At target LDL-C levels, apoB100 concentrations will be higher than recommended levels in the following populations: Tertiary centre lipid clinic patients with raised TG treated with statins. Patients with type 2 diabetes treated with statins. Patients with Chronic Kidney disease (CKD) stages 4 and 5 treated with statins. Despite achieving LDL-C and non-HDL-C targets, a significant number of statin-treated patients have residual cardiovascular risk related to raised hsCRP. The relationship between hsCRP and Lp-PLA2 (markers of inflammation) and LDL particle number measured by apoB100 is stronger than that of measured and calculated LDL and non-HDL. In statin treated patients there will be higher levels of hs-CRP and Lp-PLA2 in patients achieving LDL targets but not apo B targets. We hypothesise that non-diabetic patients with severe hypertriglyceridaemia (fasting serum triglyceride >5.5 mmol/l) have evidence of greater nerve damage compared with matched controls. LAL deficiency is underdiagnosed in patients with severe hypertriglyceridaemia, low HDL-C, hyperlipidaemias, non alcoholic fatty liver disease and idiopathic high liver enzymes.
• Therapeutic target arm
• Statin treated patients with and without hypertriglyceridemia.
• Statin treated patients with type 2 diabetes.
• Statin treated patients with CKD stages 4 and 5.
• Nerve function arm
• •Patients known to have severe hypertriglyceridaemia (defined as triglyceride >5.5 mmol/l) but not known to have diabetes and matched controls.
• Genetic screening arm
• Patients with a documented triglyceride level of more than 10 mmol/l at any time.
• Criteria for screening for FH and LAL deficiency include non-obese patients (BMI <30) with low HDL-C (<1.0 mmol/l male and <1.3 mmol female), high triglycerides >1.7 mmol/l, high total cholesterol >6.2 or LDL cholesterol >4.7 mmol/l; patients with raised liver alanine aminotransferase (ALT) (1.5 x above ULN) but no metabolic or viral disease or alcohol excess and patients diagnosed with NAFLD with or without hyperlipidaemia.
This content was sourced from clinicaltrials.gov