-C groups based on 2 measurements collected between 25 to 40 years of age. Overall, 80% of those with non–HDL-C ≥160 mg/dl at the first 2 exams remained in the high group on subsequent 25-year testing, whereas 88% of those with non–HDL-C Conclusions Most adults with elevated non–HDL-C early in life continue to have high non–HDL-C over their life course, leading to significantly increased risk of CVD. The results demonstrate that early lipid monitoring before 40 years of age would identify a majority of those with a high likelihood for lifetime elevated lipid levels who also have a high long-term risk for CVD. This information could facilitate informed patient–provider discussion about the potential benefits of preventive lipid-lowering efforts during the early midlife period.

OBJECTIVES: Industrialization has increased chronic disease prevalence, potentially due to lifestyle-induced disruptions of the gut microbiome. Decreased intake of dietary fibers is likely a key factor as they play an important role in chronic disease prevention and are growth substrates for the gut microbiota. Strategies that restore microbiome diversity, such as reintroducing health-promoting bacterial species and microbiota accessible carbohydrates (MACs), have been proposed to improve health but have not yet been systematically tested. The objective of this study was to determine the effects of a microbiome restoration strategy on metabolic markers in healthy adults. METHODS: Using a randomized controlled pilot study, 30 subjects consumed either a MAC-rich diet or their usual diet for three weeks each in a crossover fashion, with a three-week washout following each diet period. Participants were further divided into three groups and consumed either a single dose of one of two Limosilactobacillus reuteri strains, a rare species in industrialized microbiomes, or a placebo on day four of each diet period. Metabolic markers (standard lipid panel, glucose, insulin, C-reactive protein (CRP)) were assessed in blood collected at the start and end of each diet period. Data were analyzed using repeated measures ANOVA. RESULTS: Compared to baseline, the MAC-rich diet induced substantial metabolic changes, as it reduced total cholesterol (P

Funding Acknowledgements Type of funding sources: None. Background Yoga and resistance exercise are gaining popularity and can improve the health status in the adult population. There is a lack of evidence that compares these two types of physical activity and their influence on lipid profile and cardiovascular risk on people without preexisting cardiovascular disease. Aim To estimate and compare effects of yoga and resistance training on blood lipids and anthropometric parameters in people without preexisting cardiovascular disease. Methods 123 adults without preexisting cardiovascular disease were enrolled in the study. Participants had practiced in yoga (63 people) or resistance exercise (60 people) at least 2 times a week during the last 12 months. The control consisted of 35 people who did not engage in any regular physical exercise. Weight, height, waist, hip circumference and body mass index (BMI), blood pressure, total cholesterol, triglycerides and high-density lipoproteins cholesterol, blood glucose were measured. To assess physical activity and sedentary time, the International Questionnaire on long Physical Activity (IPAQ) was used. Daily calorie food intake were measured by Test of rational nutrition TRN-D03. Result The average age of all participants was 35,06 ± 8,45 years old. BMI was significantly affected in "yoga training" (1-st group) and "resistance training" (2-nd group) groups (22,9 ± 2,6 and 24,2 ± 3,7; p = 0,19), but was significantly lower than in control group (3-rd group) 25,8 ± 2,1. Total Cholesterol, triglycerides, non-HDL cholesterol and blood glucose were not with significant difference between "yoga training" and "resistance training" groups. High-density lipoprotein (HDL) level was in "yoga training" group - 1,65 ± 0,37; in "resistance training" - 1,43 ± 0,21, and in control group - 1,34 ± 0,22 mmol/l (p1-2 = 0,001; p1-3 = 0,0001; p2-3 = 0,037). Low-density lipoprotein (LDL) was in yoga training group - 2,69 ± 0,98; in resistance training group - 2,72 ± 0,77, and in control group - 2,93 ± 0,89 mmol/l (p1-2 = 0,35; p1-3 = 0,053; p2-3 = 0,20). The systolic and diastolic blood pressure were in "yoga training" group - 117,0 ± 9,79; in "resistance training" - 118,5 ± 8,93; 3-rd - 120,2 ± 10,1 mm Hg (p > 0.05). Although, there were no significant differences in LDL-cholesterol levels between the yoga and resistance training groups, we found an association between weekly vigorous physical activity level and LDL cholesterol in the male group. LDL-cholesterol level in group 1 (vigorous physical activity 0-960 MET-min/week) was 3,4 ± 0,88 mmol/l; group 2 (vigorous physical activity 960 - 1440 MET-min/week) was 2,6 ± 0,74 mmol/l and in group 3 (vigorous physical activity > 1440 MET-min/week) - 2,1 ± 0,71 mmol/l (ANOVA-test F = 16,3; p = 0,03). Conclusion Yoga and resistance training have positive effects on HDL, LDL level and BMI, without effects on blood pressure in people without preexisting cardiovascular disease. The level of LDL was influenced not by the type of training, but by intensity of weekly physical activity.

Funding Acknowledgements Type of funding sources: Other. Main funding source(s): The ATTICA study is supported by research grants from the Hellenic Cardiology Society [HCS2002] and the Hellenic Atherosclerosis Society [HAS2003]. Background/Introduction: Consistent evidence exists for a causal association between blood cholesterol and cardiovascular disease (CVD) yet alternative lipid markers are still discussed. To this issue, non-High Density Lipoprotein (non-HDL) cholesterol offers a simple way to analyze the total amount of pro-atherogenic lipoproteins containing apolipoprotein B100. Purpose: The aim of the present work was to evaluate the 10-year first fatal/non fatal CVD incidence related to non-HDL cholesterol on the basis of existing thresholds suggested by the European Society of Cardiology (ESC) in a sample with prevalent CVD. Methods: ATTICA study was conducted during 2001-2012 including n = 1,514 men and n = 1,528 women (aged >18 years old) from the greater Athens area, Greece. Baseline serum blood lipids profile was measured. Non-HDL cholesterol was evaluated according to the formula "total cholesterol minus HDL cholesterol" and the following categories were used: 220mg/dL; HR5th vs. 1st category = 1.95, 95%CI (1.10, 4.30). Sex-based stratified analysis revealed significance only in men and particularly HR5th vs. 1st category = 3.14, 95%CI (1.26, 5.10). In case of women the aggravating effect was retained yet without reaching the level of significance. Conclusion: Even if non-HDL cholesterol concentrations in blood are strongly associated with long-term risk of atherosclerotic CVD, its use in daily clinical practice is challenged. These outcomes could be useful for physician–patient communication about primary prevention strategies.

Background Low-density lipoprotein cholesterol (LDL-C) is an established risk factor for cardiovascular disease (CVD), and a target for lipid-lowering therapy. LDL-C is typically not measured directly but is estimated using the Friedewald formula, which assumes a fixed factor for the ratio of triglycerides (TG) to very low-density lipoprotein cholesterol (VLDL-C). However this assumption is sometimes not valid. The Martin/Hopkins (M/H) formula estimates LDL-C using an adjustable factor for the TG:VLDL-C ratio and is expected to improve upon Friedewald when predicting measured LDL-C, and apolipoprotein B (ApoB), one molecule of which is associated with each LDL particle. Purpose We compared values of LDL-C calculated by the Friedewald and M/H methods with respect to their correlation with non-high density lipoprotein cholesterol (non-HDL-C) and ApoB, and their classification of individuals based upon attainment of the threshold value of 70 mg/dl (1.8 mmol/l) of LDL-C. This cut-point is a treatment target for individuals at high risk of CVD in the 2019 ESC guidelines for lipid modification, and a threshold for initiating statin therapy in the 2019 ACC/AHA guidelines. Methods In this analysis we included participants in the National Health and Nutrition Examination Survey (NHANES) from 2005–2016, age ≥18, 70, we classified these participants as discordant. Statistical analyses were performed in IBM SPSS for Windows v26. Results 12,243 individuals were included. 51.8% were female, mean (±SD) age was 45.5±17.4, 15.3% were treated with statins, ApoB was available for 2179 participants. Mean lipid concentrations (mg/dl) were: TC: 191.5±41.0, TG: 120.0±67.0, HDL-C: 54.1±15.7, LDL-C (Friedewald): 113.3±35.4; LDL-C (M/H): 114.9±35.2. In the whole population, LDL-C (M/H) was more strongly correlated than LDL-C (Friedewald) with ApoB (r=0.935 v 0.894) and non-HDL-C (r=0.981 v 0.944). In statin-treated participants, LDL-C (M/H) was also more strongly correlated with ApoB (r=0.951 v 0.914) and non-HDL-C (r=0.979 v 0.928). 1139 participants had LDL-C (Friedewald) 70 mg/dl. Amongst statin-treated patients, 22.9% were discordant. Only 5.5% of individuals with LDL-C (M/H) 70 mg/dl). Conclusions The M/H method of calculating LDL-C correlates more strongly with non-HDL-C and ApoB than Friedewald. Importantly the discordant results confirm previous observations that Friedewald underestimates LDL-C at low concentrations. This may result in under-use of lipid-lowering therapies. Funding Acknowledgement Type of funding source: None

Background and aims Based on the developed technology of prerparation of ultra small size phospholipid nanoparticles without the use of detergents/surfactants and stabilizers drug preparation, exhibiting hypolipidemic properties has been obtained. Preclinical studies have shown that phospholipid nanoparticles of 20–30 nm (PLN) activate reverse cholesterol transport. PLN is now at the stage of clinical trials (Phase II study completed). The aim of the study was to compare the efficacy, safety and tolerability of PLN relative to placebo in the treatment of combined hyperlipidemia. Methods This Phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group study was conducted at 4 centers. The patients (pts) received PLN or placebo (1:1), powder for oral solution preparation (in an aqueous environment is a nanoemulsion with a particle size of 20–30 nm), 500 mg (sachet) orally 2 times a day for 12 weeks. Lipid parameters, safety and tolerability were measured. The data is presented in M (s), Me (lq; hq). Mann-Whitney U Test was to compare the significant difference of groups. P value Results A total of 100 pts with combined hyperlipidemia were randomized (age 35–70 years, males 58%).The mean age of patients was 56.4 (10.2) years. Mean total cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), TG, and apolipoprotein B 100 (apoB) levels at baseline were 5.59 (0.8) mmol/l, 4.51 (0.75) mmol/l, 2.38 (0.6) mmol/l and 114.26 (24.96) mg/dl, respectively (n=100). Mean high-density lipoprotein cholesterol (HDL-C) and Lp(a) levels at baseline were 1.0 (0.25) mmol/l and 21.1 (3.9; 20.3)mg/dl, respectively (n=100). At Week 12, PLT significantly reduced total cholesterol, non-HDL-C levels, TG and apo B compared to placebo (p=0.02, p=0.03, p=0.001 and p=0.02, respectively). At the same time, the mean HDL-C level was significantly increased (p=0.03). The drug was well tolerated and no clinically significant laboratory abnormalities were detected. Conclusions This study demonstrates that therapy with PLT is well tolerated in additional beneficial effects on key lipid parameters in patients with moderate combined hyperlipidemia. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Ministry of industry and trade

Background BANTING and BERSON showed evolocumab in type 2 diabetes (T2D) effectively lowered low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), and non-high-density lipoprotein-cholesterol (Non-HDL-C), all targets in cardiovascular disease (CVD) prevention. Purpose To evaluate the achievement of lipid treatment goals with evolocumab vs placebo in T2D. Methods We pooled two double-blind, randomised, phase 3 studies. In BANTING, participants received maximally-tolerated statins. In BERSON, participants began atorvastatin 20 mg post-baseline; almost half enrolled in China. LDL-C and non-HDL-C goal achievement were assessed at the mean of weeks 10 and 12; and ApoB at week 12. Results Of 1,402 participants analysed, 89.4% were at very high CVD risk. Treatment goals achievement was significantly greater in evolocumab vs placebo. Results were consistent in the Chinese subpopulation. Conclusion Evolocumab plus statins enabled most T2D patients at very-high/high CVD risk to achieve their lipid treatment goals Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Amgen Inc.

Background: The non-HDL-cholesterol to HDL-cholesterol (non-HDL-c/HDL-c) rate shows a close relationship to multiple dyslipidemia related disease. This paper aims at investigating the association of the non-HDL-c/HDL-c rate and the risk of NAFLD among children and adolescence in China.Methods: In this retrospective cohort study, a total of 7759 eligible children and adolescence (5692 boys, 2067 girls) having received regular medical examination were recruited. We collected anthropometric measurements and laboratory tests data of subjects. The binary logistics regression was employed for the assessment of the associations of the non-HDL-c/HDL-c rate with NAFLD. Sex-specific ROC curve analysis was conducted for comparing the predictive value of non-HDL-c/HDL-c rate, non-HDL-c and HDL-c for NAFLD.Results: The total NAFLD prevalence was 4.36%, higher in boys than that in girls (5.61% vs. 1.9%, PPP< 0.001) in the maximum tertiles (maximum non-HDLc/HDLc ratio) compared with the minimum tertiles. When potential confounders were regulated, compared with the minimum tertiles, the OR for the maximum tertiles (OR=3.94, 95%CI=2.33-6.66, P< 0.001) was still significantly higher. AUC values of the non-HDL-c/HDL-c rate ( 0.787 in boys and 0.763in girls) noticeably reached over non-HDL-c (0.719 in boys and 0.661 in girls) and HDL-c (0.726 in boys and 0.732 in girls). Furthermore, the optimal cutoff value of the non-HDL-c/HDL-c rate for NAFLD was 2.475 in boys and 2.695 in girls.Conclusions: The present study indicate that a higher non-HDL-c/ HDL-c rate caused a higher risk of NAFLD among children and adolescence. Moreover, the non-HDL-c/HDL-c rate showed a better predictive value for NAFLD than the non-HDL-c and HDL-c in both boys and girls.

Background and Aims: Non-high density lipoprotein cholesterol (non- HDL-C), which reflects all cholesterol present in potentially atherogenic lipoprotein particles, might be a useful marker of atherosclerosis in diabetic subjects. In the present study, we evaluated the prevalence of high non-HDL-C in patients with dyslipidemia in diabetic and non-diabetic subjects following LDL-C assessment as the first goal of therapy. Materials and Methods: A data set of 2142 individuals was included in the study. All values of lipid profile were compared between non-diabetic and diabetic groups and the prevalence of dyslipidemia was evaluated in two groups. Results and Conclusions: According to the results, 48% of patients with diabetes achieved combined LDL-C ≤2.5 mmol/L and non-HDL ≤3.3 mmol/L targets, and 58.2% of diabetic patients achieved LDL-C goal while only 50.2% attained non-HDL-C goal. Also, the results indicated that non-HDL-C significantly heightened in patients with diabetes. Therefore, non-HDL-C needs to be calculated as a routine assessment in patients with diabetes.

Background and Aims The association of lipid parameters with cardiovascular outcomes and the impact of kidney function on this association have not been thoroughly evaluated in chronic kidney disease (CKD) patients with diabetes. Method We reviewed the National Health Insurance Database of Korea, containing the data of 10,505,818 subjects who received routine check-ups in 2009. We analyzed the association of lipid profile parameters with major adverse cardiovascular events (MACEs) risk and all-cause mortality in a nationally representative cohort of 51,757 lipid-lowering medication-naïve patients who had CKD and diabetes. Results Advanced CKD patients with eGFR Conclusion The LDL-c level predicted the risk for MACEs and all-cause mortality in both early and advanced CKD patients with diabetes, although the patterns of the association differed from each other. However, the TG/HDL-c ratio categories could not predict the risk for either MACEs or all-cause mortality in advanced CKD patients with diabetes, except that the TG/HDL-c ratio predicted MACE risk in early CKD patients with diabetes.

OBJECTIVES: Non-HDL-cholesterol (non-HDL-C) has been reported to be a better marker of cardiovascular risk than LDL-cholesterol (LDL-C) especially in individuals with high triglyceride values. Further, levels of remnant cholesterol have been suggested to in part explain residual risk not captured with LDL-C. The aim of the present study was to define reference values for non-HDL-C and remnant cholesterol based on data from the Nordic Reference Interval Project (NORIP). METHODS: We analyzed the test results for total cholesterol, HDL-cholesterol and triglycerides from 1392 healthy females and 1236 healthy males. Non-HDL-C was calculated as measured total cholesterol minus measured HDL-cholesterol. Remnant cholesterol was calculated using the Friedewald equation for LDL-C: measured total cholesterol minus measured HDL-cholesterol and minus calculated LDL-cholesterol. The 2.5th and 97.5th percentiles for these markers were calculated according to the International Federation of Clinical Chemistry guidelines on the statistical treatment of reference values. RESULTS: Age (18

Non high density lipoprotein cholesterol (non-HDL-C) is a risk factor for cardiovascular disease (CVD) in people with type 2 diabetes. The aim of our study is to estimate the relative multivariate risk of non-HDL-C in the occurrence of CVD in a population in the extreme western Algeria with type 2 diabetes mellitus (T2DM).Our study was carried out in western Algeria on a population of 1111 subjects, 371 cardiopaths with T2DM and 740 controls. The biochemical balance was established using standard enzymatic procedures (SFBC or IFCC recommendations) on the Beckman CX7The logistic model retained the two levels of non-HDL-C: 130 mg/dl non-HDL-C≤160 mg/dl (OR = 0.11; 95% CI = 0.03-0,47, P = 0.003) and 160 mg/dl non-HDL-C≤190 mg/dl (OR = 5.02; 95% CI = 1.1-22.87, P = 0.037) and smoking (OR = 19.27; 95% CI = 3.39-109.63, P = 0.001), inbreeding (OR = 3.65; 95% CI = 1.12-11,85, P = 0.031) and the two age groups 60-70 years (OR = 2.36; 95% CI = 1.32-4.2, P0.01) and 70 years and over (OR = 2.26; 95% CI = 1.19-4.29, P0.05).Non-HDL-C is a powerful risk factor for the occurrence of cardiovascular disease in type 2 diabetics in the extreme western Algeria.

Objective Non high density lipoprotein cholesterol (non HDL-C) covers all aterojenic lipoproteins and correlates with C reactive protein (CRP) which is reliable marker of inflammation. CRP is related to poor angiographic coronary collateral circulation (CCC). We aimed to show whether non HDL-C is associated with CCC.Methods Patients who underwent coronary angiography for stable coronary artery disease and at least one epicardial coronary artery occluded in the proximal or middle region were included in the study. Accrording to the Rentrop scoring system Rentrop 0 and 1 were considered to be poor CCC, and Rentrop 2 and 3 were considered to be good CCC. Non-HDL-C was calculated by subtracting HDL-C from total cholesterol (TC).Results 84 patients were included in the study. While 44 patients (52%) had good CCC, 40 patients (48%) had poor CCC. TC was found to be higher in the poor CCC group than in the good CCC group (224.3 ± 35.6 vs 179.2 ± 25.5 p = 0.000). HDL-C levels were found to be lower in the poor CCC group than in the good CCC group (37.3 ± 9.8 vs 44.1 ± 8.6 p = 0.001). Non-HDL-C cholesterol levels were higher in the group with poor CCC (185.7 ± 39.2 vs 132.8 ± 28.1 p = 0.000). CRP levels were found to be higher in the poor CCC group (3.73 ± 2.5 vs 1.67 ± 1.4 p = 0,000).Conclusion Non-HDL-C is independent predictors of poor CCC.

Chronic cadmium exposure and its effect on cardiovascular-related markers were explored in the cross-sectional study of U.S. adults using the National Health and Nutrition Examination Survey (NHANES) 2007-2010 data. Cardiovascular-related markers, such as LDL cholesterol mg/dL (LDL-C), non-HDL cholesterol mg/dL (non-HDL-C), triglycerides mg/dL (TG), c-reactive protein mg/dL (CRP), and gamma-glutamyl transferase U/L (GGT) were explored in relation to urine cadmium level µg/L (UCL). The variables and their relation to UCL µg/L were explored both as continuous and categorical variables using linear and logistic regression models and basic descriptive statistics. Geometric Mean values of the markers of interest were statistically significantly more elevated in middle-aged adults (45-65 years) as compared to younger adults (18-44 years). In linear regression analysis, CRP mg/dL, LDL-C mg/dL, non-HDL-C mg/dL, and GGT U/L levels were significantly associated with UCLs mg/dL after adjusting for confounding variables. In binary logistic regression models, young and middle-aged adults chronically exposed to cadmium were significantly more likely to have elevated CRP mg/dL levels. This study suggests that chronic exposure to cadmium alters cardiovascular-related markers in middle-aged adults more so than younger adults, which calls for early public health intervention to limit cadmium exposure in the U.S.

IMPORTANCE: Lipid management typically focuses on levels of low-density lipoprotein cholesterol (LDL-C) and, to a lesser extent, triglycerides (TG). However, animal models and genetic studies suggest that the atherogenic particle subpopulations (LDL and very-low-density lipoprotein [VLDL]) are both important and that the number of particles is more predictive of cardiac events than their lipid content. OBJECTIVE: To determine whether common measures of cholesterol concentration, TG concentration, or their ratio are associated with cardiovascular risk beyond the number of apolipoprotein B (apoB)–containing lipoproteins. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort analysis included individuals from the population-based UK Biobank and from 2 large international clinical trials, FOURIER and IMPROVE-IT. The median (IQR) follow-up was 11.1 (10.4-11.8) years in UK Biobank and 2.5 (2.0-4.7) years in the clinical trials. Two populations were studied in this analysis: 389 529 individuals in the primary prevention group who were not taking lipid-lowering therapy and 40 430 patients with established atherosclerosis who were receiving statin treatment. EXPOSURES: ApoB, non–high-density lipoprotein cholesterol (HDL-C), LDL-C, and TG. MAIN OUTCOME AND MEASURES: The primary study outcome was incident myocardial infarction (MI). RESULTS: Of the 389 529 individuals in the primary prevention group, 224 097 (58%) were female, and the median (IQR) age was 56.0 (49.5-62.5) years. Of the 40 430 patients with established atherosclerosis, 9647 (24%) were female, and the median (IQR) age was 63 (56.2-69.0) years. In the primary prevention cohort, apoB, non–HDL-C, and TG each individually were associated with incident MI. However, when assessed together, only apoB was associated (adjusted hazard ratio [aHR] per 1 SD, 1.27; 95% CI, 1.15-1.40; P

한국 노인을 대상으로 대사증후군 예측인자로서 혈중 Non HDL-콜레스테롤과 중성지방/HDL-콜레스테롤 비율의 임상적용 가능성을 평가하고자 하였다. 2015년 1월부터 2017년 12월까지 경기지역 종합병원의 건강검진센터를 내원하여 건강검진을 실시한 65세 이상 노인을 1,543명을 대상으로 하였다. 대사증후군은 American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI)기준에 따라 진단하였다. 복부비만은 World Health Organization (WHO) West Pacific Region에서 제시하는 아시아-태평양인의 기준을 적용하였다. Non HDL-콜레스테롤은 총콜레스테롤과 HDL-콜레스테롤의 차이로 계산하였다. 대사증후군 예측력은 Non HDL-콜레스테롤보다 중성지방/HDL-콜레스테롤 비율이 높게 나타났다. 관련요인을 보정한 후 중성지방/HDL-콜레스테롤 비율은 1사분위수보다 4사분위수의 대사증후군 발병 위험이 높았다. 또한 대사증후군 발병을 예측하는 중성지방/HDL-콜레스테롤 비율의 적정 기준값은 2.8이었다. 중성지방/HDL-콜레스테롤 비율은 대사증후군 위험을 평가하는 간단하고 실용적인 지표가 될 수 있겠다.

Background and aims Non–high-density lipoprotein cholesterol (non-HDL-C) goals are defined as 30 mg/dL (0.78 mmol/L) higher than the respective low-density lipoprotein cholesterol (LDL-C) goals. This definition, however, do not consider the population distribution of non-HDL-C, which could represent a more appropriate individual goal when both markers are discordant. The aim of this study is to establish non-HDL-C goals at the same population percentiles of LDL-C. Methods Non-HDL-C values were assigned at the same percentiles correspondent to the LDL-C treatment goals for 14,837 participants from the Longitudinal Study of Adult Health (ELSA-Brasil) with triglycerides levels ≤ 400 mg/dL (4.52 mmol/L). We also assessed the frequency of reclassification, defined as the number of subjects with LDL-C levels in the recommended therapeutic category, but with non-HDL-C levels above or below the category. Results The non-HDL-C values, based on correspondent LDL-C population percentiles, were 92 (2.38), 122 (3.16), 156 (4.04), 191 (4.95), and 223 mg/dL (5.78 mmol/L). Among participants with LDL-C Conclusions Our results demonstrated that non-HDL-C percentiles-based goals were up to 8 mg/dL (0.21 mmol/L) lower than the guidelines recommended goal and had a profound impact on the reclassification of participants, notably when LDL-C was

Background Knowledge about the impact of modifiable risk factors for cardiovascular disease (CVD) onset is essential to improve CVD prevention. Purpose We estimated population-attributable fractions (PAFs) of body-mass-index (BMI), systolic blood pressure (SBP), diabetes, blood lipids (non-high-density lipoprotein cholesterol; non-HDL-C) and daily smoking for CVD. Methods Harmonized data from MOnica Risk, Genetics, Archiving and Monograph (MORGAM) and Biomarkers for Cardiovascular Risk Assessment in Europe (BiomaCaRE) consortia were used to calculate hazard ratios (HRs; 95% CI) and PAFs for incident CVD (myocardial infarction or coronary death, unstable angina, cardiac revascularization, ischemic stroke). PAFs for single risk factors or any combination of them were estimated using methods by Laaksonen 2011. Results We included 150,190 participants (77,801 men and 72,389 women) without CVD at baseline. Strongest associations were seen for SBP ≥160 mmHg (HR 1.79, 1.67–1.92 men; HR 1.93, 1.75–2.14 women), diabetes (HR 2.02, 1.86–2.20 men; HR 2.29, 2.06–2.55 women), non-HDL-C ≥220 mg/dL (HR 3.11, 2.49–3.88 men; HR 2.27, 1.68–3.05 women), daily smoking (HR 1.82, 1.73–1,90 men; HR 2.16, 2.0–2.33 women). Table 1 provides PAFs for incident CVD. Overall PAFs for men and women were 73.7% (67.7–79.1) and 73.3% (64.9–80.9). Table 1. PAFs (%) for 5-year incident CVD Risk factor/category PAFs (95% CI), men PAFs (95% CI), women Underweight 0.1 (−0.1, 0.3) 0.2 (−0.1, 0.6) Pre-obesity 6.6 (4.3, 8.9) 4.3 (1.5, 6.9) Obesity 3.9 (2.7, 5.3) 8.0 (5.3, 10.5) SBP 130 to Conclusion Uncontrolled risk factors, especially non-HDL-C and SBP in the highest category, daily smoking and diabetes had the highest impact for incident CVD. All risk factors combined accounted for a PAF of 73%. Targeting risk factors would lead to a substantial reduction of CVD onset. Acknowledgement/Funding BiomarCaRE: EU Seventh Framework Programme (FP7/2007-2013), No. HEALTH-F2-2011-278913. MORGAM: EU FP 7 CHANCES (HEALTH-F3-2010-242244).

Aims The total cholesterol (TC)/high-density lipoprotein (HDL) cholesterol ratio may carry additional information not available in more commonly used single cholesterol measures. Analysis of discordance between lipid parameters might help assess the impact of such additional information on the risk of atherosclerotic cardiovascular disease. We aimed to investigate the role of the TC/HDL-cholesterol ratio in determining atherosclerotic cardiovascular disease risk when discordant with low-density lipoprotein (LDL) cholesterol and non-HDL-cholesterol. Methods We studied 14,403 Atherosclerosis Risk in Communities (ARIC) study participants who were free of atherosclerotic cardiovascular disease at baseline. TC/HDL-cholesterol discordance with LDL-cholesterol (estimated by the novel Martin/Hopkins method) and non-HDL-cholesterol was assessed at five visits and determined by being at or above the median for each lipid parameter. We constructed Cox proportional hazard models to estimate the risk for incident atherosclerotic cardiovascular disease events associated with each lipid concordance/discordance category using a time-varying approach. Results Mean age of participants was 54.1 years, 56% women and 25% black. There were 2634 atherosclerotic cardiovascular disease events over a median (interquartile range) follow-up of 24.2 (16.0–25.4) years. Among individuals with LDL-cholesterol and non-HDL-cholesterol less than the median, 26% and 21% had discordant TC/HDL-cholesterol at or above the median, respectively. These individuals had a 24% (hazard ratio (HR) 1.24, 95% confidence interval (CI) 1.09, 1.41) and 29% (HR 1.29, 95% CI 1.13, 1.46) greater risk of incident atherosclerotic cardiovascular disease, respectively, compared to those with TC/HDL-cholesterol less than the median after multivariable adjustment. In individuals with diabetes with LDL-cholesterol or non-HDL-cholesterol less than the median, discordant TC/HDL-cholesterol at or above the median was more prevalent at 48% and 38%, respectively. Conclusion Clinically significant discordance exists between TC/HDL-cholesterol, available from the standard lipid profile, and the routinely used non-HDL-cholesterol and LDL-cholesterol. Such discordance may help inform atherosclerotic cardiovascular disease risk management, particularly in individuals with diabetes in whom discordance is more common.

Non-HDL cholesterol was originally conceived as a therapeutic target for statin treatment in hypertriglyceridaemia when apolipoprotein B100 assays were not widely available. Recently non-HDL cholesterol has been recommended to replace LDL cholesterol in the clinical management of dyslipidaemia routinely in general medical practice. This is misguided.Non-HDL cholesterol is heterogeneous, constituting a mixture of triglyceride-rich VLDL, intermediate density lipoprotein and LDL in which small dense LDL is poorly represented and to which VLDL cholesterol contributes increasingly as triglyceride levels rise. This makes it unsuitable as a goal of lipid-lowering treatment or as an arbiter of who should receive such treatment. Results of trials designed to lower LDL cholesterol are not easily translated to non-HDL cholesterol. Fasting is no longer thought essential for screening the general population for raised LDL cholesterol. ApoB100 measurement also does not require fasting even in rarer more extreme lipoprotein disorders encountered in the Lipid Clinic, provides greater precision and specificity and overcomes the problems posed by LDL and non-HDL cholesterol. It is more easily interpreted both in diagnosis and as a therapeutic goal and it includes SD-LDL.If we are to discourage use of LDL cholesterol, it should be in favour of apoB100 not non-HDL cholesterol.

Previous report showed that more intensive lipid-lowering therapy was associated with less mortality when baseline LDL-C levels were > 100 mg/dL. Non-HDL-C is a better predictor of cardiovascular risk than simpler LDL-C. The objective of this meta-analysis was to define the impact of lipid-lowering therapy on the reduction of total and cardiovascular mortality by different baseline levels of non-HDL-C. We performed a meta-analysis including randomized, controlled clinical trials of lipid-lowering therapy, reporting mortality with a minimum of 6 months of follow-up, searching in PubMed/Medline, EMBASE and Cochrane Clinical Trials databases. The random-effects model and meta-regression were performed. Twenty nine trials of lipid-lowering drugs, including 233,027 patients, were considered eligible for the analyses. According to the baseline non-HDL-C level, the results on cardiovascular mortality were: (1) ≥ 190 mg/dL: OR 0.63 (95% CI 0.53–0.76); (2) 160–189 mg/dL: OR 0.82 (95% CI 0.75–0.89); (3) 130–159 mg/dL: OR 0.71 (95% CI 0.52–0.98); (4)

Background Low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol (non–HDL-C) are targets for prevention of atherosclerotic cardiovascular disease (ASCVD). The American Heart Association and American College of Cardiology recently modified recommendations for clinical management of cholesterol in secondary and primary prevention. Accordingly, the present article examines the need for cholesterol-lowering drugs in the U.S. population with ASCVD. Objective This study examines trends in non–HDL-C and LDL-C levels in a free living population of ASCVD subjects between 1999 and 2016. Methods National Health and Nutrition Examination Surveys database included 4920 adults with ASCVD aged 40 to 85 years. Complete data were available for 4226. Trend analysis of changes in lipids is shown in box plots. Results Mean age was 67 years with 57% males. Over 17 years, LDL-C decreased significantly by 24% and non–HDL-C by 21%. Over the period of study, reported intake of cholesterol-lowering drugs rose from 37% in 1999-2000 to 69% in 2015 to 2016. Over this same period, serum triglycerides decreased by 29% (P Conclusions The changes in LDL-C and non–HDL-C in patients with ASCVD over a 17-year period probably are related to increased treatment with statins. However, the changes are too small to be explained by widespread use of high-intensity statins, which is the current recommendation for patients with ASCVD. These findings pose a challenge for professional education to support implementation of current guidelines for cholesterol-lowering therapies.

Lowe density lipoproteins (LDL) are the causal agent of cardiovascular diseases. In practice, we identify LDL with cholesterol transported in LDL (cLDL). So, cLDL has become the major target for cardiovascular prevention. Howewer, we have progressive evidences about the role of triglycerides rich lipoproteins, particularly those very low density lipoprotein (VLDL) in promotion and progression of atherosclerosis, that leads cholesterol in VLDL and its remanents as a potential therapeutic target. This feature is particularly important and of a great magnitude, in patients with hypertiglyceridemia. We can to considere, that the non-HDL cholesterol -cLDL+cVLDL+c-remmants+Lp(a)- is the real measurement of atherogenic cholesterol. In addition, non-HDL-cholesterol do not show any variations between postprandial states. In fact, non-HDL-cholesterol should be an excellent marker of atherogenic cholesterol, and an major therapeutic target in patients with atherogenic dyslipidaemia. According with different clinical trials and with the epidemiological and mendelian studies, in patients with high cardiovascular risk, optimal level of cLDL will be under 70mg/dl, and under 100 ng/dl for non-HDL-cholesterol; and in high risk patients, 100mg/dl and 130mg/dl, respectively.