Universität zu Köln

Olsson, A. G., Angelin, B., Assmann, G., Binder, C. J., Bjoerkhem, I., Cedazo-Minguez, A., Cohen, J., von Eckardstein, A., Farinaro, E., Mueller-Wieland, D., Parhofer, K. G., Parini, P., Rosenson, R. S., Starup-Linde, J., Tikkanen, M. J. and Yvan-Charvet, L. (2017). Can LDL cholesterol be too low? Possible risks of extremely low levels. J. Intern. Med., 281 (6). S. 534 - 554. HOBOKEN: WILEY. ISSN 1365-2796

Full text not available from this repository.

Abstract

Following the continuous accumulation of evidence supporting the beneficial role of reducing low-density lipoprotein cholesterol (LDL-C) levels in the treatment and prevention of atherosclerotic cardiovascular disease and its complications, therapeutic possibilities now exist to lower LDL-C to very low levels, similar to or even lower than those seen in newborns and nonhuman species. In addition to the important task of evaluating potential side effects of such treatments, the question arises whether extremely low LDL-C levels per se may provoke adverse effects in humans. In this review, we summarize information from studies of human cellular and organ physiology, phenotypic characterization of rare genetic diseases of lipid metabolism, and experience from clinical trials. Specifically, we emphasize the importance of the robustness of the regulatory systems that maintain balanced fluxes and levels of cholesterol at both cellular and organismal levels. Even at extremely low LDL-C levels, critical capacities of steroid hormone and bile acid production are preserved, and the presence of a cholesterol blood-brain barrier protects cells in the central nervous system. Apparent relationships sometimes reported between less pronounced low LDL-C levels and disease states such as cancer, depression, infectious disease and others can generally be explained as secondary phenomena. Drug-related side effects including an increased propensity for development of type 2 diabetes occur during statin treatment, whilst further evaluation of more potent LDL-lowering treatments such as PCSK9 inhibitors is needed. Experience from the recently reported and ongoing large event-driven trials are of great interest, and further evaluation including careful analysis of cognitive functions will be important. This is an article from the symposium: Risks and benefits of Extremely Low LDL Cholesterol.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Olsson, A. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Angelin, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Assmann, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Binder, C. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bjoerkhem, I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cedazo-Minguez, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cohen, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED von Eckardstein, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Farinaro, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller-Wieland, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Parhofer, K. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Parini, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenson, R. S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Starup-Linde, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tikkanen, M. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Yvan-Charvet, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-230032
DOI:	10.1111/joim.12614
Journal or Publication Title:	J. Intern. Med.
Volume:	281
Number:	6
Page Range:	S. 534 - 554
Date:	2017
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1365-2796
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LOW-DENSITY-LIPOPROTEIN; CORONARY-ARTERY-DISEASE; SUBTILISIN/KEXIN TYPE 9; HMG-COA REDUCTASE; MONOCLONAL-ANTIBODY; BRAIN CHOLESTEROL; FAMILIAL HYPERCHOLESTEROLEMIA; CARDIOVASCULAR-DISEASE; INTERSTITIAL FLUID; REDUCING LIPIDS Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23003