A Review of the Treatment Guidelines on the Management of Low Levels of High-Density Lipoprotein Cholesterol

Devroey, Dirk; Vantomme, Karolien; Betz, Willem; Vandevoorde, Jan; Kartounian, Jan

doi:10.1159/000077906

Cited by 13 publications

(7 citation statements)

References 31 publications

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“…In the same experiment, Lu et al (1995) observed a smaller BFT in high cholesterol line boars compared with low cholesterol line boars. In humans, people who are overweight generally have higher total and LDL cholesterol, lower HDL cholesterol and higher triglycerides (Hagan et al, 1983;Devroey et al, 2004;Wilsgaard and Arnesen, 2004).…”

Section: Discussionmentioning

confidence: 99%

Behaviour influences cholesterol plasma levels in a pig model

Rauw

Portolés

Corella

et al. 2007

Animal

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Little is known about the relationship between feed intake behaviour and cholesterol levels in humans. This can be attributed to the fact that feed intake behaviour in humans is difficult to assess. The relationships between feed intake, feed efficiency and feed intake behaviour, and cholesterol and triglyceride levels were investigated at an average age of 187 days, in a pig model consisting of 202 Duroc barrows. Feed intake and feed intake behaviour were recorded individually and daily by means of an electronic identification system. Animals with high levels of total cholesterol also had high levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol and triglycerides. Animals with high levels of HDL also had high levels of LDL and triglycerides, and animals with high levels of LDL also had high levels of triglycerides. Animals with higher BW, higher backfat thickness, higher BW gain, higher gain of backfat deposition, higher feed intake, higher residual feed intake (RFI) and higher feed intake rate had higher levels of total, HDL and LDL plasma cholesterol. Results indicate that the relationship between feed intake and cholesterol levels is a long-term relationship, while the relationship between RFI and cholesterol levels is more of a short-term nature. The relationship between intake rate and cholesterol plasma levels disappeared after correction for the amount of feed consumed. Results indicate that feed intake independent of metabolic BW, growth and fatness, i.e. 'RFI', was positively correlated with cholesterol plasma levels. This suggests that eating food over and above the maintenance and growth requirements constitutes a health risk independent of the level of fatness.

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Section: Discussionmentioning

confidence: 99%

Behaviour influences cholesterol plasma levels in a pig model

Rauw

Portolés

Corella

et al. 2007

Animal

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“…HDL cholesterol levels lower than 1.0 mmol/l in men and 1.2 mmol/l in women were defined as low [16]. A total/HDL cholesterol ratio of greater than 5 was considered to be high [17]. Diabetes was defined as self-reported diabetes and current use of anti-diabetic medication or non-fasting glucose levels above 11.0 mmol/l with HbA 1c levels above 48 mmol/mol (6.5%).…”

Section: Methodsmentioning

confidence: 99%

Ethnic differences in total and HDL cholesterol among Turkish, Moroccan and Dutch ethnic groups living in Amsterdam, the Netherlands

et al. 2010

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BackgroundHigh total cholesterol and low HDL (high-density lipoprotein) cholesterol are important determinants of cardiovascular disease. Little is known about dyslipidemia among Turkish and Moroccan migrants, two of the largest ethnic minority groups in several European countries. This study examines ethnic differences in total and HDL cholesterol levels between Dutch, Turkish and Moroccan ethnic groups.MethodsData were collected in the setting of a general health survey, in Amsterdam, the Netherlands, in 2004. Total response rate was 45% (Dutch: 46%, Turks: 50%, Moroccans: 39%). From 1,220 adults information on history of hypercholesterolemia, lifestyle and demographic background was obtained via health interviews. In a physical examination measurements of anthropometry and blood pressure were performed and blood was collected. Total and HDL cholesterol were determined in serum.ResultsTotal cholesterol levels were lower and hypercholesterolemia was less prevalent among the Moroccan and Turkish than the Dutch ethnic population. HDL cholesterol was also relatively low among these migrant groups. The resulting total/HDL cholesterol ratio was particularly unfavourable among the Turkish ethnic group. Controlling for Body Mass Index and alcohol abstinence substantially attenuated ethnic differences in HDL cholesterol levels and total/HDL cholesterol ratio.ConclusionsTotal cholesterol levels are relatively low in Turkish and Moroccan migrants. However part of this advantage is off-set by their relatively low levels of HDL cholesterol, resulting in an unfavourable total/HDL cholesterol ratio, particularly in the Turkish population. Important factors in explaining ethnic differences are the relatively high Body Mass Index and level of alcohol abstinence in these migrant groups.

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“…As a general rule pharmacotherapy follows lifestyle interventions, if lipid levels are beyond normal values and persist to be abnormal despite life style therapies (see §1). In reviewing nine guidelines for the treatment of patients with low HDLC, Devroey et al [28] found the majority of them consider low HDLC as a marker of an increased risk for CHD, but only NCEP AT-PIII includes HDLC level in the calculation of coronary risk. Grundy et al (2005) [3], specifically identifies reduced HDLC as a tertiary target but acknowledges there is not no specific goal to target increases in HDLC.…”

Section: Fenofibrate Monotherapymentioning

confidence: 99%

Fenofibrate and Metabolic Syndrome

Kraja¹,

Province²,

Straka³

et al. 2010

EMIDDT

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The fibric acid derivative, fenofibrate (FF) has been used in the US since 1998 to manage patients with dyslipidemia. Typical changes in serum lipids as a result of FF treatment include clinically important mean reductions of serum triglycerides (TG) by a mean change of −93.7 mg/dL (−39.3%), increases of high density lipoprotein cholesterol (HDLC) by +5.5 mg/dL (+12.4%), and reductions in low density lipoprotein cholesterol (LDLC) by −17.9 mg/dL (−12.3%). The greatest reductions in serum TG are usually observed in subjects with elevated baseline TG including those with the metabolic syndrome (MetS). Although statins remain the mainstay of therapy for most dyslipidemic patients, their combined use with FF would be expected to address residual risk resulting from less than optimal TG and HDLC levels in such patients. Clinical trials examining the cardiovascular benefits of FF alone or combined with statins have produced mixed results. These observations underscore our lack of understanding of which patients may benefit from FF therapy and which do not. Although FF’s basic mechanism of action is known to involve PPAR-α agonist activity resulting in altered transcription of several genes, the actual genetic bases for variability in lipid response is poorly understood. Studies, such as our GOLDN study and others were designed to better understand the genetic determinants of variability in the response to FF treatment and lipid levels. As a result several important genetic determinants of lipid levels have been identified. For example, in the GOLDN study SNPs from different genes were significantly associated with baseline lipid levels before treatment (APOA5-rs662799, rs3135506; APOC3-rs5128, rs2854117, rs4520); APOA4-rs5104; PPARA-rs9626730, rs135543, rs11703495; LPL-rs1801177), after treatment PPARA-rs11708495; LPL-rs1801177, and appeared to modulate overall response to FF treatment (NOS3-rs1799983). In this article, we will review the literature leading up to the contemporary use of FF as an agent to manage patients with dyslipidemia and focus on emerging understanding of the genetic variability in response to FF treatment. On the basis of the available evidence, we conclude that FF is of benefit in the treatment of dyslipidemia, especially among those with MetS. However, more work is needed to specifically identify which individuals derive a benefit from FF administration in terms of clinical outcomes and which do not – particularly in the context of type 2 diabetes.

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A Review of the Treatment Guidelines on the Management of Low Levels of High-Density Lipoprotein Cholesterol

Cited by 13 publications

References 31 publications

Behaviour influences cholesterol plasma levels in a pig model

Behaviour influences cholesterol plasma levels in a pig model

Ethnic differences in total and HDL cholesterol among Turkish, Moroccan and Dutch ethnic groups living in Amsterdam, the Netherlands

Fenofibrate and Metabolic Syndrome

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