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RECENT PUBLICATIONS ON RESIDUAL RISK

2019

Remnant lipoproteins contain one-third of total plasma cholesterol

Studies have shown that calculated remnant cholesterol in triglyceride-rich lipoproteins is causally associated with increased risk of ischaemic heart disease, although what this represents (as direct measurement) as a proportion of total circulating plasma cholesterol is unclear. Results from the Copenhagen General Population Study provide insights. Researchers evaluated total cholesterol, free- and esterified cholesterol, triglycerides, phospholipids, and particle concentration using nuclear magnetic resonance spectroscopy in 9,293 individuals. Remnant lipoproteins were defined as the combination of very-low-density lipoproteins (VLDL) and intermediate-density lipoproteins (IDL). Mean nonfasting remnant cholesterol concentration was 1.84 mmol/L (72 mg/dL), equivalent to 32% of total plasma total cholesterol. These results reaffirm that triglyceride-rich remnant lipoproteins contain a substantial proportion of circulating cholesterol and therefore represent a key target for therapeutic intervention.
A third of nonfasting plasma cholesterol is in remnant lipoproteins: Lipoprotein subclass profiling in 9293 individuals.

Balling M, Langsted A, Afzal S