Determinants of Treatment Modification in Hypercholesterolemic Patients

Effects of plant protein and animal protein on lipid profile, body weight and body mass index on patients with hypercholesterolemia: a systematic review and meta-analysis

OBJECTIVE

We conducted a meta-analysis on the effect of plant protein or animal protein on body weight (BW), body mass index (BMI) and blood lipid profiles in patients with hypercholesterolemia.

MATERIALS AND METHODS

We used subject and free words to search PubMed, Embase and Cochrane Library databases. The risk-of-bias evaluation tool was used to assess literature quality. Data merging and statistical analyses were carried out using Review Manager 5.3 and Stata 13.0. All indicators were expressed as the mean difference (MD) and 95% confidence interval (95% CI). The heterogeneity test was conducted according to I² and Q tests. We used Egger's test to evaluate publication bias quantitatively.

RESULTS

This was a meta-analysis of intervention trials. Thirty-two studies (1562 patients) were included. The quality of the included studies was acceptable. Compared with consumption of animal protein, plant protein reduced total cholesterol (TC) (MD = - 0.19 mmol/L, 95% CI - 0.26, - 0.12), triglyceride (MD = - 0.07 mmol/L, 95% CI - 0.13, - 0.02), low-density lipoprotein cholesterol (LDL-C) (MD = - 0.19 mmol/L, 95% CI - 0.26, - 0.13), very low-density lipoprotein cholesterol (MD = - 0.05 mmol/L, 95% CI - 0.09, - 0.01), TC/LDL-C ratio (MD = - 0.17, 95% CI - 0.32, - 0.02) and LDL-C/HDL-C ratio (MD = - 0.20, 95% CI - 0.33, - 0.06) significantly and increased high-density lipoprotein cholesterol (HDL-C) (MD = 0.03 mmol/L, 95% CI 0.01, 0.06) levels, but had no effect on BW (MD = - 0.41 kg, 95% CI - 2.14, 1.33) or BMI (MD = 0.11 kg/m², 95% CI - 0.51, 0.73).

CONCLUSION

Compared with animal protein, consumption of plant protein could improve lipid profile in patients with hypercholesterolemia.

The Correlation between Waist-Hip Ratio and Achieving Therapeutic Lipid Goals in Taiwan

Background

Body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) are all simple anthropometric tools used to categorize obesity status. This study aimed to determine associations between different anthropometric indices and the attainment of therapeutic lipid goals in patients with atherosclerotic cardiovascular disease (CVD) undergoing secondary prevention.

Methods

Between 2010 and 2014, this multi-center study enrolled 5718 patients undergoing secondary prevention for CVD. At study enrollment, total cholesterol, high-density lipoprotein protein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) were recorded. This cross-sectional study analyzed these three anthropometric obesity indices and correlations with achieving therapeutic lipid goals.

Results

Among the 5718 patients, multivariate analysis revealed that those with higher BMI or WC tended not to meet their HDL-C and TG therapeutic goals. However, neither BMI nor WC showed a relationship with achieving the LDL-C target. The patients with an elevated WHR (≥ 0.98 for males and ≥ 0.97 for females) were less likely to achieve all three lipid target values, including LDL-C (p = 0.05), HDL-C (p < 0.001) and TG (p < 0.001).

Conclusions

Among Taiwanese patients undergoing secondary prevention for CVD, the higher the WHR the lower the likelihood of achieving the lipid therapeutic goals.