Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec;24(12):290-300.
doi: 10.1007/s11892-024-01555-1. Epub 2024 Oct 2.

Impact of Remnant Cholesterol on Cardiovascular Risk in Diabetes

Daniel Elías-López  1   2   3 , Benjamin Nilsson Wadström  1   2   4 , Signe Vedel-Krogh  1   2   4 , Camilla Jannie Kobylecki  1   2 , Børge Grønne Nordestgaard  5   6   7
Affiliations
Review

Impact of Remnant Cholesterol on Cardiovascular Risk in Diabetes

Daniel Elías-López et al. Curr Diab Rep. 2024 Dec.

Abstract

Purpose of review: Individuals with diabetes face increased risk of atherosclerotic cardiovascular disease (ASCVD), in part due to hyperlipidemia. Even after LDL cholesterol-lowering, residual ASCVD risk persists, part of which may be attributed to elevated remnant cholesterol. We describe the impact of elevated remnant cholesterol on ASCVD risk in diabetes.

Recent findings: Preclinical, observational, and Mendelian randomization studies robustly suggest that elevated remnant cholesterol causally increases risk of ASCVD, suggesting remnant cholesterol could be a treatment target. However, the results of recent clinical trials of omega-3 fatty acids and fibrates, which lower levels of remnant cholesterol in individuals with diabetes, are conflicting in terms of ASCVD prevention. This is likely partly due to neutral effects of these drugs on the total level of apolipoprotein B(apoB)-containing lipoproteins. Elevated remnant cholesterol remains a likely cause of ASCVD in diabetes. Remnant cholesterol-lowering therapies should also lower apoB levels to reduce risk of ASCVD.

Keywords: Atherosclerosis; Hyperglycemia; Insulin Resistance; Lipoproteins; Triglyceride-rich Lipoproteins; VLDL.

PubMed Disclaimer

References

    1. Collaborators GBDF. Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2204–56. https://doi.org/10.1016/S0140-6736(24)00685-8 . - DOI
    1. Chan JCN, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, et al. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet. 2021;396(10267):2019–82. https://doi.org/10.1016/S0140-6736(20)32374-6 . - DOI - PubMed
    1. Wong ND, Sattar N. Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention. Nat Rev Cardiol. 2023;20(10):685–95. https://doi.org/10.1038/s41569-023-00877-z . - DOI - PubMed
    1. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91. https://doi.org/10.1056/NEJMoa0706245 . - DOI - PubMed
    1. Rawshani A, Rawshani A, Franzen S, Sattar N, Eliasson B, Svensson AM, et al. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018;379(7):633–44. https://doi.org/10.1056/NEJMoa1800256 . - DOI - PubMed

MeSH terms

LinkOut - more resources