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Low high-density lipoprotein cholesterol to monitor long-term average increased triglycerides



Low high-density lipoprotein cholesterol to monitor long-term average increased triglycerides



Journal of Clinical Endocrinology and Metabolism 2019:



Increased triglyceride-rich remnants represent a causal risk factor for ischemic cardiovascular disease. We tested the hypothesis that low HDL cholesterol can monitor long-term high triglycerides/remnant cholesterol, just as high HbA1c can monitor long-term high glucose. We studied cross-sectionally 108,731 individuals, dynamically 1313 individuals with lipid measurement at ten repeated visits, short-term 305 individuals during a fat load, and long-term 10,479 individuals with two lipid measurements ten years apart. Levels of HDL cholesterol and triglycerides. Cross-sectionally, HDL cholesterol was inversely associated with triglycerides(R2=0.26) and remnant cholesterol(R2=0.26). Dynamically, major changes in triglyceride levels from measurement to measurement were mimicked by corresponding modest changes in HDL cholesterol. Short-term after a fat load, median triglycerides increased 96% while HDL cholesterol decreased only 1%. Long-term, in individuals with measurements ten years apart, those with highest triglycerides and corresponding lowest HDL cholesterol initially, still had highest triglycerides and lowest HDL cholesterol ten years later. Prospectively, individuals with increased triglycerides/remnant cholesterol had increased risk of myocardial infarction; however, when the HDL cholesterol monitoring was removed, increased triglycerides/remnant cholesterol largely no longer were associated with increased risk of myocardial infarction. Low HDL cholesterol is a stable marker of average high triglycerides/remnant cholesterol. This suggests that low HDL cholesterol can be used to monitor long-term average high triglycerides and remnant cholesterol, just like high HbA1c is a long-term monitor of average high glucose levels.

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Accession: 069601763

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PMID: 31822888


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