Comparison of Serum Lipid Values in Subjects With and Without the Metabolic Syndrome

Cordero, Alberto; Laclaustra, Martín; León, Montserrat; Casasnovas, José A.; Grima, Alberto; Luengo, Emilio; Ordoñez, Beatriz; Bergua, Clara; Bes, María; Pascual, Isaac; Alegría, Eduardo

doi:10.1016/j.amjcard.2008.03.079

Cited by 86 publications

(49 citation statements)

References 24 publications

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“…TG, also, is a reliable predictor for these cardiometabolic syndromes (1). Moreover, the index TG/HDL-C ratio (O3) has showed both high SEN and SP for diagnosis of MS (19) and together with TG (O1.47 mmol/l) are probably among the best measures available for clinical assessment of IR (20). However, some studies do not support this view (21), or suggested that diagnostic ability of these variables depends on ethnic background (10,22).…”

Section: Discussionmentioning

confidence: 99%

Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population

Taverna

Martı́nez-Larrad

Frechtel

et al. 2011

European Journal of Endocrinology

122

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Objective: The metabolic syndrome (MS) is a cluster of cardiometabolic factors, which predisposes to diabetes and cardiovascular disease (CVD). Early detection of high-risk individuals for MS using accurate measures of insulin resistance (IR) could improve detection and prevention of CVD and diabetes. The aim of this study was to explore the ability of lipid accumulation product (LAP), compared with traditional measures of IR, to identify MS. Design: In total, 768 Spanish adults were recruited. MS was assessed using the revised criteria of National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF). Measures of IR such as homeostasis model assessment of IR and LAP, an index of lipid accumulation based on a combination of waist circumference and serum triglycerides, were calculated. Receiver operating characteristic analysis was performed in order to detect the parameter with the best predictive capability for MS. Results: The prevalence of MS-NCEP/ATP III and MS-IDF was 15.1 and 20.5% for men respectively, and 15.4 and 17.5% for women. LAP showed the highest diagnostic accuracy for MS-NCEP/ATP III (area under the curve 0.91 and 0.90 among males and females) and MS-IDF (0.88 for both males and females). This was confirmed by internal validation using 20 000 bootstrap samples. Among males and females, different LAP cut-off values exhibited high sensitivity (78-85%) and specificity (78-85%) for MS-NCEP/ATP III and MS-IDF identification with elevated efficiency (proportion of positives and negatives classified correctly by the testZ78-85%). When the sample was stratified according to decades of life, LAP exhibited a slightly lower performance among women than men, especially for MS-IDF detection. Conclusions: In non-diabetic adults LAP has a strong and reliable diagnostic accuracy for MS-IDF and, especially, MS-NCEP/ATP III among females and, in particular, among males from Spain.

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Section: Discussionmentioning

confidence: 99%

Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population

Taverna

Martı́nez-Larrad

Frechtel

et al. 2011

European Journal of Endocrinology

122

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“…No difference was observed in the index related to triglycerides and HDLc as these lipids were not modified since statin treatment had little effect on such parameters. The triglyceride/HDLc index has been reported to be highly predictive of a first ischemic heart disease eevent [17], mainly in overweight patients or those with type-2 diabetes or metabolic syndrome [18]. From the pharmacologic point of view, statins do not appear to exert any effect on this index.…”

Section: Discussionmentioning

confidence: 99%

Atherogenic Ratios in Patients with Recurrent Acute Coronary Syndrome and Receiving Statin Therapy: Clinical Usefullness as Cardiovascular Predictors

Civeira¹,

Pedro-Botet²,

Pintó³

et al. 2015

J Clin Exp Cardiolog

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Patients who have already suffered a vascular event require more and better control of cardiovascular risk factors. Different atherogenic indexes such as TC/HDLc, LDLc/HDLc, apoB/apoA-I, LDLc/apoB and non-HDLc/HDLc have been used to follow-up the patients because of their predictive capacity of the lipid profile. The aim of this study was to evaluate atherogenic ratios as a marker of the lipid residual risk in high-risk patients receiving statin therapy and to know the changes produced by previous lipid-lowering drugs treatment for a previous coronary event.The study including patients admitted to coronary care units of six Spanish tertiary hospitals for Acute Coronary Syndrome (ACS). A total of 633 ACS patients were included; of these, 478 (75.8%) had presented a myocardial infarction and 153 (24.2%) angina. A previous ACS had occurred in 43.1% of cases, and was the first episode in 56.9% of the studied patients.Among patients with known ischemic heart disease, 187 (52.2%) were receiving lipid-lowering drugs, mainly statins (182 patients, 50.7%). Of those with a first ACS, 59 (21.7%) were on lipid-lowering drugs: 55 (20.1%) statins and 4 (1.7%) fibrates. Patients with recurrent ACS had similar triglyceride and HDLc levels, but significantly lower total cholesterol and LDLc concentrations compared with those presenting the first ACS. Patients with recurrent ACS had significantly lower non-HDLc levels, TC/HDLc and LDLc/HDLc, but higher HDLc/TC and HDLc/LDLc ratios compared with first ACS patients.In patients taking statins the lipid residual vascular risk was related with the persistence of cardiovascular risk factors, and related with lipid profile with dyslipemia no-LDL dependent. So, we can conclude that the correction of lipid profile by statin is not per se sufficient to control cardiovascular risk.

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“…As such, computing a ratio from log fasting TG (numerator) and fasting HDL-C (denominator) appears intuitively logical [Hermans et al 2010a;Kim-Dorner et al 2010;Bittner et al 2009;Cordero et al 2009;da Luz et al 2008;Kannel et al 2008;Dobiásová and Frohlich, 2001]. The TG to HDL-C ratio was also identified as an accurate marker for the presence of other features of the MetS, and also correlates with LDL-P size [Cordero et al 2008 [Wilson, 2009;Coleman et al 2007;Eichler et al 2007;Assmann et al 2002;Kothari et al 2002;Stevens et al 2001]. As for patients without diabetes, RvR in patients with dyslipidaemia and T2DM can be also inferred from major risk factors using the T2DM-specific UK Prospective Diabetes Study risk engine [Stevens et al 2001].…”

Section: Non-ldls and Non-ldl Dyslipidaemiamentioning

confidence: 99%

Reducing vascular events risk in patients with dyslipidaemia: an update for clinicians

Hermans¹,

Fruchart²

2011

Therapeutic Advances in Chronic Disease

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Reducing the risk of vascular events in patients with dyslipidaemia requires cardiovascular disease risk stratification and lifestyle/pharmacological intervention on modifiable risk factors. Reduction of low-density lipoprotein cholesterol (LDL-C) with statins is highly effective in reducing cardiovascular disease in patients with and without diabetes, but leaves unaddressed a sizeable residual vascular risk (RvR), which is rarely quantified in routine clinical practice. Such RvR may relate to lack of strict target attainment for all atherogenic variables [LDL-C, non-high-density lipoprotein cholesterol (HDL-C) and/or apolipoprotein B 100 ]. Another substantial lipid-related and modifiable RvR component is related to atherogenic dyslipidaemia, especially as global rates of obesity, type 2 diabetes and metabolic syndrome are increasing. Atherogenic dyslipidaemia is associated with insulin-stimulated verylow-density lipoprotein overproduction and reduced reverse cholesterol transport. The hallmark of atherogenic dyslipidaemia is the coexistence of low HDL-C and elevated triglycerides. Therapeutic lifestyle changes and combination lipid-lowering therapy with drugs targeting atherogenic dyslipidaemia (such as fibrates or innovative drugs targeting atherogenic dyslipidaemia and/or apolipoprotein B 100 metabolism) on top of background statins, have a potential to reduce RvR in high-risk groups, as shown in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, in which combination therapy with simvastatin plus fenofibrate decreased macrovascular risk in patients with diabetes and atherogenic dyslipidaemia, and retinopathy risk irrespective of baseline lipids.

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Comparison of Serum Lipid Values in Subjects With and Without the Metabolic Syndrome

Cited by 86 publications

References 24 publications

Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population

Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population

Atherogenic Ratios in Patients with Recurrent Acute Coronary Syndrome and Receiving Statin Therapy: Clinical Usefullness as Cardiovascular Predictors

Reducing vascular events risk in patients with dyslipidaemia: an update for clinicians

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