Combined Dyslipidemia: Should the Focus be LDL Cholesterol or Atherogenic Dyslipidemia?

Manfredi      Rizzo; Marcin      Barylski; Ali A.      Rizvi; Giuseppe      Montalto; Dimitri      P. Mikhailidis; Maciej      Banach

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.

Keywords: Combined dyslipidemia, cholesterol, low-density lipoprotein-cholesterol, small, dense low-density lipoprotein, high-density lipoprotein- cholesterol, non-high-density lipoprotein-cholesterol.

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