Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.09.009
Mingjie Yin MD , Feipeng Cui MD , Xiaoyu Xu MS , Yuxin Yang MS , Shuohua Chen MS , Yanan Sun MD , Yanfeng Zhen MD , Hongjia Zhai MS , Shouling Wu MD , Hui Fang MD
BACKGROUND
This study, for the first time, stratified a larger sample size of participants according to the Framingham Risk Score and applied a fine-grained classification of non-high-density lipoprotein cholesterol (non-HDL-C) in 20 mg/dL increments, aiming to further analyze the associations of baseline non-HDL-C and its changes with atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality across different baseline risk populations.
METHODS
The study included 90,072 low-risk individuals, 77,499 primary prevention individuals, and 15,653 secondary prevention individuals. Using time-varying Cox proportional hazards regression models, we assessed the association of non-HDL-C levels with the risks of ASCVD and all-cause mortality across different baseline risk populations. Furthermore, based on non-HDL-C levels in 2 consecutive measurements, we evaluated the association of changes in non-HDL-C with the risks of ASCVD and all-cause mortality.
RESULTS
This study found that non-HDL-C levels below 140 mg/dL in low-risk populations, below 120 mg/dL in primary prevention populations, and below 100 mg/dL in secondary prevention populations were significantly associated with a reduced risk of ASCVD and all-cause mortality. Furthermore, sustained lower non-HDL-C was associated with a 43% reduced risk of ASCVD in low-risk populations and a 27% reduced risk in primary prevention populations, whereas in secondary prevention populations it corresponded to a 25% reduced risk of all-cause mortality.
CONCLUSIONS
As baseline risk levels increase, lower non-HDL-C levels are significantly associated with reduced risks of ASCVD and all-cause mortality. Moreover, sustained lower non-HDL-C levels are associated with a significant decrease in ASCVD and all-cause mortality risks across different baseline risk populations.
{"title":"Association of non-high-density lipoprotein cholesterol with atherosclerotic cardiovascular disease and all-cause mortality in Chinese populations with different baseline risks: A prospective cohort study","authors":"Mingjie Yin MD , Feipeng Cui MD , Xiaoyu Xu MS , Yuxin Yang MS , Shuohua Chen MS , Yanan Sun MD , Yanfeng Zhen MD , Hongjia Zhai MS , Shouling Wu MD , Hui Fang MD","doi":"10.1016/j.jacl.2025.09.009","DOIUrl":"10.1016/j.jacl.2025.09.009","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>This study, for the first time, stratified a larger sample size of participants according to the Framingham Risk Score and applied a fine-grained classification of non-high-density lipoprotein cholesterol (non-HDL-C) in 20 mg/dL increments, aiming to further analyze the associations of baseline non-HDL-C and its changes with atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality across different baseline risk populations.</div></div><div><h3>METHODS</h3><div>The study included 90,072 low-risk individuals, 77,499 primary prevention individuals, and 15,653 secondary prevention individuals. Using time-varying Cox proportional hazards regression models, we assessed the association of non-HDL-C levels with the risks of ASCVD and all-cause mortality across different baseline risk populations. Furthermore, based on non-HDL-C levels in 2 consecutive measurements, we evaluated the association of changes in non-HDL-C with the risks of ASCVD and all-cause mortality.</div></div><div><h3>RESULTS</h3><div>This study found that non-HDL-C levels below 140 mg/dL in low-risk populations, below 120 mg/dL in primary prevention populations, and below 100 mg/dL in secondary prevention populations were significantly associated with a reduced risk of ASCVD and all-cause mortality. Furthermore, sustained lower non-HDL-C was associated with a 43% reduced risk of ASCVD in low-risk populations and a 27% reduced risk in primary prevention populations, whereas in secondary prevention populations it corresponded to a 25% reduced risk of all-cause mortality.</div></div><div><h3>CONCLUSIONS</h3><div>As baseline risk levels increase, lower non-HDL-C levels are significantly associated with reduced risks of ASCVD and all-cause mortality. Moreover, sustained lower non-HDL-C levels are associated with a significant decrease in ASCVD and all-cause mortality risks across different baseline risk populations.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 112-122"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kawasaki disease and familial hypercholesterolemia: Their potential synergistical impact on coronary arterial vascular health and viewpoints","authors":"Daisuke Matsubara MD , Mitsuru Seki MD , Kazuhiko Kotani MD","doi":"10.1016/j.jacl.2025.08.019","DOIUrl":"10.1016/j.jacl.2025.08.019","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 224-225"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.09.006
Macit Kalçık MD
{"title":"Reconsidering uric acid to HDL ratio as a predictor of vascular calcification","authors":"Macit Kalçık MD","doi":"10.1016/j.jacl.2025.09.006","DOIUrl":"10.1016/j.jacl.2025.09.006","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 220-221"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.10.062
Manuel Castro Cabezas PhD, MD , Mattea Orsini PhD , Lale Tokgözoğlu MD , Nikolaus Marx MD , José Tuñón MD , Michal Vrablík MD, PhD , Hagai Tavori PhD , Deepak L. Bhatt MD, MPH, MBA , Pasquale Perrone-Filardi MD
BACKGROUND
This post hoc analysis aimed to determine the efficacy and safety of alirocumab vs placebo or ezetimibe in patients with established atherosclerotic cardiovascular disease (ASCVD), but without previous acute coronary syndrome (ACS; myocardial infarction/unstable angina) or stroke.
METHODS
Data were pooled from 12 phase 3 ODYSSEY studies with alirocumab. Adults with established ASCVD, without prior ischemic event (ACS or stroke) were included. Data were analyzed in 3 pools: pool 1 (alirocumab 75/150 mg once every 2 weeks [Q2W] vs ezetimibe), and pools 2 and 3 (alirocumab 75/150 mg Q2W or 150 mg Q2W, respectively, vs placebo). Primary objectives were percentage change in calculated low-density lipoprotein cholesterol (LDL-C) levels from baseline to week 24 and percentage of patients with treatment-emergent adverse events (TEAEs).
RESULTS
Overall, 963 patients were identified with ASCVD (without previous ACS or stroke). At baseline, mean calculated LDL-C levels ranged from 112.0 to 123.5 mg/dL across all pools. Alirocumab resulted in a significantly greater reduction in LDL-C levels at week 24 (pool 1: 51.5% reduction; pool 2: 47.8% reduction; pool 3: 60.9% reduction; P < .0001 for all), vs ezetimibe and placebo across all pools. The percentage of patients who experienced TEAEs was similar in the alirocumab and comparator arms (pool 1: 74.8% for alirocumab and 76.5% for ezetimibe; pools 2 and 3: 81.4% for alirocumab and 78.9% for placebo).
CONCLUSION
Among patients with ASCVD without previous ACS or stroke, alirocumab significantly reduced calculated LDL-C levels vs controls and was well tolerated.
{"title":"Efficacy and safety of alirocumab in patients with established atherosclerotic vascular disease before the first cardiovascular event: Pooled analysis of phase 3 ODYSSEY studies","authors":"Manuel Castro Cabezas PhD, MD , Mattea Orsini PhD , Lale Tokgözoğlu MD , Nikolaus Marx MD , José Tuñón MD , Michal Vrablík MD, PhD , Hagai Tavori PhD , Deepak L. Bhatt MD, MPH, MBA , Pasquale Perrone-Filardi MD","doi":"10.1016/j.jacl.2025.10.062","DOIUrl":"10.1016/j.jacl.2025.10.062","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>This post hoc analysis aimed to determine the efficacy and safety of alirocumab vs placebo or ezetimibe in patients with established atherosclerotic cardiovascular disease (ASCVD), but without previous acute coronary syndrome (ACS; myocardial infarction/unstable angina) or stroke.</div></div><div><h3>METHODS</h3><div>Data were pooled from 12 phase 3 ODYSSEY studies with alirocumab. Adults with established ASCVD, without prior ischemic event (ACS or stroke) were included. Data were analyzed in 3 pools: pool 1 (alirocumab 75/150 mg once every 2 weeks [Q2W] vs ezetimibe), and pools 2 and 3 (alirocumab 75/150 mg Q2W or 150 mg Q2W, respectively, vs placebo). Primary objectives were percentage change in calculated low-density lipoprotein cholesterol (LDL-C) levels from baseline to week 24 and percentage of patients with treatment-emergent adverse events (TEAEs).</div></div><div><h3>RESULTS</h3><div>Overall, 963 patients were identified with ASCVD (without previous ACS or stroke). At baseline, mean calculated LDL-C levels ranged from 112.0 to 123.5 mg/dL across all pools. Alirocumab resulted in a significantly greater reduction in LDL-C levels at week 24 (pool 1: 51.5% reduction; pool 2: 47.8% reduction; pool 3: 60.9% reduction; <em>P</em> < .0001 for all), vs ezetimibe and placebo across all pools. The percentage of patients who experienced TEAEs was similar in the alirocumab and comparator arms (pool 1: 74.8% for alirocumab and 76.5% for ezetimibe; pools 2 and 3: 81.4% for alirocumab and 78.9% for placebo).</div></div><div><h3>CONCLUSION</h3><div>Among patients with ASCVD without previous ACS or stroke, alirocumab significantly reduced calculated LDL-C levels vs controls and was well tolerated.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 44-55"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.09.015
Vinh Q.T. Ho , Nghi Bao Tran , Nhan Nguyen MD , David Downes , Giang Son Arrighini , Mrunalini Dandamudi MD , Rhanderson Cardoso MD, FACC , Juliana Giorgi MD
BACKGROUND
Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are effective lipid-lowering therapies that reduce cardiovascular risk in hypercholesterolemia. Recent advances include oral PCSK9i, which may offer advantages over injectables.
PURPOSE
We aimed to assess the efficacy and safety of oral PCSK9i in reducing low-density lipoprotein cholesterol (LDL-C) levels, triglycerides, apolipoprotein B, and lipoprotein(a) compared with placebo on the background of standard medical therapy (SMT) in hypercholesterolemic populations.
METHODS
This systematic review and meta-analysis included randomized controlled trials of oral PCSK9i vs placebo in patients with hypercholesterolemia at varying levels of atherosclerotic cardiovascular disease risk, and on stable lipid-lowering therapies. PubMed, Embase, and Cochrane were searched. Mean difference (MD) and odds ratio (OR) with 95% CI were pooled across trials for continuous and binary endpoints, respectively.
RESULTS
We included 3 randomized controlled trials, with 1020 patients, of whom 804 (78.9%) received oral PCSK9i. The average patient age was 61.6 years, and 55.2% were male. Mean percent changes from baseline of LDL-C levels (MD = −47.83%; 95% CI: −54.91, −40.74; P < .00001), triglycerides (MD = −11.65%; 95% CI: −15.44, −7.87; P < .0001), apolipoprotein B (MD = −38.71%; 95% CI: −45.48, −31.93; P < .00001), and lipoprotein(a) (MD = −19.80; 95% CI: −25.60, −14; P < .0001) were significantly reduced in patients treated with oral PCSK9i compared with placebo on the background of SMT. Serious adverse events were not increased with oral PCSK9i (OR = 0.74; 95% CI: 0.34, 1.62; P = .45).
CONCLUSION
Oral PCSK9i significantly reduced LDL-C, triglycerides, apolipoprotein B, and lipoprotein(a) without increasing serious adverse events. They show promise as effective, well-tolerated, and accessible lipid-lowering therapies for cardiovascular risk management.
{"title":"Oral PCSK9 inhibitors as an emerging frontier in lipid management: A meta-analysis","authors":"Vinh Q.T. Ho , Nghi Bao Tran , Nhan Nguyen MD , David Downes , Giang Son Arrighini , Mrunalini Dandamudi MD , Rhanderson Cardoso MD, FACC , Juliana Giorgi MD","doi":"10.1016/j.jacl.2025.09.015","DOIUrl":"10.1016/j.jacl.2025.09.015","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are effective lipid-lowering therapies that reduce cardiovascular risk in hypercholesterolemia. Recent advances include oral PCSK9i, which may offer advantages over injectables.</div></div><div><h3>PURPOSE</h3><div>We aimed to assess the efficacy and safety of oral PCSK9i in reducing low-density lipoprotein cholesterol (LDL-C) levels, triglycerides, apolipoprotein B, and lipoprotein(a) compared with placebo on the background of standard medical therapy (SMT) in hypercholesterolemic populations.</div></div><div><h3>METHODS</h3><div>This systematic review and meta-analysis included randomized controlled trials of oral PCSK9i vs placebo in patients with hypercholesterolemia at varying levels of atherosclerotic cardiovascular disease risk, and on stable lipid-lowering therapies. PubMed, Embase, and Cochrane were searched. Mean difference (MD) and odds ratio (OR) with 95% CI were pooled across trials for continuous and binary endpoints, respectively.</div></div><div><h3>RESULTS</h3><div>We included 3 randomized controlled trials, with 1020 patients, of whom 804 (78.9%) received oral PCSK9i. The average patient age was 61.6 years, and 55.2% were male. Mean percent changes from baseline of LDL-C levels (MD = −47.83%; 95% CI: −54.91, −40.74; <em>P</em> < .00001), triglycerides (MD = −11.65%; 95% CI: −15.44, −7.87; <em>P</em> < .0001), apolipoprotein B (MD = −38.71%; 95% CI: −45.48, −31.93; <em>P</em> < .00001), and lipoprotein(a) (MD = −19.80; 95% CI: −25.60, −14; <em>P</em> < .0001) were significantly reduced in patients treated with oral PCSK9i compared with placebo on the background of SMT. Serious adverse events were not increased with oral PCSK9i (OR = 0.74; 95% CI: 0.34, 1.62; <em>P</em> = .45).</div></div><div><h3>CONCLUSION</h3><div>Oral PCSK9i significantly reduced LDL-C, triglycerides, apolipoprotein B, and lipoprotein(a) without increasing serious adverse events. They show promise as effective, well-tolerated, and accessible lipid-lowering therapies for cardiovascular risk management.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 31-43"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.11.010
Andrea Faggiano MD , Alessandro Maloberti MD, PhD , Marco Ambrosetti MD , Francesco Giallauria MD, PhD , Gianfrancesco Mureddu MD , Elio Venturini MD , Matteo Ruzzolini MD , Francesco Maranta MD , Marco Vatri MD , Lana Zadre BSc , Stefano Carugo MD , Massimiliano Ruscica BSc, PhD , Francesco Fattirolli MD, PhD , Pompilio Faggiano MD
BACKGROUND
Despite the intensive approach recommended by the 2019 European Society of Cardiology/European Atherosclerosis Society guidelines, low-density lipoprotein cholesterol (LDL-C) target attainment (<55 mg/dL or <40 mg/dL for patients with recurrent events within 2 years) in atherosclerotic cardiovascular disease (ASCVD) patients remains low, with clinical inertia and lack of lipid-lowering therapy (LLT) optimization as major barriers.
METHODS
We analyzed real-world LLT patterns in the ITACARE-P registry, enrolling 1909 Italian ASCVD patients referred to cardiovascular rehabilitation or secondary prevention programs. Baseline LLT and LDL-C levels were recorded. For patients not at LDL-C target, a Monte Carlo simulation with 10,000 iterations was performed using efficacy data from pivotal randomized trials to model sequential addition of ezetimibe, bempedoic acid, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and inclisiran to estimate potential LDL-C goal attainment rates.
RESULTS
Among 1909 patients (mean age 66 ± 10 years, 26% women), 41.3% were at LDL-C target. Most (90%) were on statins, predominantly at moderate or high intensity, whereas only 3% were untreated. Among patients not at LDL-C target, the Monte Carlo simulation predicted a stepwise increase in goal attainment from 43% to 50% after ezetimibe, 63% after bempedoic acid, 95% after PCSK9 inhibitors, and 90% after inclisiran. A baseline percentage distance of 23.66% from the LDL-C target was identified as a threshold beyond which the addition of bempedoic acid alone was rarely sufficient (<5% success), supporting direct escalation to injectables.
CONCLUSION
A structured, guideline-based intensification strategy in secondary prevention could close the treatment gap and enable near-universal LDL-C target achievement, supporting early implementation of combination therapy.
{"title":"From clinical inertia to therapeutic optimization in patients with atherosclerotic cardiovascular disease: A Monte Carlo simulation within the ITACARE-P registry","authors":"Andrea Faggiano MD , Alessandro Maloberti MD, PhD , Marco Ambrosetti MD , Francesco Giallauria MD, PhD , Gianfrancesco Mureddu MD , Elio Venturini MD , Matteo Ruzzolini MD , Francesco Maranta MD , Marco Vatri MD , Lana Zadre BSc , Stefano Carugo MD , Massimiliano Ruscica BSc, PhD , Francesco Fattirolli MD, PhD , Pompilio Faggiano MD","doi":"10.1016/j.jacl.2025.11.010","DOIUrl":"10.1016/j.jacl.2025.11.010","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Despite the intensive approach recommended by the 2019 European Society of Cardiology/European Atherosclerosis Society guidelines, low-density lipoprotein cholesterol (LDL-C) target attainment (<55 mg/dL or <40 mg/dL for patients with recurrent events within 2 years) in atherosclerotic cardiovascular disease (ASCVD) patients remains low, with clinical inertia and lack of lipid-lowering therapy (LLT) optimization as major barriers.</div></div><div><h3>METHODS</h3><div>We analyzed real-world LLT patterns in the ITACARE-P registry, enrolling 1909 Italian ASCVD patients referred to cardiovascular rehabilitation or secondary prevention programs. Baseline LLT and LDL-C levels were recorded. For patients not at LDL-C target, a Monte Carlo simulation with 10,000 iterations was performed using efficacy data from pivotal randomized trials to model sequential addition of ezetimibe, bempedoic acid, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and inclisiran to estimate potential LDL-C goal attainment rates.</div></div><div><h3>RESULTS</h3><div>Among 1909 patients (mean age 66 ± 10 years, 26% women), 41.3% were at LDL-C target. Most (90%) were on statins, predominantly at moderate or high intensity, whereas only 3% were untreated. Among patients not at LDL-C target, the Monte Carlo simulation predicted a stepwise increase in goal attainment from 43% to 50% after ezetimibe, 63% after bempedoic acid, 95% after PCSK9 inhibitors, and 90% after inclisiran. A baseline percentage distance of 23.66% from the LDL-C target was identified as a threshold beyond which the addition of bempedoic acid alone was rarely sufficient (<5% success), supporting direct escalation to injectables.</div></div><div><h3>CONCLUSION</h3><div>A structured, guideline-based intensification strategy in secondary prevention could close the treatment gap and enable near-universal LDL-C target achievement, supporting early implementation of combination therapy.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 21-30"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.10.055
Junliang Shen MM, Xiuqin Que MM, Jianjun Li MM, Ping Fu MM, Yi Lu MB, Qiping Zhu MB
BACKGROUND
Sleep disorders affect a large share of adults, and excess body fat is a recognized risk factor. Relative fat mass (RFM) is a recently developed anthropometric index intended to estimate body fat percentage more closely than body mass index (BMI). This study examined the association between RFM and physician-diagnosed sleep disorders in a nationally representative sample of U.S. adults.
METHODS
We analyzed data on 21,115 participants (≥20 years) from the National Health and Nutrition Examination Survey 2007 to 2014. RFM was calculated from measured waist circumference and height with adjustment for gender. Logistic regression assessed associations between RFM (continuous and quartile) and sleep disorder, adjusting sequentially for demographic, socioeconomic, lifestyle, and clinical factors. Restricted cubic splines and segmented models explored nonlinear trends, and stratified analyses evaluated consistency across subgroups.
RESULTS
Participants with sleep disorders had markedly higher mean RFM than those without. After full adjustment, higher RFM remained positively linked to sleep disorder, with risk rising steeply up to an inflection around RFM = 39.3 and then attenuating. The pattern was consistent across age, gender, smoking, alcohol use, and comorbidity strata, indicating a broad, dose-dependent relationship between adiposity and impaired sleep.
CONCLUSIONS
This cross-sectional analysis suggests a strong association between elevated RFM and a greater prevalence of sleep disorders among U.S. adults. These findings highlight adiposity as a modifiable contributor to poor sleep health and support integrating body fat reduction into preventive and therapeutic strategies. Prospective and interventional research is needed to clarify causality, mechanisms, and the potential sleep benefits of targeted fat-loss interventions.
{"title":"Association between relative fat mass and sleep disorder among US adults: Results from NHANES 2007 to 2014","authors":"Junliang Shen MM, Xiuqin Que MM, Jianjun Li MM, Ping Fu MM, Yi Lu MB, Qiping Zhu MB","doi":"10.1016/j.jacl.2025.10.055","DOIUrl":"10.1016/j.jacl.2025.10.055","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Sleep disorders affect a large share of adults, and excess body fat is a recognized risk factor. Relative fat mass (RFM) is a recently developed anthropometric index intended to estimate body fat percentage more closely than body mass index (BMI). This study examined the association between RFM and physician-diagnosed sleep disorders in a nationally representative sample of U.S. adults.</div></div><div><h3>METHODS</h3><div>We analyzed data on 21,115 participants (≥20 years) from the National Health and Nutrition Examination Survey 2007 to 2014. RFM was calculated from measured waist circumference and height with adjustment for gender. Logistic regression assessed associations between RFM (continuous and quartile) and sleep disorder, adjusting sequentially for demographic, socioeconomic, lifestyle, and clinical factors. Restricted cubic splines and segmented models explored nonlinear trends, and stratified analyses evaluated consistency across subgroups.</div></div><div><h3>RESULTS</h3><div>Participants with sleep disorders had markedly higher mean RFM than those without. After full adjustment, higher RFM remained positively linked to sleep disorder, with risk rising steeply up to an inflection around RFM = 39.3 and then attenuating. The pattern was consistent across age, gender, smoking, alcohol use, and comorbidity strata, indicating a broad, dose-dependent relationship between adiposity and impaired sleep.</div></div><div><h3>CONCLUSIONS</h3><div>This cross-sectional analysis suggests a strong association between elevated RFM and a greater prevalence of sleep disorders among U.S. adults. These findings highlight adiposity as a modifiable contributor to poor sleep health and support integrating body fat reduction into preventive and therapeutic strategies. Prospective and interventional research is needed to clarify causality, mechanisms, and the potential sleep benefits of targeted fat-loss interventions.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 145-153"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.11.002
Belén Davico BSc , Ezequiel Lozano Chiappe PhD , Laura Gaete MD , Amanda Yánez Sanchez BSc , Walter F. Tetzlaff PhD , Valeria Martinez PhD , Verónica De Giusti PhD , Augusto Bava BSc , Cynthia Rodriguez BSc , Ivana Masci BSc , Melisa Kurtz PhD , Deborah Tasat PhD , María G. Ballerini PhD , Leonardo Gómez Rosso PhD , Fernando Brites PhD , Maximiliano Martin PhD
BACKGROUND
Childhood obesity is associated with alterations in lipoprotein metabolism and increased oxidative stress, assessed by lipid peroxidation products, reactive oxygen species (ROS) and nitric oxide (NO) levels, oxidized/reduced glutathione (GSH/GSSG) ratio, and the activities of superoxide dismutase (SOD) and catalase. High-density lipoproteins (HDL) play an antioxidant role, conditioned by cholesteryl ester transfer protein (CETP), paraoxonase (PON) 1, lecithin:cholesterol acyltransferase (LCAT), lipoprotein-associated phospholipase A2 (Lp-PLA2), and apolipoprotein (apo) A-I.
OBJECTIVE
This study aims to evaluate HDL antioxidant capacity in children and adolescents with obesity and the status of its conditioning factors.
METHODS
Thirty children and adolescents, 15 with obesity and 15 normal-weight controls were studied in a cross-sectional observational study. Lipid profile and high-sensitivity C-reactive protein were assessed using standardized methods. Lipid peroxidation products, ROS, NO, GSH and GSSG levels, and catalase, SOD, CETP, LCAT, PON 1 (PON and arylesterase [ARE]) and Lp-PLA2 activities were assessed by developed techniques. Total HDL antioxidant activity and its intrinsic oxidation were evaluated.
RESULTS
Children with obesity showed lower HDL cholesterol and apo A-I levels (P < .01), reduced CETP (P < .05), ARE (Lp-PLA2 < .05), LCAT (P < .05), and HDL-associated Lp-PLA2 (P < .01) activities, increased HDL intrinsic oxidation (P < 0.01) and reduced total HDL antioxidant activity (P < .05). Patients revealed increased oxidative stress: higher ROS (P < .001) and NO levels (P < .05), lower GSH/GSSG ratio (P < .01) and catalase activity (P < .001).
CONCLUSIONS
Children and adolescents with obesity exhibited reduced HDL antioxidant activity, alterations in its conditioning factors, intrinsic oxidative modification of HDL particles, and increased oxidative stress. These alterations may affect long-term cardiovascular risk in children and adolescents with obesity.
{"title":"Disruption of HDL antioxidant properties in children and adolescents with obesity","authors":"Belén Davico BSc , Ezequiel Lozano Chiappe PhD , Laura Gaete MD , Amanda Yánez Sanchez BSc , Walter F. Tetzlaff PhD , Valeria Martinez PhD , Verónica De Giusti PhD , Augusto Bava BSc , Cynthia Rodriguez BSc , Ivana Masci BSc , Melisa Kurtz PhD , Deborah Tasat PhD , María G. Ballerini PhD , Leonardo Gómez Rosso PhD , Fernando Brites PhD , Maximiliano Martin PhD","doi":"10.1016/j.jacl.2025.11.002","DOIUrl":"10.1016/j.jacl.2025.11.002","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Childhood obesity is associated with alterations in lipoprotein metabolism and increased oxidative stress, assessed by lipid peroxidation products, reactive oxygen species (ROS) and nitric oxide (NO) levels, oxidized/reduced glutathione (GSH/GSSG) ratio, and the activities of superoxide dismutase (SOD) and catalase. High-density lipoproteins (HDL) play an antioxidant role, conditioned by cholesteryl ester transfer protein (CETP), paraoxonase (PON) 1, lecithin:cholesterol acyltransferase (LCAT), lipoprotein-associated phospholipase A<sub>2</sub> (Lp-PLA<sub>2</sub>), and apolipoprotein (apo) A-I.</div></div><div><h3>OBJECTIVE</h3><div>This study aims to evaluate HDL antioxidant capacity in children and adolescents with obesity and the status of its conditioning factors.</div></div><div><h3>METHODS</h3><div>Thirty children and adolescents, 15 with obesity and 15 normal-weight controls were studied in a cross-sectional observational study. Lipid profile and high-sensitivity C-reactive protein were assessed using standardized methods. Lipid peroxidation products, ROS, NO, GSH and GSSG levels, and catalase, SOD, CETP, LCAT, PON 1 (PON and arylesterase [ARE]) and Lp-PLA<sub>2</sub> activities were assessed by developed techniques. Total HDL antioxidant activity and its intrinsic oxidation were evaluated.</div></div><div><h3>RESULTS</h3><div>Children with obesity showed lower HDL cholesterol and apo A-I levels (<em>P</em> < .01), reduced CETP (<em>P</em> < .05), ARE (Lp-PLA<sub>2</sub> < .05), LCAT (<em>P</em> < .05), and HDL-associated Lp-PLA<sub>2</sub> (<em>P</em> < .01) activities, increased HDL intrinsic oxidation (<em>P</em> < 0.01) and reduced total HDL antioxidant activity (<em>P</em> < .05). Patients revealed increased oxidative stress: higher ROS (<em>P</em> < .001) and NO levels (<em>P</em> < .05), lower GSH/GSSG ratio (<em>P</em> < .01) and catalase activity (<em>P</em> < .001).</div></div><div><h3>CONCLUSIONS</h3><div>Children and adolescents with obesity exhibited reduced HDL antioxidant activity, alterations in its conditioning factors, intrinsic oxidative modification of HDL particles, and increased oxidative stress. These alterations may affect long-term cardiovascular risk in children and adolescents with obesity.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 154-166"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jacl.2025.10.064
Lishan Bai BS, Yuanming Li BS
{"title":"“Reconsidering uric acid to HDL ratio as a predictor of vascular calcification” author response to letter to the editor","authors":"Lishan Bai BS, Yuanming Li BS","doi":"10.1016/j.jacl.2025.10.064","DOIUrl":"10.1016/j.jacl.2025.10.064","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 1","pages":"Pages 222-223"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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