Key result
Remnant cholesterol encompasses the cholesterol carried by all triglyceride-rich lipoproteins and can be measured directly or approximated by dividing total serum triglycerides by 5 (mg/dL).
Design
Review
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Clarifies remnant lipoprotein definitions; leaves open their role in ASCVD risk assessment pending validation.
Lipoproteins and definitions of ‘remnants. The serum cholesterol and triglycerides are transported in lipoproteins of different size and composition. Triglycerides of exogenous origin are carried in apoB-48-containing chylomicrons, while the triglycerides synthesized in the liver are mainly released in VLDL particles. Chylomicrons and VLDL undergo hydrolysis by lipoprotein lipase, and thus reducing the triglyceride content, and forming chylomicron and VLDL remnants, respectively. Both are also referred to as ‘triglyceride-rich lipoprotein (TRL) remnants’, and their cholesterol content is denoted ‘remnant lipoprotein particle cholesterol’ (RLP-C). Another definition of remnants used by the group of Nordestgaard, the ‘remnant cholesterol’ (RC), additionally encompasses the cholesterol content of VLDL, chylomicrons, and IDL, and therefore the cholesterol carried by all TRL. This ‘remnant cholesterol’ can either be measured (‘RC-direct’) or approximated by dividing total serum triglycerides in mg/dL by 5 or in mmol/L by 2.2 (‘RC-calculated’).
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Stürzebecher et al. (2023) reported a review. Remnant cholesterol encompasses the cholesterol carried by all triglyceride-rich lipoproteins and can be measured directly or approximated by dividing total serum triglycerides by 5 (mg/dL).
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