Low HDL cholesterol may help monitor long-term, average high triglyceride levels
Denmark: Low-HDL cholesterol is a stable marker of high triglycerides and remnant cholesterol, suggests a recent study published in the Journal of Clinical Endocrinology & Metabolism. This implies that low HDL cholesterol can be used to monitor long-term average high triglycerides and remnant cholesterol in the same way as HbA1c is used for long-term monitoring of average high glucose levels.
The findings are significant as individuals with increased triglycerides/remnant cholesterol had increased risk of myocardial infarction.
Increased triglyceride-rich remnants represent a causal risk factor for ischemic cardiovascular disease. Borge G Nordestgaard, University of Copenhagen, Copenhagen, Denmark, and colleagues 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.
For the study, the researchers cross-sectionally studied 108,731 people with lipid measurements 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.
- Cross-sectionally, HDL cholesterol was inversely associated with triglycerides and remnant cholesterol.
- 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 by only 1%.
- Long-term, in individuals with measurements ten years apart, those with highest triglycerides and corresponding lowest HDL cholesterol initially, still had the 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.
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“The measurements of triglycerides regressed substantially towards the mean, which was much less pronounced for HDL cholesterol; remnant cholesterol behaved similarly to triglycerides,” the researchers wrote.
The study, "Low high-density lipoprotein cholesterol to monitor long-term average increased triglycerides," is published in the Journal of Clinical Endocrinology & Metabolism.
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