Lipoprotein Disorders

  • Shriram Nallamshetty
  • Jorge Plutzky
  • Jorge Plutzky
Chapter

Abstract

Disorders of serum lipid and lipoproteins account for approximately 50 % of population-attributable risk for myocardial infarction (MI) [1, 2]. Randomized control trial (RCT) data demonstrate that treating elevated levels of low density lipoprotein (LDL) cholesterol results in substantial reductions in cardiovascular events and death [3]. Evidence-based guidelines identify serum lipids and lipoprotein disorders as important targets in primary and secondary prevention of coronary heart disease (CHD) [4, 5].

Keywords

Cholesterol Foam Lipase Pancreatitis Triglyceride 

Abbreviations

ABCA

ATP-binding cassette transporter A

ABCG

ATP-binding cassette transporter G

ACS

Acute Coronary Syndrome

ATPIII

Adult Treatment Panel III

CAD

Coronary artery disease

CE

Cholesterol esters

CETP

Cholesterol ester transfer protein

CHD

Coronary Heart Disease

CK

Creatine kinase

CKD

Chronic kidney disease

CM

Chylomicron

CV

Cardiovascular

DM

Diabetes Mellitus

FA

Fatty acid

FC

Free cholesterol

FCH

Familial combined hyperlipidemia

FDB

Familial defective apolipoprotein B

FFA

Free fatty acids

FH

Familial hypercholesterolemia

FRS

Framingham Risk Score

GFR

Glomerular Filtration Rate

GI

Gastrointestinal

HDL

High density lipoprotein

HDL-C

High density lipoprotein cholesterol

IDL

Intermediate density lipoprotein

LCAT

Lecithin cholesterolacyl transferase

LDL

Low density lipoprotein

LDL-C

Low density lipoprotein cholesterol

LDL-R

LDL receptor

LFTs

Liver function tests

LPL

Lipoprotein lipase

MetS

Metabolic syndrome

MI

Myocardial Infarction

Non-HDL-C

Non high density lipoprotein cholesterol

NCEP

National Cholesterol Education Program

PCI

Percutaneous intervention

PL

Phospholipids

PPARα

Peroxisome proliferator-activated receptor alpha

RCT

Randomized control trial

RF

Risk factors

TC

Total cholesterol

TLC

Therapeutic lifestyle changes

TG

Triglycerides

T2D

Type 2 diabetes mellitus

VLDL

Very low density lipoprotein

References

  1.  1.
    Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–52.PubMedCrossRefGoogle Scholar
  2.  2.
    Fruchart JC, Sacks FM, Hermans MP, Assmann G, Brown WV, Ceska R, et al. The residual risk reduction initiative: a call to action to reduce residual vascular risk in dyslipidaemic patient. Diab Vasc Dis Res. 2008;5(4):319–35.PubMedCrossRefGoogle Scholar
  3.  3.
    Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366(9493):1267–78.PubMedCrossRefGoogle Scholar
  4.  4.
    Expert Panel on Detection, and Treatment of High Blood Cholesterol in Adults. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–421.Google Scholar
  5.  5.
    Grundy SM, Cleeman JI, Merz CN, Brewer Jr HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation. 2004;110(2):227–39.PubMedCrossRefGoogle Scholar
  6. 6.
    Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–47.PubMedCrossRefGoogle Scholar
  7.  7.
    Pekkanen J, Linn S, Heiss G, Suchindran CM, Leon A, Rifkind BM, et al. Ten-year mortality from cardiovascular disease in relation to cholesterol level among men with and without preexisting cardiovascular disease. N Eng J Med. 1990;322(24):1700–7.CrossRefGoogle Scholar
  8.  8.
    Gordon DJ, Probstfield JL, Garrison RJ, Neaton JD, Castelli WP, Knoke JD, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989;79(1):8–15.PubMedCrossRefGoogle Scholar
  9.  9.
    Sniderman A, McQueen M, Contois J, Williams K, Furberg CD. Why is non-high-density lipoprotein cholesterol a better marker of the risk of vascular disease than low-density lipoprotein cholesterol? J Clin Lipidol. 2010;4(3):152–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Stubbs P, Seed M, Lane D, Collinson P, Kendall F, Noble M. Lipoprotein(a) as a risk predictor for cardiac mortality in patients with acute coronary syndromes. Eur Heart J. 1998;19(9):1355–64.PubMedCrossRefGoogle Scholar
  11. 11.
    Lamarche B, Tchernof A, Moorjani S, Cantin B, Dagenais GR, Lupien PJ, et al. Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study. Circulation. 1997;95(1):69–75.PubMedCrossRefGoogle Scholar
  12. 12.
    Pischon T, Girman CJ, Sacks FM, Rifai N, Stampfer MJ, Rimm EB. Non-high-density lipoprotein cholesterol and apolipoprotein B in the prediction of coronary heart disease in men. Circulation. 2005;112(22):3375–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005;294(3):326–33.PubMedCrossRefGoogle Scholar
  14. 14.
    Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.PubMedGoogle Scholar
  15. 15.
    Nauck M, Warnick GR, Rifai N. Methods for measurement of LDL-cholesterol: a critical assessment of direct measurement by homogeneous assays versus calculation. Clin Chem. 2002;48(2):236–54.PubMedGoogle Scholar
  16. 16.
    Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalmi P, Helo P, et al. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Eng J Med. 1987;317(20):1237–45.CrossRefGoogle Scholar
  17. 17.
    Rubins HB, Robins SJ, Collins D, Fye CL, Anderson JW, Elam MB, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Eng J Med. 1999;341(6):410–8.CrossRefGoogle Scholar
  18. 18.
    Keech A, Simes RJ, Barter P, Best J, Scott R, Taskinen MR, et al. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366(9500):1849–61.PubMedCrossRefGoogle Scholar
  19. 19.
    Ginsberg HN, Elam MB, Lovato LC, Crouse 3rd JR, Leiter LA, Linz P, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Eng J Med. 2010;362(17):1563–74.CrossRefGoogle Scholar
  20. 20.
    Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA. 1975;231(4):360–81.CrossRefGoogle Scholar
  21. 21.
    Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Eng J Med. 2011;365(24):2255–67.CrossRefGoogle Scholar
  22. 22.
    Kastelein JJ, Akdim F, Stroes ES, Zwinderman AH, Bots ML, Stalenhoef AF, et al. Simvastatin with or without ezetimibe in familial hypercholesterolemia. N Eng J Med. 2008;358(14):1431–43.CrossRefGoogle Scholar
  23. 23.
    Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet. 2011;377(9784):2181–92.PubMedCrossRefGoogle Scholar
  24. 24.
    de Jongh S, Ose L, Szamosi T, Gagne C, Lambert M, Scott R, et al. Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized, double-blind, placebo-controlled trial with simvastatin. Circulation. 2002;106(17):2231–7.PubMedCrossRefGoogle Scholar
  25. 25.
    McCrindle BW, Ose L, Marais AD. Efficacy and safety of atorvastatin in children and adolescents with familial hypercholesterolemia or severe hyperlipidemia: a multicenter, randomized, placebo-controlled trial. J Pediatr. 2003;143(1):74–80.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Shriram Nallamshetty
    • 1
  • Jorge Plutzky
    • 2
  • Jorge Plutzky
    • 3
  1. 1.Harvard Medical School Cardiology Division, Department of MedicineMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Vascular Disease Prevention Program, Cardiovascular Medicine, Department of MedicineBrigham and Women’s HospitalBostonUSA

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