The 17th International Symposium
on Atherosclerosis
23-26 May    Amsterdam    The Netherlands
The R3i announces with regret the
retirement of Professor Jean Davignon
from the R3i Trustee Board.
He will remain as
Honorary Vice President of the R3i.
Landmark study
Hypertriglyceridemia increases risk for diabetic renal complications
Focus on...
MULTI-GAP: Non-high-density lipoprotein cholesterol goal attainment and elevated triglycerides
The National Lipid Association (NLA)
The National Lipid Association (NLA) is a nonprofit, multidisciplinary medical society focused on enhancing the practice of lipid management in clinical medicine.
MSDA 2015 Congress
8 June 2015

Targeting triglycerides: what lies on the horizon for novel therapies?

Prof. Jean Charles Fruchart, Prof. Michel Hermans, Prof. Pierre Amarenco
Prof. Jean Charles Fruchart, Prof. Michel Hermans, Prof. Pierre Amarenco
An Editorial from the R3i Trustees

Accumulating evidence strengthens the case for consideration of an appropriate marker of triglyceride (TG)-rich lipoproteins in guidelines for the management of dyslipidaemia. The consensus of opinion from epidemiologic, genetic and mechanistic studies supports remnant cholesterol as a possible contender, although apolipoprotein (apo) CIII may represent an alternative approach. However, in translating such evidence to the clinic, what are the available therapeutic options?
R3i Education Channel

Time to re-evaluate the role of HDL in cardiovascular risk?

Extensive epidemiologic data support low high-density lipoprotein cholesterol (HDL-C) as a risk factor for cardiovascular disease. However, to date clinical trials evaluating HDL-targeted therapy have been largely negative, and in the case of niacin (nicotinic acid), associated with harm. Given these discrepancies, together with growing realisation that the HDL particle population is heterogeneous in terms of size, structure, composition and functionality, there has been a view that the functional activity of HDL particles may be more relevant than HDL-C level. This report from the University of Pennsylvania helps to clarify this. This nested case-control sample from the prospective EPIC-Norfolk study showed that cholesterol efflux capacity, a potentially atheroprotective function of HDL, was significantly and inversely associated with incident coronary heart disease events, independent of several established cardiovascular risk factors and even after adjusting for HDL-C or apolipoprotein A-I concentrations. However, the researchers advise caution in the interpretation of causality, until Mendelian randomisation studies have been conducted to investigate this potential association.
Association of HDL cholesterol efflux capacity with incident coronary heart disease events: a prospective case-control study.
Saleheen D, Scott R, Javad S et al.

Adiponectin implicated in diabetic retinopathy

Findings from this cross-sectional, family-based observational cohort study suggest a role for adiponectin in the underlying pathogenesis of diabetic retinopathy. The study included 507 Latino subjects with type 2 diabetes, with diabetes for at least 10 years or more and/or with diabetic retinopathy. Serum adiponectin was measured and insulin sensitivity was estimated using homeostasis model assessment (HOMA). Diabetic retinopathy was assessed by digital fundus photography and graded using the modified Airlie House classification and the Early Treatment Diabetic Retinopathy Scale. Fasting adiponectin concentrations were elevated in patients with diabetic retinopathy compared with those without (12.9±0.5 ug/ml vs. 10.5±0.5 ug/ml, p=0.0004). This effect remained significant after multiple covariate adjustment (age, gender, body mass index, HbA1c, diabetes duration, statin use, blood pressure, and renal function, p=0.013 - 0.018). Adiponectin was also positively correlated with the severity of diabetic retinopathy in patients with non-proliferative disease (p<0.0003). Further research is indicated to investigate whether adiponectin is a marker or biological mediator of diabetic retinopathy.
Adiponectin, Insulin Sensitivity and Diabetic Retinopathy in Latinos with Type 2 Diabetes.
Kuo JZ, Guo X, Klein R et al.

Insights into the renoprotective effects of fenofibrate

Attenuation of endothelial function may underlie the renoprotective effects of fenofibrate, according to results in an animal model of diabetic nephropathy. Diabetic rats were treated with fenofibrate (100 mg/kg/day) for 12 weeks. At the end of treatment, there was improvement in renal function, as shown by reduction in urinary albumin excretion and serum levels of creatinine and urea, as well as an increase in creatinine clearance compared with controls. Mechanistically, fenofibrate led to increases in renal nitric oxide (NO) production and mRNA expression of endothelial NO synthase (eNOS), adenosine monophosphate-activated protein kinase (AMPK) and liver kinase B1 (LKB1), indicative of improved endothelial function. These findings merit further investigation of the underlying effects of fenofibrate on renal function.
Renoprotective effects of fenofibrate via modulation of LKB1/AMPK mRNA expression and endothelial dysfunction in a rat model of diabetic nephropathy.
Al-Rasheed NM, Al-Rasheed NM, Attia HAet al.

Elevated triglycerides and cardiovascular risk in Korea

In this large prospective observational study, elevated triglycerides were independently associated with an increased risk for cardiovascular disease. The study included 76,434 participants who had undergone a regular health check between January 2007 and June 2011. Higher triglycerides were associated with ?50% increase in risk for major cardiovascular disease events (odds ratio: 1.52, 95% CI: 1.27-1.82) and overall cardiovascular disease events (odds ratio 1.49, 95% CI: 1.37-1.63). These findings remained significant after adjustment for multiple risk factors including HDL-cholesterol. These findings add to the evidence-base supporting elevated triglycerides as a cardiovascular risk factor.
Serum triglyceride levels and cardiovascular disease events in Koreans.
Kim EH, Lee JB, Kim SH et al.