Medicine:Remnant cholesterol
Remnant cholesterol, also known as remnant lipoprotein, is a very atherogenic lipoprotein composed primarily of very low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL).[1] Stated another way, remnant cholesterol is all plasma cholesterol that is not LDL cholesterol or HDL cholesterol,[1] which are triglyceride-poor lipoproteins.[2] However, remnant cholesterol is primarily chylomicron and VLDL, and each remnant particle contains about 40 times more cholesterol than LDL.[3] According to one study, high remnant cholesterol is more predictive of myocardial infarction than any other lipid particle.[4] Remnant cholesterol is especially predictive of coronary artery disease in patients with normal total cholesterol.[5][6]
High plasma remnant cholesterol is associated with increased plasma triglyceride levels.[7] Hypertriglyceridemia is characteristic of high plasma remnant cholesterol, but persons with high plasma triglycerides without high remnant cholesterol rarely have coronary artery disease.[8]
Remnant cholesterol has about twice the association with ischemic heart disease as LDL cholesterol.[9] Although remnant cholesterol tends to be higher in people who are overweight (high body mass index), normal-weight persons with high remnant cholesterol tend to have a higher risk of myocardial infarction.[10]
Remnant cholesterol is associated with chronic inflammation, whereas LDL cholesterol is not.[11][2]
See also
- Chylomicron remnant
- Lipid profile
References
- ↑ 1.0 1.1 "Genetically elevated non-fasting triglycerides and calculated remnant cholesterol as causal risk factors for myocardial infarction". European Heart Journal 34 (24): 1826–1833. 2013. doi:10.1093/eurheartj/ehs431. PMID 23248205.
- ↑ 2.0 2.1 Nordestgaard BG (2016). "Triglyceride-Rich Lipoproteins and Atherosclerotic Cardiovascular Disease: New Insights From Epidemiology, Genetics, and Biology". Circulation Research 118 (4): 547–563. doi:10.1161/CIRCRESAHA.115.306249. PMID 26892957.
- ↑ "Triglyceride-Rich Lipoproteins and Remnants: Targets for Therapy?". Current Cardiology Reports 18 (7): 67. 2016. doi:10.1007/s11886-016-0745-6. PMID 27216847.
- ↑ "Premature myocardial infarction is strongly associated with increased levels of remnant cholesterol". Journal of Clinical Lipidology 9 (6): 801–6.e1. 2015. doi:10.1016/j.jacl.2015.08.009. PMID 26687701.
- ↑ "Association of remnant-like particle cholesterol with coronary artery disease in patients with normal total cholesterol levels". American Heart Journal 139 ((2 Pt 1)): 305–310. 2000. doi:10.1016/j.atherosclerosis.2008.05.024. PMID 10650304.
- ↑ "Triglycerides and remnant particles as risk factors for coronary artery disease". Current Atherosclerosis Reports 8 (2): 107–110. 2006. doi:10.1007/s11883-006-0047-3. PMID 16510044.
- ↑ "Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management". European Heart Journal 32 (11): 1345–1361. 2011. doi:10.1093/eurheartj/ehr112. PMID 21531743.
- ↑ "Remnant lipoproteins as strong key particles to atherogenesis". Journal of Atherosclerosis and Thrombosis 16 (3): 145–154. 2009. doi:10.5551/jat.E598. PMID 19556722.
- ↑ "Remnant cholesterol as a causal risk factor for ischemic heart disease". Journal of the American College of Cardiology 61 (4): 427–436. 2013. doi:10.1016/j.jacc.2012.08.1026. PMID 23265341.
- ↑ "Remnant Cholesterol and Myocardial Infarction in Normal Weight, Overweight, and Obese Individuals from the Copenhagen General Population Study". Clinical Chemistry 64 (1): 219–230. 2018. doi:10.1373/clinchem.2017.279463. PMID 29021326.
- ↑ "Remnant cholesterol and ischemic heart disease". Current Opinion in Lipidology 25 (4): 266–273. 2014. doi:10.1097/MOL.0000000000000093. PMID 24977981.
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