Current opinion in lipidology最新文献

{"title":"Machine learning to predict elevated lipoprotein(a).","authors":"Arya Aminorroaya, Rohan Khera","doi":"10.1097/MOL.0000000000001024","DOIUrl":"10.1097/MOL.0000000000001024","url":null,"abstract":"<p><strong>Purpose of review: </strong>Lipoprotein(a), Lp(a), is a genetically determined, lifelong risk factor for atherosclerotic cardiovascular disease (ASCVD). Despite broad guideline support for universal one-time testing, Lp(a) measurement remains rare in clinical practice. This review summarizes recent advances in machine learning-based strategies that can enhance the efficiency, yield, and equity of Lp(a) screening.</p><p><strong>Recent findings: </strong>To date, three studies have developed and validated machine learning models to identify individuals with elevated Lp(a) using routinely available clinical variables. The ARISE framework, derived from the UK Biobank and validated across multiple US cohorts, reduced the number needed to test by more than 50% while maintaining consistent discrimination across demographic subgroups. Additional studies have confirmed the feasibility of decision-tree and neural network models to improve case finding for elevated Lp(a) in both clinical and population-based settings.</p><p><strong>Summary: </strong>Machine learning-based strategies provide a scalable means of operationalizing universal Lp(a) testing recommendations within health systems. When developed using unbiased data, externally validated, and assessed for fairness and interpretability, these models can support systematic identification of individuals with elevated Lp(a) and integration of Lp(a) measurement into routine cardiovascular risk assessment.</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":" ","pages":"58-64"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonfasting lipid testing: all the good reasons to do it, and potential physician and patient behaviors preventing its implementation.","authors":"Pinhao Xiang, Khashayar Hanjani, Gordon A Francis","doi":"10.1097/MOL.0000000000001028","DOIUrl":"10.1097/MOL.0000000000001028","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this report is to summarize evidence supporting the use of nonfasting lipid testing for cardiovascular risk assessment, the potential reasons nonfasting lipid testing predicts cardiovascular risk better than fasting measurement, and to provide a preliminary survey of the status of adoption of nonfasting lipid testing by individual physicians and patients.</p><p><strong>Recent findings: </strong>There is increased awareness of the importance of remnant lipoprotein cholesterol, which is increased after eating, as a key factor predicting risk for ischemic vascular disease. Nonfasting lipid measurement is now recommended in guidelines and consensus statements worldwide, but has not yet been adopted in many countries. Preliminary evidence suggests physician's practice of requesting a fasting glucose along with a lipid profile is decreasing over time, but still limits implementation of nonfasting lipid testing. Patient's perception of the optimal conditions for lipid testing as well as their preferred time of day to perform the test may also be limiting adoption of nonfasting measurements.</p><p><strong>Summary: </strong>Nonfasting testing is now accepted as the preferred method of lipid measurement for cardiovascular risk prediction and lipid target achievement. Further acceptance of nonfasting lipid testing requires increased awareness by physicians and patients of the rationale for this recommendation.</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":" ","pages":"73-78"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial introduction.","authors":"","doi":"10.1097/MOL.0000000000001037","DOIUrl":"https://doi.org/10.1097/MOL.0000000000001037","url":null,"abstract":"","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":"37 2","pages":"v"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond cellular distress: reframing GDF15 as a lipid-sensitive metabolic signal.","authors":"Dongdong Wang, Logan K Townsend, Gregory R Steinberg","doi":"10.1097/MOL.0000000000001025","DOIUrl":"10.1097/MOL.0000000000001025","url":null,"abstract":"<p><strong>Purpose of review: </strong>Growth differentiation factor-15 (GDF15) is widely described as a hormone that conveys somatic distress to the brain, yet this framework does not explain why GDF15 is elevated in many common metabolic states. Recent work shows that GDF15 rises most consistently when fatty acid availability exceeds mitochondrial and endoplasmic reticulum capacity. This review synthesizes emerging evidence that positions GDF15 as an endocrine sensor of lipid load rather than a general stress signal.</p><p><strong>Recent findings: </strong>Across acute dietary lipid exposure, endogenous lipolysis during fasting, chronic overnutrition, ketogenic feeding, and mitochondrial dysfunction, free fatty acids activate lipid-sensitive transcriptional pathways that induce GDF15 expression in kidney, liver, intestine, and adipose tissue macrophages. Once elevated, GDF15 engages hindbrain glial-cell-derived neurotrophic factor family receptor α-like (GFRAL) signaling to increase sympathetic outflow, promote whole-body fatty acid oxidation, redistribute lipid burden, and improve metabolic flexibility. These effects occur independently of reduced food intake and reflect coordinated actions across liver, adipose tissue, and skeletal muscle.</p><p><strong>Summary: </strong>Viewing GDF15 as a lipid-responsive hormonal signal reshapes our understanding of its physiological role and provides new insight into metabolic adaptations to lipid overload. This pattern suggests that GDF15 is part of a feedback system that attempts to match fatty acid oxidation with supply, analogous to how carbohydrate ingestion stimulates insulin to promote glucose oxidation and suppress hepatic glucose production to restore euglycemia. Within this framework, individual tissues respond in complementary ways to reduce lipid burden and maintain metabolic balance. Understanding this coordinated lipid-responsive network highlights opportunities to target the GDF15 pathway in disorders characterized by impaired fatty acid handling including obesity, type 2 diabetes, cardiovascular disease, cancer cachexia and metabolic dysfunction-associated steatotic liver disease (MASLD).</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":" ","pages":"45-51"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic insights from Greenland: when geography, history and genomics converge.","authors":"Robert A Hegele","doi":"10.1097/MOL.0000000000001038","DOIUrl":"https://doi.org/10.1097/MOL.0000000000001038","url":null,"abstract":"","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":"37 2","pages":"27-29"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of mRNA and protein isoforms in lipoprotein metabolism and how to modulate them.","authors":"Kelly M Martinovich, Jessica M Cale, May T Aung-Htut","doi":"10.1097/MOL.0000000000001026","DOIUrl":"10.1097/MOL.0000000000001026","url":null,"abstract":"<p><strong>Purpose of review: </strong>More than 95% of human genes undergo alternative pre-mRNA processing based on cell type, developmental stages, and environmental stimuli, among other factors. Not all alternatively spliced mRNAs are translated to proteins, and some of the noncoding mRNA isoforms play vital roles in cellular homeostasis. This review summarizes protein coding and noncoding RNA isoforms reported for key genes involved in lipoprotein metabolism, and emerging technologies that can be exploited to specifically induce a desired isoform.</p><p><strong>Recent findings: </strong>As sequencing technologies become more accessible, more variations in gene transcripts are being detected. Publicly available databases collate these as they arise, but not all of them are captured. Additionally, the function, if any, of many of these alternatively spliced transcripts is currently unknown. Novel strategies to investigate specific transcripts are also continuously evolving.</p><p><strong>Summary: </strong>Most human genes are alternatively spliced, generating various mRNAs and protein isoforms. Any cis or trans factors that alter the balance of these isoforms can have deleterious effects. The fundamental knowledge on the role of each isoform in maintaining cellular health is currently lacking. Emerging technologies which allow modulation of natural mRNA splicing can be used to further our understanding of natural isoform expression and function.</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":" ","pages":"52-57"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed foods and CKD: a review of evidence, limitations, and future directions.","authors":"Giulia Barbieri, Cristina Valle-Hita, Essi Hantikainen","doi":"10.1097/MOL.0000000000001020","DOIUrl":"https://doi.org/10.1097/MOL.0000000000001020","url":null,"abstract":"<p><strong>Purpose of review: </strong>To critically examine the emerging evidence linking ultra-processed food (UPF) consumption to chronic kidney disease (CKD), with a particular focus on prevention strategies, biological mechanisms, and implications for dietary guidelines and public health policy.</p><p><strong>Recent findings: </strong>Recent systematic reviews and meta-analyses consistently report a positive association between high UPF consumption and CKD risk. Mechanistic insights suggest roles for food additives, altered nutrient bioavailability, and inflammatory pathways, while omics-based studies offer preliminary biomarker candidates. The KDIGO 2024 guidelines now emphasize dietary interventions, including reduced UPF consumption, as a core component of CKD management.</p><p><strong>Summary: </strong>The findings support limiting UPF consumption as part of CKD prevention strategies. Nonetheless, the evidence base is largely derived from overlapping observational studies, with limited original research published in the considered timeframe. Moreover, the scarcity of recent original studies, methodological inconsistencies in UPF classification and CKD outcome definitions, highlight the urgent need for further research and standardization of approaches. Integrating precision nutrition and validated biomarkers into nephrology could enhance individualized dietary recommendations and public health interventions.</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":"37 1","pages":"7-13"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing dysglycaemia heterogeneity for precision type 2 diabetes prevention.","authors":"Suyi Xie, Jordi Merino","doi":"10.1097/MOL.0000000000001018","DOIUrl":"10.1097/MOL.0000000000001018","url":null,"abstract":"<p><strong>Purpose of review: </strong>Type 2 diabetes (T2D) is a heterogeneous, progressive metabolic disease and a major contributor to cardiovascular disease worldwide. Current prevention strategies, centred on population-level lifestyle recommendations, have had limited success, highlighting the need for more comprehensive approaches that account for interindividual variation in intervention response.</p><p><strong>Recent findings: </strong>Although discrete T2D subtypes using genomics or clinical variables have been proposed for targeted diabetes prevention and care strategies, emerging evidence supports a more dynamic view of heterogeneity as a continuous spectrum of metabolic dysfunction. Continuous glucose monitoring and multiomics profiling have shown promises in detecting early metabolic dysfunction in individuals with normal glycemia.</p><p><strong>Summary: </strong>In this review, we synthesize advances in modelling T2D phenotypic continuum and highlight how emerging technologies, including continuous glucose monitoring and multiomics profiling, can detect early metabolic dysregulation. We also discuss methodological challenges, such as the need for standardized deep phenotyping, robust analytic frameworks, and inclusion of diverse populations to ensure equity in translation. Finally, we outline future directions for translating these insights into scalable, mechanism-informed interventions that address glycaemic progression from subclinical changes to more advanced forms of the disease.</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":" ","pages":"1-6"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current landscape of prospective proteomics research into dementia using blood-based samples.","authors":"Josefine Tvermoes Meineche, Michael Wierer, Majken Karoline Jensen","doi":"10.1097/MOL.0000000000001019","DOIUrl":"10.1097/MOL.0000000000001019","url":null,"abstract":"<p><strong>Purpose of review: </strong>Well conducted, prospective, blood-based biomarker studies on dementia risk are growing, providing valuable insights into disease mechanisms that precede clinical symptoms. These investigations are crucial for advancing our understanding of dementia pathology and identifying early biological changes.</p><p><strong>Recent findings: </strong>Emerging evidence shows that proteins detected in peripheral tissues and the circulatory system can also play a role in neurological diseases. Both neuronal and nonbrain-specific proteins have been associated with dementia prior to symptom onset, highlighting the complex and multisystem nature of disease development. Of the 11 studies included in this review that focused on prospective studies of dementia that applied plasma proteomics, 36 proteins were identified in at least two independent cohorts, suggesting that blood-based proteomics detects consistent protein levels that may be altered years before dementia diagnosis.</p><p><strong>Summary: </strong>Blood-based biomarkers hold promise for early diagnosis, patient stratification, and mechanistic research in dementia. The observed overlap in protein profiles across studies suggests we are beginning to uncover systemic biological differences that contribute to disease progression.</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":" ","pages":"14-26"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving guidelines on lipoprotein(a).","authors":"Michael B Boffa, Marlys L Koschinsky, Robert A Hegele","doi":"10.1097/MOL.0000000000001016","DOIUrl":"https://doi.org/10.1097/MOL.0000000000001016","url":null,"abstract":"<p><strong>Purpose of review: </strong>Elevated plasma lipoprotein(a) [Lp(a)] is a causal and independent risk factor for atherosclerotic cardiovascular disease and an emerging therapeutic target. Over the past 15 years, many medical bodies from around the world have released scientific statements and clinical guidelines regarding Lp(a). This review tracks how recommendations on Lp(a) have evolved over this timeframe.</p><p><strong>Recent findings: </strong>Powerful studies demonstrating the independent association of elevated Lp(a) in large numbers of patients have been published. The data allowed a more precise formulation of risk categories for Lp(a) levels and of models for how a given level of Lp(a) in a moderate-risk to high-risk primary prevention patient might inform management of modifiable risk factors such as LDL cholesterol. Guidelines and statements have increasingly recommended universal screening for elevated Lp(a) and have identified elevated Lp(a) as a risk-enhancing or amplifying factor. However, some gaps and inconsistencies remain.</p><p><strong>Summary: </strong>Ongoing cardiovascular outcomes trials of potent Lp(a)-lowering therapies will inform clinical use of Lp(a) in the future. Presently, consensus is building for measurement of Lp(a) in all adults and for incorporation of Lp(a) levels into clinical decision-making for prevention of cardiovascular disease. However, caution is warranted as the evidence base underlying this consensus has several important missing pieces.</p>","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":"36 6","pages":"300-309"},"PeriodicalIF":4.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}