Very Low-Density Lipoprotein Cholesterol May Mediate a Substantial Component of the Effect of Obesity on Myocardial Infarction Risk:The Copenhagen General Population Study
| Autor: | Børge G. Nordestgaard, George Davey Smith, Mia Ø. Johansen, Signe Vedel-Krogh, Sune F. Nielsen, Shoaib Afzal |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Very low-density lipoprotein Epidemiology Lipoproteins Cholesterol VLDL Clinical Biochemistry Myocardial Infarction 030204 cardiovascular system & hematology digestive system Body Mass Index 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Interquartile range Internal medicine Diabetes mellitus medicine Humans Metabolomics Obesity 030212 general & internal medicine Myocardial infarction Aged Cholesterol business.industry Remnant cholesterol Biochemistry (medical) nutritional and metabolic diseases Cholesterol LDL Middle Aged medicine.disease Stroke Endocrinology chemistry Atherosclerotic cardiovascular disease Population study Female lipids (amino acids peptides and proteins) business Body mass index Lipoprotein |
| Zdroj: | Johansen, M, Nielsen, S F, Afzal, S, Vedel-Krogh, S, Davey Smith, G & Nordestgaard, B G 2021, ' Very Low-Density Lipoprotein Cholesterol May Mediate a Substantial Component of the Effect of Obesity on Myocardial Infarction Risk : The Copenhagen General Population Study ', Clinical Chemistry, vol. 67, no. 1, pp. 276-287 . https://doi.org/10.1093/clinchem/hvaa290 Johnasen, M, Nielsen, S F, Afzal, S, Vedel-Krogh, S, Davey Smith, G & Nordestgaard, B G 2021, ' Very low-density lipoprotein cholesterol may mediate a substantial component of the effect of obesity on myocardial infarction risk : the Copenhagen General Population Study ', Clinical Chemistry, vol. 67, no. 1, pp. 276–287 . https://doi.org/10.1093/clinchem/hvaa290 |
| Popis: | Background Individuals with obesity have higher concentrations of very low-density lipoprotein (VLDL) cholesterol and increased risk of myocardial infarction. We hypothesized that VLDL cholesterol explains a fraction of the excess myocardial infarction risk in individuals with obesity. Methods We included 29 010 individuals free of myocardial infarction at baseline, nested within 109 751 individuals from the Copenhagen General Population Study. During 10 years of follow-up, 2306 individuals developed myocardial infarction. Cholesterol content in large and small VLDLs, in intermediate-density lipoprotein (IDL), and in LDL was measured directly with nuclear magnetic resonance spectroscopy. Results Median concentrations of cholesterol in large and small VLDLs were 0.12 mmol/L (interquartile range [IQR], 0.07–0.20 mmol/L; 4.5 mg/dL [IQR, 2.6–6.9 mg/dL]) and 0.6 mmol/L (IQR, 0.5–0.8 mmol/L; 25 mg/dL [IQR, 20–30 mg/dL]) in individuals with obesity vs 0.06 mmol/L (IQR, 0.03–0.1 mmol/L; 2.2 mg/dL [IQR, 1.1–3.8 mg/dL]), and 0.5 mmol/L (IQR, 0.4–0.6 mmol/L; 20 mg/dL (IQR, 16–25 mg/dL]) in individuals with normal weight; in contrast, concentrations of IDL and LDL cholesterol were similar across body mass index (BMI) categories. Cholesterol in large and small VLDLs combined explained 40% (95% CI, 27%–53%) of the excess risk of myocardial infarction associated with higher BMI. In contrast, IDL and LDL cholesterol did not explain excess risk of myocardial infarction, whereas systolic blood pressure explained 17% (11%–23%) and diabetes mellitus explained 8.6% (3.2%–14%). Conclusions VLDL cholesterol explains a large fraction of excess myocardial infarction risk in individuals with obesity. These novel findings support a focus on cholesterol in VLDL for prevention of myocardial infarction and atherosclerotic cardiovascular disease in individuals with obesity. |
| Databáze: | OpenAIRE |
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