Combined dyslipidemia: should the focus be LDL cholesterol or atherogenic dyslipidemia?

Curr Pharm Des. 2013;19(21):3858-68. doi: 10.2174/13816128113199990324.

Abstract

As the population becomes more obese and the prevalence of diabetes and the metabolic syndrome increases, low-density lipoprotein-cholesterol (LDL-C) may lose its value as a sole predictor for cardiovascular risk among lipids. Combined dyslipidemia is typically characterized by elevations in LDL-C and triglyceride levels, often accompanied by decreased high-density lipoproteincholesterol (HDL-C) concentrations and increased levels of small, dense LDL. This common disorder results from overproduction of hepatically synthesized apolipoprotein B in very low-density lipoproteins. In the last few years most of the international scientific guidelines as well as several expert panels have confirmed that LDL-C represents the primary or even the only target of treatment. Yet, increasing evidence suggests moving away from a LDL-C target-based approach to a more tailored treatment approach. For example, non- HDL-C has been introduced in the last few years as a target of treatment.

Publication types

  • Review

MeSH terms

  • Animals
  • Apolipoproteins B / blood
  • Atherosclerosis / etiology
  • Atherosclerosis / prevention & control*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy*
  • Humans
  • Practice Guidelines as Topic
  • Risk Factors
  • Triglycerides / blood

Substances

  • Apolipoproteins B
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides