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Differential response of high-density lipoproteins to first-step lipid-lowering diet according to their initial level
G D Kolovou1, Y P Fostinis, G Athanassopoulos
1Department of Cardiology, Tzanio State Hospital, Piraeus, Greece.
Insights
A lipid-lowering diet impacts high-density-lipoprotein (HDL) cholesterol differently based on baseline levels. Patients with lower HDL benefited, while those with higher HDL saw a decrease, suggesting personalized treatment approaches.
Area of Science:
- Cardiology
- Nutrition Science
- Metabolic Disorders
Background:
- Dietary interventions are crucial for managing lipid profiles.
- Lipid-lowering diets can affect high-density-lipoprotein (HDL) cholesterol levels.
- Understanding diet-induced HDL changes is vital for cardiovascular health.
Purpose of the Study:
- To investigate the effect of a first-step lipid-lowering diet on HDL cholesterol levels.
- To analyze differential responses to diet based on baseline HDL cholesterol.
- To inform personalized treatment strategies for dyslipidemia.
Main Methods:
- A cohort of 129 Greek patients (78 men, 51 women) followed a European Atherosclerosis Society-recommended diet for 3 months.
- Assessed total cholesterol, HDL, LDL cholesterol, triglycerides, and total:HDL ratio before and after the dietary intervention.
- Stratified analysis based on baseline HDL levels (≥39 mg/dl vs. <39 mg/dl).
Main Results:
- Overall, the diet reduced total cholesterol (12%), LDL (15%), and triglycerides (12%).
- HDL cholesterol showed a non-significant decrease of 3% overall.
- Patients with baseline HDL <39 mg/dl experienced a significant HDL increase (17%), while those with HDL ≥39 mg/dl saw a decrease (10%).
Conclusions:
- Dietary response of HDL cholesterol is heterogeneous and depends on baseline levels.
- Patients with low baseline HDL (<39 mg/dl) benefit from diet with HDL increase.
- Consideration of HDL-raising therapies alongside diet is recommended for patients with high baseline HDL (≥39 mg/dl).
Background:
A lipid-lowering diet has been shown to lower total cholesterol but also high-density-lipoprotein (HDL) cholesterol. The effect of the first-step lipid-lowering diet (as suggested by the European Atherosclerosis Society) on HDL levels was studied in 129 Greek patients aged 52.7 +/- 9.8 years, of whom 78 were men and 51 women of similar ages.
Methods:
Total, HDL, and low-density-lipoprotein (LDL) cholesterol, and the total: HDL cholesterol and triglyceride ratio were assessed before and 3 months after the diet.
Results:
Overall, total cholesterol decreased by 12% (P < 0.001), LDL by 15% (P < 0.001), HDL by 3% (NS), triglycerides by 12% (P < 0.01), and total: HDL cholesterol ratio by 11% (P < 0.001). A difference was found in the response to diet according to baseline HDL levels: in patients with HDL of 39 mg/dl or higher (group A), HDL decreased by 10% and the total: HDL cholesterol ratio by 3%, whereas in those with HDL lower than 39 mg/dl (group B) HDL increased by 17% and the total: HDL cholesterol ratio decreased by 22%. The difference between the groups was statistically significant (P < 0.001) for these two values as well as for triglycerides, but not for total cholesterol and LDL. No difference in the responses between men and women was found.
Conclusion:
This differential response to diet should be taken into account when planning treatment. Patients with baseline HDL levels higher than 39 mg/dl should probably be considered for early treatment not only by diet but by lipid-lowering-HDL-raising drugs as well.