Key result
Calculated remnant cholesterol levels differed from NMR-measured levels but showed significant correlation in the highest triglyceride quartile at fasting (R = 0.611).
Why the study?
A consensus method for measuring remnant cholesterol has not been established, and standard clinical calculations do not reflect true remnant cholesterol levels.
Observational (n=98)
No
Effect estimate: R = 0.611
p-value: p=0.002
Calculated remnant cholesterol warrants caution versus NMR measures across TG levels; leaves open validation for clinical or research substitution.
BACKGROUND: Remnant cholesterol (RC) can partly explain the residual risk in atherosclerotic cardiovascular disease (ASCVD). A consensus method of measuring RC levels has not been established yet. In clinical practice, RC levels are usually calculated from the standard lipid profile, which are not true RC. Nuclear magnetic resonance (NMR) can measure RC levels directly. This study aimed to characterize RC at fasting and non-fasting states in more details and establish the performance of calculated RC and NMR-measured RC. RC levels calculated from the standard lipid profile or measured by NMR were referred here as RCe or RCn. RESULTS: The RCe and RCn levels were different, but both of them increased after a meal (P < 0.05), especially at 4 h postprandial state. Low correlations were found between RCe and RCn in the 1st, 2nd, and 3rd quartiles of TG, but RCn showed great correlation with RCe in the highest quartile regardless of the fasting or non-fasting state (R = 0.611, 0.536, and 0.535 for 0 h, 2 h, and 4 h, respectively). However, across the 2nd and 3rd quartiles, RCe levels were nearly close to RCn levels. RCe levels tended to overestimate RCn levels in the 1st quartile of TGe levels with median differences of 0.23(- 0.13, 0.63) and underestimate RCn levels with median differences of - 0.23(- 0.33, 0.07) in the highest quartile of TGe levels. CONCLUSIONS: RC calculated from the standard lipid profile as TC minus LDL-C minus HDL-C is different from the NMR-measured RC. According to different TG levels, RC could overestimate or underestimate the actual RC level. Developing a consensus clinical method to measure RC levels is necessary, so that results from different studies and platforms can be more directly compared. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900020873. Registered in 21 January 2019 - Retrospectively registered.
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Chen et al. (2020) conducted an observational in Coronary artery disease (n=98). Calculated remnant cholesterol (RCe) vs. NMR-measured remnant cholesterol (RCn) was evaluated on Correlation between calculated and NMR-measured remnant cholesterol in the highest triglyceride quartile at fasting (R = 0.611, p=0.002). Calculated remnant cholesterol levels differed from NMR-measured levels but showed significant correlation in the highest triglyceride quartile at fasting (R = 0.611).
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