Cardiovascular risk profile of patients with atherogenic dyslipidemia in middle age Lithuanian population

Abstract

BackgroundAtherogenic dyslipidemia (AD) is a blood serum lipid profile abnormality characterized by elevation of triglycerides and reduced levels of high density lipoprotein cholesterol (HDL-C). It is associated with residual cardiovascular risk. This study evaluated and compared the risk profiles of patients with hypertriglyceridemia, low-HDL-C levels or AD, in order to understand, which lipid profile is associated with greater risk.MethodsDuring the period of 2009–2016 a population of 92,373 Lithuanian adults (men 40–54 years old and women 50–64 years old) without overt cardiovascular disease were analyzed. Data of 25,746 patients (68.6% women and 31.4% men) with hypertriglyceridemia and/or low HDL-C low levels were collected and used for further statistical analysis.ResultsParticipants with AD tend to have more unfavorable risk profile than participants with hypertriglyceridemia or low-HDL-C. AD tends to cluster with other atherogenic risk factors, such as arterial hypertension [odds ratio (OR) 1.96, 95% confidence intervals (CI) 1.87–2.01], smoking [OR 1.20, 95% CI 1.14–1.27], diabetes mellitus [OR 2.74, 95% CI 2.58–2.90], obesity [OR 2.92, 95% CI 2.78–3.10], metabolic syndrome [OR 22.27, 95% CI 20.69–23.97], unbalanced diet [OR 1,59, 95% CI 1.51–1.68], low physical activity [OR 1.80, 95% CI 1.71–1,89], CHD history in first degree relatives [OR 1.18, 95% CI 1.12–1.25] and total number of risk factors [OR 1.47, 95% CI 1.38–1.57].ConclusionAD is associated with more unfavorable cardiovascular risk profile than hypertriglyceridemia or low-HDL cholesterol levels. Once identified AD should require additional medical attention since it is an important factor of residual cardiovascular risk.

Atherogenic index of plasma is related to arterial stiffness but not to blood pressure in normotensive and never-treated hypertensive subjects

“…This combination has been associated with more unfavourable cardiovascular risk profile, higher heart rate and systolic BP than hypertriglyceridemia or low HDL-C levels alone [48]. Furthermore, reduced HDL-C together with elevated triglycerides, and also elevated AIP, have been associated with decreased insulin sensitivity [19,48,49]. This view corresponds to the present findings whereby insulin sensitivity, as evaluated by means of QUICKI, was different in every AIP tertile with the lowest values in the highest AIP tertile.…”

“…High LDL-C level, smoking, and hypertension have been identified as causes for atherosclerosis that is an intimal disease, while ageing, diabetes, and chronic kidney disease have been associated with arteriosclerosis, which is a medial disease and especially related to arterial stiffening [47]. Though LDL-C has been the major focus on the link between lipids and cardiovascular disease, the combination of reduced HDL-C and elevated triglycerides has been identified as atherogenic dyslipidaemia [48]. This combination has been associated with more unfavourable cardiovascular risk profile, higher heart rate and systolic BP than hypertriglyceridemia or low HDL-C levels alone [48].…”

“…Though LDL-C has been the major focus on the link between lipids and cardiovascular disease, the combination of reduced HDL-C and elevated triglycerides has been identified as atherogenic dyslipidaemia [48]. This combination has been associated with more unfavourable cardiovascular risk profile, higher heart rate and systolic BP than hypertriglyceridemia or low HDL-C levels alone [48]. Furthermore, reduced HDL-C together with elevated triglycerides, and also elevated AIP, have been associated with decreased insulin sensitivity [19,48,49].…”

Atherogenic Index of Plasma (AIP) a Tool to Assess Changes in Cardiovascular Disease Risk Post Laparoscopic Sleeve Gastrectomy

“…In the absence of T2D, people with obesity and normal weight had low AIP values indicating a negligible adverse effect on vascular health ( Figure 1(a) ). This was emphasized in a recent report where having a combination of low HDL levels and high TG accompanied by reduced insulin sensitivity defined atherogenic dyslipidemia [ 37 ]. Additionally, we used Framingham's CVD Risk Predictive formula as a method to estimate the vascular age of participants [ 38 , 39 ].…”

Lower than average HDL cholesterol efflux capacity in Lithuanian population

“…While in Poland NATPOL 2011 representative 40–59 years sample, prevalence of low-HDL was 35.2% in men and 22.2% in women, average HDL was 1.22 mmol/l (47.3 mg/dL) in men and 1.41 mmol/l (54.7 mg/dL) in women [20]. Interestingly participants of LitHiR with isolated low HDL-C had more favorable risk profile than participants with other lipid abnormalities, such as isolated triglyceridemia and atherogenic dyslipidemia [21]. In addition, recent studies suggest that low HDL-C may paradoxically be associated with reduced risk of incident CHD in black participants population [22], which led us to investigate the quality of HDL-C.…”