-
Cardiovascular Diabetology Jan 2014Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best... (Review)
Review
Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R3i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R3i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R3i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptorα agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R3i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk.
Topics: Animals; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Dyslipidemias; Humans; Learning; Risk Factors
PubMed: 24460800
DOI: 10.1186/1475-2840-13-26 -
International Journal of Molecular... Feb 2023The purpose of this Special Issue is to present the impact in clinical practice as well as in medical research of novel molecules that have been introduced in the...
The purpose of this Special Issue is to present the impact in clinical practice as well as in medical research of novel molecules that have been introduced in the treatment of diabetes mellitus, dyslipidaemia, and cardiovascular disease [...].
Topics: Humans; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Dyslipidemias; Risk Factors
PubMed: 36835441
DOI: 10.3390/ijms24044029 -
American Journal of Transplantation :... Aug 2012Cardiovascular disease is the leading cause of mortality in kidney transplant recipients. Dyslipidemia is a common finding after renal transplantation and a significant... (Review)
Review
Cardiovascular disease is the leading cause of mortality in kidney transplant recipients. Dyslipidemia is a common finding after renal transplantation and a significant risk factor in the development of coronary heart disease. Although a causal relationship with cardiovascular mortality has not been proven in the transplant population, it is reasonable to extrapolate data from the general population and aggressively treat posttransplant dyslipidemia. Statins are considered the agents of choice, though their use may be complicated by drug misadventures. Pravastatin, fluvastatin and pitavastatin are considered to be the safest statins to use in this population; however, given their low-potency, a high-potency statin, such as atorvastatin, may be necessary in patients with significant dyslipidemia. In this article, we discuss the etiology of and treatment strategies for dyslipidemia in renal transplant recipients based on a literature review of potential therapeutic adverse effects and benefits in this population. We will also evaluate the reasons for and consequences of the latest Food and Drug Administration (FDA) warnings regarding the use of simvastatin.
Topics: Dyslipidemias; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypolipidemic Agents; Kidney Failure, Chronic; Kidney Transplantation; Practice Guidelines as Topic
PubMed: 22578270
DOI: 10.1111/j.1600-6143.2012.04084.x -
WMJ : Official Publication of the State... Dec 2012The recent publication of new pediatric lipid screening guidelines represents a change in recommendations regarding lipid screening and management for pediatric patients... (Review)
Review
The recent publication of new pediatric lipid screening guidelines represents a change in recommendations regarding lipid screening and management for pediatric patients that will affect all health care professionals who care for children and adolescents. The guidelines differ from the selective screening recommended by the 2007 US Preventive Services Task Force, instead recommending routine lipid screening for children and adolescents at ages 9-11 years and again at 17-21 years. Studies have shown that limiting lipid screening to patients with risk factors fails to identify many patients with genetic or acquired dyslipidemias. Without universal screening, many at-risk children will not be identified.
Topics: Adolescent; Child; Dyslipidemias; Humans; Practice Guidelines as Topic; Risk Factors; United States; Young Adult
PubMed: 23362704
DOI: No ID Found -
Diabetes & Metabolism Journal Sep 2023This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and...
BACKGRUOUND
This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022.
METHODS
We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020.
RESULTS
In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia-more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)-was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL.
CONCLUSION
Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
Topics: Adult; Male; Humans; Female; Hypercholesterolemia; Nutrition Surveys; Risk Factors; Dyslipidemias; Cholesterol, LDL; Republic of Korea
PubMed: 37528532
DOI: 10.4093/dmj.2023.0135 -
Circulation Journal : Official Journal... 2013Cardiovascular disease (CVD) is the leading cause of death in the world and half of the cases of CVD are estimated to occur in Asia. Compared with Western countries,... (Review)
Review
Cardiovascular disease (CVD) is the leading cause of death in the world and half of the cases of CVD are estimated to occur in Asia. Compared with Western countries, most Asian countries, except for Japan, South Korea, Singapore and Thailand, have higher age-adjusted mortality from CVD. In Japan, the mortality from CVD, especially stroke, has declined continuously from the 1960s to the 2000s, which has contributed to making Japan into the top-ranking country for longevity in the world. Hypertension and smoking are the most notable risk factors for stroke and coronary artery disease, whereas dyslipidemia and diabetes mellitus are risk factors for ischemic heart disease and ischemic stroke. The nationwide approach to hypertension prevention and control has contributed to a substantial decline in stroke mortality in Japan. Recent antismoking campaigns have contributed to a decline in the smoking rate among men. Conversely, the prevalence of dyslipidemia and diabetes mellitus increased from the 1980s to the 2000s and, therefore, the population-attributable risks of CVD for dyslipidemia and diabetes mellitus have increased moderately. To prevent future CVD in Asia, the intensive prevention programs for hypertension and smoking should be continued and that for emerging metabolic risk factors should be intensified in Japan. The successful intervention programs in Japan can be applied to other Asian countries.
Topics: Asia; Cardiovascular Diseases; Diabetes Complications; Diabetes Mellitus; Dyslipidemias; Female; Humans; Male; Prevalence; Risk Factors; Smoking; Smoking Prevention
PubMed: 23803294
DOI: 10.1253/circj.cj-13-0702 -
Journal of Cellular and Molecular... Sep 2012Sound data support the concept that in atherosclerosis, inflammation and dyslipidemia intersect each other and that irrespective of the initiator, both participate from... (Review)
Review
Sound data support the concept that in atherosclerosis, inflammation and dyslipidemia intersect each other and that irrespective of the initiator, both participate from the early stages to the ultimate fate of the atheromatous plaque. The two partakers manoeuvre a vicious circle in atheroma formation: dyslipidaemia triggers an inflammatory process and inflammation elicits dyslipidaemia. Independent of the initial cause, the atherosclerotic lesions occur focally, in particular arterial-susceptible sites, by a process that, although continuous, can be arbitrarily divided into a sequence of consecutive stages that lead from fatty streak to the fibro-lipid plaque and ultimately to plaque rupture and thrombosis. In the process, the initial event is a change in endothelial cells (EC) constitutive properties. Then, the molecular alarm signals send by dysfunctional EC are decoded by specific blood immune cells (monocytes, T lymphocytes, neutrophils, mast cells) and by the resident vascular cells, that respond by initiating a robust inflammatory process, in which the cells and the factors they secrete hasten the atheroma development. Direct and indirect crosstalk between the cells housed within the nascent plaque, complemented by the increase in risk factors of atherosclerosis lead to atheroma development and outcome. The initial inflammatory response can be regarded as a defense/protective reaction mechanism, but its further amplification, speeds up atherosclerosis. In this review, we provide an overview on the role of inflammation and dyslipidaemia and their intersection in atherogenesis. The data may add to the foundation of a novel attitude in the diagnosis and treatment of atherosclerosis.
Topics: Animals; Atherosclerosis; Cardiovascular Diseases; Disease Models, Animal; Dyslipidemias; Endothelium, Vascular; Humans; Inflammation; Lymphocytes; Mast Cells; Monocytes; Plaque, Atherosclerotic; Risk Factors; Thrombosis
PubMed: 22348535
DOI: 10.1111/j.1582-4934.2012.01552.x -
Journal of the American Board of Family... 2022There is considerable interest in the association between food insecurity (FIS) and various cardiovascular risk factors such as dyslipidemia. Although the association... (Meta-Analysis)
Meta-Analysis
PURPOSE
There is considerable interest in the association between food insecurity (FIS) and various cardiovascular risk factors such as dyslipidemia. Although the association between FIS and dyslipidemia has been studied across various methodologies and populations, there is no comprehensive systematic review and meta-analysis of these data.
METHODS
A systematic literature search was conducted. Cross-sectional peer-review studies assessing the association between FIS and dyslipidemia were identified. Data extracted included population characteristics, study sizes, covariates explored, and laboratory assessments of dyslipidemia. Effect sizes were extracted or calculated, then synthesized across studies using a random effect model, and the heterogeneity, publication bias, and subgroup dependence for each meta-analysis were assessed.
RESULTS
For adults, meta-analysis demonstrated no significantly elevated odds for FIS individuals to have a concomitant abnormal lipid measurement. Covariate-unadjusted analysis of standardized mean differences showed no significant differences in lipid measurements between food-insecure and food-secure individuals. In contrast to quantitative laboratory results, food-insecure patients were more likely to self-report previous diagnoses of dyslipidemia.
CONCLUSIONS
Although current data do not suggest an association between FIS and dyslipidemia, more longitudinal studies and studies targeting women, children, the elderly, and patients with chronic diseases such as diabetes are needed to further address this issue.
Topics: Adult; Aged; Child; Cross-Sectional Studies; Diabetes Mellitus; Dyslipidemias; Female; Food Insecurity; Humans; Lipids
PubMed: 35896471
DOI: 10.3122/jabfm.2022.04.210413 -
Journal of Atherosclerosis and... May 2024Transitional medicine refers to the seamless continuity of medical care for patients with childhood-onset diseases as they grow into adulthood. The transition of care... (Review)
Review
Transitional medicine refers to the seamless continuity of medical care for patients with childhood-onset diseases as they grow into adulthood. The transition of care must be seamless in medical treatment as the patients grow and in other medical aids such as subsidies for medical expenses in the health care system. Inappropriate transitional care, either medical or social, directly causes poorer prognosis for many early-onset diseases, including primary dyslipidemia caused by genetic abnormalities. Many primary dyslipidemias are designated as intractable diseases in the Japanese health care system for specific medical aids, as having no curative treatment and requiring enormous treatment costs for lipid management and prevention of complications. However, there are problems in transitional medicine for primary dyslipidemia in Japan. As for the medical treatment system, the diagnosis rate remains low due to the shortage of specialists, their insufficient link with generalists and other field specialists, and poor linkage between pediatricians and physicians for adults. In the medical care system, there is a mismatch of diagnostic criteria of primary dyslipidemias between children and adults for medical care expense subsidization, as between The Program for the Specific Pediatric Chronic Diseases and the Program for Designated Adult Intractable Diseases. This could lead some patients subsidized in their childhood to no longer be under the coverage of the aids after transition. This review intends to describe these issues in transitional medicine of primary dyslipidemia in Japan as a part of the efforts to resolve the problems by the Committee on Primary Dyslipidemia under the Research Program on Rare and Intractable Disease of the Ministry of Health, Labour and Welfare of Japan.
Topics: Humans; Dyslipidemias; Japan; Adult; Transition to Adult Care; Child
PubMed: 38538336
DOI: 10.5551/jat.RV22016 -
Reviews in Cardiovascular Medicine Mar 2018Diabetic dyslipidemia in type 2 diabetes (T2DM) is characterized by elevated levels of triglycerides (TG), decreased levels of high density lipoprotein-cholesterol... (Review)
Review
Diabetic dyslipidemia in type 2 diabetes (T2DM) is characterized by elevated levels of triglycerides (TG), decreased levels of high density lipoprotein-cholesterol (HDL-C), elevated levels of low density lipoprotein-cholesterol (LDLC), and the predominance of small and dense LDL particles (sdLDL). The mechanism underlying diabetic dyslipidemia remains unclear. Insulin resistance is believed to be an important determinant. Mechanisms underlying insulin resistance-induced diabetic dyslipidemia seem to be related to apolipoprotein CIII (ApoCIII), a known inhibitor of lipoprotein lipase. The concentration of very low density lipoprotein1 (VLDL) with a higher TG content and abundant ApoCIII was found to be significantly elevated in patients with T2DM. Recently, volanesorsen as a promising ApoIII inhibitor was shown to improve the lipid profile in patients with diabetic dyslipidemia. Herein, this paper will review recent advance in pathophysiology of diabetic dyslipidemia and the role of ApoCIII in this condition, with focus on describing a novel drug volanesorsen as potential treatment strategy.
Topics: Apolipoprotein C-III; Biomarkers; Diabetes Mellitus, Type 2; Dyslipidemias; Humans; Hypolipidemic Agents; Insulin Resistance; Oligonucleotides; Treatment Outcome
PubMed: 31032598
DOI: 10.31083/j.rcm.2018.01.890