Is non HDL cholesterol linked to heart disease outcomes?

[NicoleC1971]

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32519-X/fulltext

This caught my ear on the news today but I cnnot access the full text in The Lancet. It follows a large cohort of Europeans and links higher non HDL cholesterol to higher rates of stroke or heart disease/heart attack.
It then draws an implication that reducing non HDL cholesterol in those over 25 before they exhibit signs of disease would reduce event rates.
Appear to be funded by the EU rather than Pzizer however my choleserol sceptic bias is pushing me not to want to believe that there is a causal relationship between CVD and higher LDL.
Any thoughts open minded forum people ? Is the high LDL a marker or a maker and can this study answer that question ?

 

[xfieldok]

Heard something of this on the news. My first thought was that they could flog their statins to millions more people.

 

[bulkbiker]

More (deliberate?) obfuscation.. do they really not have a breakdown of the Trig and LDL numbers from these people?

Dave Feldman asks that question.. If the high non_HDL number comes about through elevated triglycerides then the effect will likely be diff to high LDL numbers.

As with all things Lancet its behind a paywall but something sounds dodgy...I'm guessing the devil will be in the details.

 

[NicoleC1971]

More (deliberate?) obfuscation.. do they really not have a breakdown of the Trig and LDL numbers from these people?

Dave Feldman asks that question.. If the high non_HDL number comes about through elevated triglycerides then the effect will likely be diff to high LDL numbers.

As with all things Lancet its behind a paywall but something sounds dodgy...I'm guessing the devil will be in the details.

Hoping Harcombe and Kendrick will explain/debunk soon! I agree that dilipaemia (high ldl plus low hdl/high trigs) is different to high LDL with low trig/high hdl and in a Western European population you'd expect the latter condition to be associated with increased incidence of cvd.

 

[bulkbiker]

Hoping Harcombe and Kendrick will explain/debunk soon! I agree that dilipaemia (high ldl plus low hdl/high trigs) is different to high LDL with low trig/high hdl and in a Western European population you'd expect the latter condition to be associated with increased incidence of cvd.

I think that current thinking is the trigs being high is the bad thing (hence fasting before the blood draw is increasingly important to get "accurate" figures). That's why looking at the Trig/HDL ratio is deemed pertinent.

 

[Guzzler]

https://twitter.com/ChrisSmolinski/status/1202192368642002945/photo/1

 

[ianf0ster]

It is one of those stupid Meta Analyses. Of the type where you pre-determine the outcome by carefully choosing the studies that you include versus those you reject.

The clue as to how flawed it is lies in the following extracted text which shows a maximum follow-up time of 43.6yrs where the median follow-up is only 13.5yrs ! Going back 43.6 yrs they would only be measuring HDL and Total Cholesterol.

Extract:
"Of the 524 444 individuals in the 44 cohorts in the Consortium database, we identified 398 846 individuals belonging to 38 cohorts (184 055 [48·7%] women; median age 51·0 years [IQR 40·7–59·7]). 199 415 individuals were included in the derivation cohort (91 786 [48·4%] women) and 199 431 (92 269 [49·1%] women) in the validation cohort. During a maximum follow-up of 43·6 years (median 13·5 years, IQR 7·0–20·1), 54 542 cardiovascular endpoints occurred."

 

[lindisfel]

Next thing they will be insisting babies should be bottle fed so they can add statins to the milk! D.

 

[DavidGrahamJones]

The chart below is old and doesn't separate LDL/HDL, it just shows total cholesterol. It looks like 5.4 is some sort of optimum as cardio vascular events increae in number either side of 5.4. I've added the units I recognise, hence I refer to 5.4 and not 210?mg/dl.