Page 260 - fbkCardioDiabetes_2017

236 Cardio Diabetes Medicine 2017

Advantages:
1. Inexpensive.

2. Can be done from standard lipid profile.
3. Should be in Non Fasting state.

Atherogensity of elevated RLP s:
Elevated remnant lipoprotein-cholesterol like LDL
Cholesterol enter and is trapped in the arterial wall
leading to accumulation of intimal Cholesterol and
progressive vascular injury.

Also, they are associated with lowgrade inflamma-
tory reactions like endothelial Dysfunction ,impaired
vasodilatation. Leading to thrombus formation.

CAUSES:

Obesity
Poorly controlled DM
Alcoholic excess
High estrogen Endogenous
↓
Exogenous

Drugs –Steroids oral contraceptives.
Genetic variants
↓
COMMON -------→ RARE

↓
Combination of multiple factors Chylomicronemia
Syndrome

Like Obesity | DM | High estrogen
Evidence Based:3

Measurement of RLP s:1 MAJOR TRIALS FOR RLP ----→ ↑RESIDUAL
Limitations: RISK:
• Remnant Lipoproteins are different both in compo- RLPs contribute to atherogenesis was first made by
sition of lipids and apolipoproteins as a result of Zilversmit in 1979.
different stages of lipolysis at the time of study .
• Framingham Off spring study Serum levels of RLP
• -Formed by two different pathways . correlate well with the risk of events in women with
established CAD.
• -So very difficult to measure them precisely.
• Honolulu heart study :Serum levels of RLP correlat-
Alternatively :
ed well with CV events of asian men.
Non Fasting Remnant Lipoprotein Cholesterol=Total
Cholesterol –HDL-c –LDL-cholesterol. • ACCORD trial –RLP level correlated well with the
CV risks in diabetic women in post prandial sub-
study.

GCDC 2017