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Article ; Online: Worldwide Increasing Use of Nonfasting Rather Than Fasting Lipid Profiles.

Langsted, Anne / Nordestgaard, Børge G

2024

Abstract: Background: Historically, lipids and lipoproteins were measured in the fasting state for cardiovascular risk prediction; however, since 2009 use of nonfasting lipid profiles has increased substantially worldwide. For patients, nonfasting lipid profiles ... ...

Abstract	Background: Historically, lipids and lipoproteins were measured in the fasting state for cardiovascular risk prediction; however, since 2009 use of nonfasting lipid profiles has increased substantially worldwide. For patients, nonfasting lipid profiles are convenient and avoid any risk of hypoglycemia. For laboratories, blood sampling in the morning and extra visits for patients who have not fasted are avoided. For patients, clinicians, hospitals, and society, nonfasting sampling allows same-day visits with first blood sampling followed by a short wait for test results before clinical consultation. Therefore, nonfasting compared to fasting lipid profiles will save money and time and may improve patient compliance with cardiovascular prevention programs. Content: We report on the progression of endorsement and implementation of nonfasting lipid profiles for cardiovascular risk prediction worldwide and summarize the recommendations from major medical societies and health authorities in different countries. We also describe practical advantages and disadvantages for using nonfasting lipid profiles. Further, we include a description of why fasting has been the standard historically, the barriers against implementation of nonfasting lipid profiles, and finally we suggest the optimal content of a nonfasting lipid profile. Summary: Lipid, lipoprotein, and apolipoprotein concentrations vary minimally in response to normal food intake and nonfasting lipid profiles are equal or superior to fasting profiles for cardiovascular risk prediction. Major guidelines and consensus statements in Europe, the United States, Canada, Brazil, Japan, India, and Australia now endorse use of nonfasting lipid profiles in some or all patients; however, there are still gaps in endorsement and implementation of nonfasting lipid profiles worldwide.
Language	English
Publishing date	2024-04-22
Publishing country	England
Document type	Journal Article
ZDB-ID	80102-1
ISSN	1530-8561 ; 0009-9147
ISSN (online)	1530-8561
ISSN	0009-9147
DOI	10.1093/clinchem/hvae046
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Article ; Online: Lipids and lipoproteins.

Wulff, Anders Berg / Nordestgaard, Børge G

Danish medical journal

2023 Volume 70, Issue 7

Abstract: Lipids are essential in human physiology, triglycerides for energy and cholesterol as a structural component in cells and as a precurser for hormones and vitamins. However, high blood levels of cholesterol cause atherosclerosis, leading to cardiovascular ...

Abstract	Lipids are essential in human physiology, triglycerides for energy and cholesterol as a structural component in cells and as a precurser for hormones and vitamins. However, high blood levels of cholesterol cause atherosclerosis, leading to cardiovascular disease, which is the number one cause of death globally. Genetic evidence suggests that lipoprotein(a) and remnant cholesterol, cholesterol in very low-density and intermediate-density lipoproteins, are causally involved in the development of cardiovascular disease together with low-density lipoproteins and this has spurred the development of drugs potently lowering these.
MeSH term(s)	Humans ; Cardiovascular Diseases/genetics ; Lipoproteins ; Atherosclerosis ; Triglycerides ; Vitamin A
Chemical Substances	Lipoproteins ; Triglycerides ; Vitamin A (11103-57-4)
Language	English
Publishing date	2023-06-26
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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Article ; Online: Mass changes in remnant cholesterol and LDL cholesterol explain part of the results of gemfibrozil and non-gemfibrozil fibrate trials.

Doi, Takahito / Langsted, Anne / Nordestgaard, Børge G

Journal of internal medicine

2024 Volume 295, Issue 5, Page(s) 707–710

MeSH term(s)	Humans ; Gemfibrozil/pharmacology ; Gemfibrozil/therapeutic use ; Cholesterol, LDL ; Fibric Acids ; Cholesterol ; Hypolipidemic Agents/therapeutic use ; Triglycerides ; Cholesterol, HDL ; Lipoproteins, LDL
Chemical Substances	Gemfibrozil (Q8X02027X3) ; Cholesterol, LDL ; Fibric Acids ; Cholesterol (97C5T2UQ7J) ; Hypolipidemic Agents ; Triglycerides ; Cholesterol, HDL ; Lipoproteins, LDL
Language	English
Publishing date	2024-02-11
Publishing country	England
Document type	Letter
ZDB-ID	96274-0
ISSN	1365-2796 ; 0954-6820
ISSN (online)	1365-2796
ISSN	0954-6820
DOI	10.1111/joim.13771
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Article ; Online: Novel Therapies for Lipoprotein(a): Update in Cardiovascular Risk Estimation and Treatment.

Wulff, Anders Berg / Nordestgaard, Børge G / Langsted, Anne

Current atherosclerosis reports

2024 Volume 26, Issue 4, Page(s) 111–118

Abstract: Purpose of review: Lipoprotein(a) is an important causal risk factor for cardiovascular disease but currently no available medication effectively reduces lipoprotein(a). This review discusses recent findings regarding lipoprotein(a) as a causal risk ... ...

Abstract	Purpose of review: Lipoprotein(a) is an important causal risk factor for cardiovascular disease but currently no available medication effectively reduces lipoprotein(a). This review discusses recent findings regarding lipoprotein(a) as a causal risk factor and therapeutic target in cardiovascular disease, it reviews current clinical recommendations, and summarizes new lipoprotein(a) lowering drugs. Recent findings: Epidemiological and genetic studies have established lipoprotein(a) as a causal risk factor for cardiovascular disease and mortality. Guidelines worldwide now recommend lipoprotein(a) to be measured once in a lifetime, to offer patients with high lipoprotein(a) lifestyle advise and initiate other cardiovascular medications. Clinical trials including antisense oligonucleotides, small interfering RNAs, and an oral lipoprotein(a) inhibitor have shown great effect on lowering lipoprotein(a) with reductions up to 106%, without any major adverse effects. Recent clinical phase 1 and 2 trials show encouraging results and ongoing phase 3 trials will hopefully result in the introduction of specific lipoprotein(a) lowering drugs to lower the risk of cardiovascular disease.
MeSH term(s)	Humans ; Cardiovascular Diseases/drug therapy ; Cardiovascular Diseases/etiology ; Heart Disease Risk Factors ; Lipoprotein(a)/drug effects ; Lipoprotein(a)/genetics ; Lipoprotein(a)/metabolism ; Oligonucleotides, Antisense/therapeutic use ; Risk Factors
Chemical Substances	Lipoprotein(a) ; Oligonucleotides, Antisense
Language	English
Publishing date	2024-02-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057369-8
ISSN	1534-6242 ; 1523-3804
ISSN (online)	1534-6242
ISSN	1523-3804
DOI	10.1007/s11883-024-01192-9
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Article ; Online: Remnant cholesterol, LDL cholesterol, and apoB absolute mass changes explain results of the PROMINENT trial.

Doi, Takahito / Langsted, Anne / Nordestgaard, Børge G

Atherosclerosis

2024 Volume 393, Page(s) 117556

Abstract: Background and aims: The PROMINENT trial, a cardiovascular outcome trial of the triglyceride- and remnant cholesterol-lowering agent pemafibrate, has shown neutral results despite reduction in plasma triglycerides and remnant cholesterol. We tested the ... ...

Abstract	Background and aims: The PROMINENT trial, a cardiovascular outcome trial of the triglyceride- and remnant cholesterol-lowering agent pemafibrate, has shown neutral results despite reduction in plasma triglycerides and remnant cholesterol. We tested the hypothesis that absolute mass changes in remnant cholesterol, LDL cholesterol, and apolipoprotein B explain the results of the PROMINENT trial. Methods: Among 108,431 individuals from the Copenhagen General Population Study (CGPS), those who met the key inclusion criteria of the PROMINENT trial were analyzed to mimic the trial design. Endpoint atherosclerotic cardiovascular disease (ASCVD) was cardiovascular death, myocardial infarction, ischemic stroke, and coronary revascularization as defined in PROMINENT. Results: In the PROMINENT trial, treatment with pemafibrate resulted in -7 mg/dL (-0.18 mmol/L; -18 %) change in remnant cholesterol, +10 mg/dL (+0.26 mmol/L; +12 %) LDL cholesterol, and +5 mg/dL (+0.05 g/L; +5 %) apolipoprotein B. In the CGPS mimicking PROMINENT, the estimated hazard ratios for ASCVD were 0.97 (95 % confidence interval: 0.94-0.99) for a -7 mg/dL (-0.18 mmol/L) change in remnant cholesterol, 1.04 (1.01-1.07) for a +10 mg/dL (+0.26 mmol/L) change in LDL cholesterol, and 1.02 (1.01-1.03) for a +5 mg/dL (+0.05 g/L) change in apolipoprotein B. When combining absolute changes in remnant cholesterol, LDL cholesterol, and apolipoprotein B, the estimated hazard ratio for ASCVD was 1.05 (0.96-1.14) in the CGPS mimicking PROMINENT compared to 1.03 (0.91-1.15) in the PROMINENT trial. Conclusions: Absolute mass changes in remnant cholesterol, LDL cholesterol, and apolipoprotein B can explain results of the PROMINENT trial. The 3 mg/dL (0.08 mmol/L) higher total atherogenic cholesterol together with 5 mg/dL (0.05 g/L) higher apolipoprotein B seem to explain the trend toward more ASCVD in the pemafibrate arm.
Language	English
Publishing date	2024-04-20
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	80061-2
ISSN	1879-1484 ; 0021-9150
ISSN (online)	1879-1484
ISSN	0021-9150
DOI	10.1016/j.atherosclerosis.2024.117556
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Zs.A 226: Show issues

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Article ; Online: Value of Genetic Testing for Lipoprotein(a) Variants.

Langsted, Anne / Nordestgaard, Børge G

Circulation. Genomic and precision medicine

2022 Volume 15, Issue 2, Page(s) e003737

MeSH term(s)	Genetic Testing ; Humans ; Hyperlipoproteinemia Type II/genetics ; Lipoprotein(a)/genetics
Chemical Substances	Lipoprotein(a)
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Editorial ; Comment
ISSN	2574-8300
ISSN (online)	2574-8300
DOI	10.1161/CIRCGEN.122.003737
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Article ; Online: Lipoprotein(a) as Part of the Diagnosis of Clinical Familial Hypercholesterolemia.

Langsted, Anne / Nordestgaard, Børge G

Current atherosclerosis reports

2022 Volume 24, Issue 4, Page(s) 289–296

Abstract: Purpose of review: Individuals with familial hypercholesterolemia have very high risk of cardiovascular disease due to lifelong elevations in LDL cholesterol. Elevated lipoprotein(a) is a risk factor for cardiovascular diseases such as myocardial ... ...

Abstract	Purpose of review: Individuals with familial hypercholesterolemia have very high risk of cardiovascular disease due to lifelong elevations in LDL cholesterol. Elevated lipoprotein(a) is a risk factor for cardiovascular diseases such as myocardial infarction and aortic valve stenosis. It has been proposed to include elevated lipoprotein(a) in the diagnosis of clinical familial hypercholesterolemia. Recent findings: Lipoprotein(a) is co-measured in LDL cholesterol, and up to one-quarter of all diagnoses of clinical familial hypercholesterolemia are due to high levels of lipoprotein(a). Further, individuals with both familial hypercholesterolemia and elevated lipoprotein(a) have an extremely high risk of myocardial infarction. We discuss the background for familial hypercholesterolemia and elevated lipoprotein(a) as risk factors for cardiovascular disease and the consequences of the fact that LDL cholesterol measurements/calculations include the cholesterol present in lipoprotein(a). Finally, we discuss the potential of including lipoprotein(a) as part of the diagnosis of familial hypercholesterolemia and in consequence possible treatments.
MeSH term(s)	Aortic Valve Stenosis ; Cholesterol, LDL ; Humans ; Hyperlipoproteinemia Type II/diagnosis ; Lipoprotein(a) ; Myocardial Infarction
Chemical Substances	Cholesterol, LDL ; Lipoprotein(a)
Language	English
Publishing date	2022-02-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057369-8
ISSN	1534-6242 ; 1523-3804
ISSN (online)	1534-6242
ISSN	1523-3804
DOI	10.1007/s11883-022-01002-0
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Zs.A 5534: Show issues

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Article ; Online: Elevated plasma triglycerides increase risk of psoriasis: A cohort and Mendelian randomization study.

Greve, Anders M / Wulff, Anders B / Bojesen, Stig E / Nordestgaard, Børge G

The British journal of dermatology

2024

Abstract: Background: It is increasingly clear that triglyceride-rich lipoproteins are proinflammatory and cause low-grade systemic inflammation. However, it is currently unknown whether elevated plasma triglycerides are causally related to development of ... ...

Abstract	Background: It is increasingly clear that triglyceride-rich lipoproteins are proinflammatory and cause low-grade systemic inflammation. However, it is currently unknown whether elevated plasma triglycerides are causally related to development of psoriasis, a skin disorder driven by chronic inflammation. Objective: To determine if elevated plasma triglycerides are associated with increased risk of psoriasis in observational and Mendelian randomization analysis. Methods: Consecutive individuals from the Copenhagen General Population Study (CGPS) were included. We used plasma triglycerides (n = 108,043) and a weighted triglyceride allele score (n = 92,579) on nine known triglyceride-altering genetic variants. Genetic results were replicated in 337,159 individuals from the UK biobank. Psoriasis was ICD10-code hospital contact in main analyses, and prescription of topical antipsoriatics for mild psoriasis in sensitivity analysis. Results: During a median 9.3 years (0.1-15.1) of follow-up (from 2003-2015 through 2018), 855 (1%) individuals were diagnosed with psoriasis by ICD-10 in observational analysis and 772 (1%) in Mendelian randomization analysis. In observational analysis, multivariable adjusted hazard ratio for psoriasis by ICD-10 were 1.26 (95% CI:1.15-1.39) per doubling in plasma triglycerides with a corresponding causal, genetic risk ratio of 2.10 (1.30-3.38). Causality was confirmed in the UK biobank. Results were similar but slightly attenuated when we used topical antipsoriatics prescription for mild psoriasis. Conclusion: Elevated plasma triglycerides are associated with increased risk of psoriasis in observational and Mendelian randomization analysis.
Language	English
Publishing date	2024-02-27
Publishing country	England
Document type	Journal Article
ZDB-ID	80076-4
ISSN	1365-2133 ; 0007-0963
ISSN (online)	1365-2133
ISSN	0007-0963
DOI	10.1093/bjd/ljae089
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Article ; Online: Remnant Cholesterol, Not LDL Cholesterol, Explains Peripheral Artery Disease Risk Conferred by apoB: A Cohort Study.

Wadström, Benjamin N / Pedersen, Kasper M / Wulff, Anders B / Nordestgaard, Børge G

Arteriosclerosis, thrombosis, and vascular biology

2024 Volume 44, Issue 5, Page(s) 1144–1155

Abstract: Background: Elevated apoB-containing lipoproteins (=remnants+LDLs [low-density lipoproteins]) are a major risk factor for atherosclerotic cardiovascular disease, including peripheral artery disease (PAD) and myocardial infarction. We tested the ... ...

Abstract	Background: Elevated apoB-containing lipoproteins (=remnants+LDLs [low-density lipoproteins]) are a major risk factor for atherosclerotic cardiovascular disease, including peripheral artery disease (PAD) and myocardial infarction. We tested the hypothesis that remnants and LDL both explain part of the increased risk of PAD conferred by elevated apoB-containing lipoproteins. For comparison, we also studied the risk of chronic limb-threatening ischemia and myocardial infarction. Methods: apoB, remnant cholesterol, and LDL cholesterol were measured in 93 461 individuals without statin use at baseline from the Copenhagen General Population Study (2003-2015). During up to 15 years of follow-up, 1207 had PAD, 552 had chronic limb-threatening ischemia, and 2022 had myocardial infarction in the Danish National Patient Registry. Remnant and LDL cholesterol were calculated from a standard lipid profile. Remnant and LDL particle counts were additionally measured with nuclear magnetic resonance spectroscopy in 25 347 of the individuals. Results were replicated in 302 167 individuals without statin use from the UK Biobank (2004-2010). Results: In the Copenhagen General Population Study, multivariable adjusted hazard ratios for risk of PAD per 1 mmol/L (39 mg/dL) increment in remnant and LDL cholesterol were 1.9 (95% CI, 1.5-2.4) and 1.1 (95% CI, 1.0-1.2), respectively; corresponding results in the UK Biobank were 1.7 (95% CI, 1.4-2.1) and 0.9 (95% CI, 0.9-1.0), respectively. In the association from elevated apoB to increased risk of PAD, remnant and LDL cholesterol explained 73% (32%-100%) and 8% (0%-46%), respectively; corresponding results were 63% (30%-100%) and 0% (0%-33%) for risk of chronic limb-threatening ischemia and 41% (27%-55%) and 54% (38%-70%) for risk of myocardial infarction; results for remnant and LDL particle counts corroborated these findings. Conclusions: PAD risk conferred by elevated apoB-containing lipoproteins was explained mainly by elevated remnants, while myocardial infarction risk was explained by both elevated remnants and LDL.
MeSH term(s)	Humans ; Peripheral Arterial Disease/epidemiology ; Peripheral Arterial Disease/blood ; Peripheral Arterial Disease/diagnosis ; Male ; Female ; Cholesterol, LDL/blood ; Middle Aged ; Denmark/epidemiology ; Aged ; Cholesterol/blood ; Biomarkers/blood ; Apolipoprotein B-100/blood ; Risk Assessment ; Risk Factors ; Myocardial Infarction/epidemiology ; Myocardial Infarction/blood ; Myocardial Infarction/diagnosis ; Registries ; Adult ; Time Factors ; Ischemia/blood ; Ischemia/epidemiology ; Ischemia/diagnosis ; Prospective Studies ; Lipoproteins ; Triglycerides
Chemical Substances	Cholesterol, LDL ; APOB protein, human ; Cholesterol (97C5T2UQ7J) ; Biomarkers ; Apolipoprotein B-100 ; remnant-like particle cholesterol ; Lipoproteins ; Triglycerides
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Comparative Study
ZDB-ID	1221433-4
ISSN	1524-4636 ; 1079-5642
ISSN (online)	1524-4636
ISSN	1079-5642
DOI	10.1161/ATVBAHA.123.320175
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Article ; Online: Smoking as the most important risk factor for chronic pancreatitis in the general population.

Hansen, Signe E J / Nordestgaard, Børge G / Langsted, Anne

European journal of epidemiology

2023 Volume 38, Issue 1, Page(s) 95–107

Abstract: We tested the hypothesis that six toxic risk factors from the TIGAR-O classification system are equally important for risk of chronic pancreatitis, at the level of the individual patient and in the general population. 108,438 women and men aged 20-100 ... ...

Abstract	We tested the hypothesis that six toxic risk factors from the TIGAR-O classification system are equally important for risk of chronic pancreatitis, at the level of the individual patient and in the general population. 108,438 women and men aged 20-100 years participating in the Copenhagen General Population Study from 2003 to 2015 were included. Associations of smoking, alcohol intake, waist/hip ratio, kidney function, plasma triglycerides, plasma Ca
MeSH term(s)	Male ; Humans ; Female ; Acute Disease ; Risk Factors ; Smoking/adverse effects ; Smoking/epidemiology ; Pancreatitis, Chronic/epidemiology ; Pancreatitis, Chronic/etiology ; Diabetes Mellitus ; Gallstones ; Triglycerides
Chemical Substances	Triglycerides
Language	English
Publishing date	2023-01-03
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	632614-6
ISSN	1573-7284 ; 0393-2990
ISSN (online)	1573-7284
ISSN	0393-2990
DOI	10.1007/s10654-022-00945-7
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