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Apolipoprotein profiling may enhance CV risk assessment

10 Oct 2018

Novel methods can greatly enhance the accuracy of lipoprotein profiling, thus improving cardiovascular (CV) risk prediction.

“Currently, we just monitor lipid classes, namely total cholesterol, triglycerides [TG], LDL-cholesterol [LDL-C] and HDL-cholesterol, focusing on quantity rather than molecular composition. Using mass spectrometry of plasma samples, we can identify proteins directly and more precisely,” said Professor Manuel Mayr of King's College London, UK. “The technique, called lipidomics, has shown that TG species containing saturated or monounsaturated fatty acids are associated with the highest CV risk.” [Circulation 2014;129:1821-1831; Am J Clin Nutr 2017;106;973-983]

Apolipoprotein profiling by mass spectrometry has demonstrated that apoB-100, apo C-I, apo C-II and apoL-I are positively associated with CV disease (CVD). Importantly, very low density lipoprotein (VLDL) carries not only apoB-100 (the main apolipoprotein on LDL-C), but also those other high-risk apolipoprotein species, suggesting a remaining high CV risk beyond LDL-C. [J Am Coll Cardiol 2017;69:789-900; J Am Coll Cardiol 2018;71;620-632]

“The strong association of certain TG species and VLDL-associated apolipoproteins with incident CVD supports the concept of targeting TG-rich lipoproteins to further reduce CVD risk in the statin era where LDL-C is already very low,” he suggested.

Proteomics studies have also identified several inflammation-related lipid species in atherosclerotic plaques. [J Clin Invest 2017;127:1546-1560] “Apolipoprotein constituents of LDL seem to be associated with inflammation and symptomatic plaques. This inflammatory signature seems to be driving the progression of atherosclerosis to manifest CVD, supporting the concept of targeting inflammation on top of lipid lowering,” noted Mayr.

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Most Read Articles
6 days ago
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Pearl Toh, 3 days ago
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from a large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
5 days ago
Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.
3 days ago
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.