Research
Print page Print page
Switch language
Bispebjerg Hospital - a part of Copenhagen University Hospital
Published

LDL-cholesterol versus glucose in microvascular and macrovascular disease

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Triglycerides as a shared risk factor between dementia and atherosclerotic cardiovascular disease: a study of 125 727 individuals

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Increased Plasma Ferritin Concentration and Low-Grade Inflammation-A Mendelian Randomization Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Dairy Consumption and Body Mass Index Among Adults: Mendelian Randomization Analysis of 184802 Individuals from 25 Studies

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Frida Emanuelsson
  • Marianne Benn
View graph of relations

BACKGROUND: The causal relationships between increased concentrations of low density lipoprotein (LDL)-cholesterol and glucose and risk of ischemic heart disease are well established. The causal contributions of LDL-cholesterol and glucose to risk of peripheral micro- and macrovascular diseases are less studied, especially in prediabetic stages and in a general population setting.

CONTENT: This review summarizes the current evidence for a causal contribution of LDL-cholesterol and glucose to risk of a spectrum of peripheral micro- and macrovascular diseases and reviews possible underlying disease mechanisms, including differences between vascular compartments, and finally discusses the clinical implications of these findings, including strategies for prevention and treatment.

SUMMARY: Combined lines of evidence suggest that LDL-cholesterol has a causal effect on risk of peripheral arterial disease and chronic kidney disease, both of which represent manifestations of macrovascular disease due to atherosclerosis and accumulation of LDL particles in the arterial wall. In contrast, there is limited evidence for a causal effect on risk of microvascular disease. Glucose has a causal effect on risk of both micro- and macrovascular disease. However, most evidence is derived from studies of individuals with diabetes. Further studies in normoglycemic and prediabetic individuals are warranted. Overall, LDL-cholesterol-lowering reduces risk of macrovascular disease, while evidence for a reduction in risk of microvascular disease is inconsistent. Glucose-lowering has a beneficial effect on risk of microvascular diseases and on risk of chronic kidney disease and estimated glomerular filtration rate (eGFR) in some studies, while results on risk of peripheral arterial disease are conflicting.

Original languageEnglish
JournalClinical Chemistry
Volume67
Issue number1
Pages (from-to)167-182
Number of pages16
ISSN0009-9147
DOIs
Publication statusPublished - 8 Jan 2021

ID: 61720129