Journal of Lipid and Atherosclerosis最新文献

{"title":"Cardiovascular Disease Incidence and Lipid-Lowering Medication Use in Korean Adults With Dyslipidemia: A Nationwide Population-Based Retrospective Cohort Study From 2010 to 2019.","authors":"Osung Kwon, Jong-Chan Youn, Sang Yeub Lee, Bokyoung Kim, Kyungdo Han, Jihyun Ahn","doi":"10.12997/jla.2026.15.3.471","DOIUrl":"10.12997/jla.2026.15.3.471","url":null,"abstract":"<p><strong>Objective: </strong>Dyslipidemia is a major modifiable risk factor for cardiovascular disease (CVD). We investigated temporal trends in CVD incidence and lipid-lowering therapy in individuals with dyslipidemia.</p><p><strong>Methods: </strong>We conducted a nationwide population-based retrospective cohort study using the Korean National Health Insurance Service-National Sample Cohort (2010-2019) to assess age- and sex-standardized incidence rates of overall CVD, including ischemic heart disease, ischemic stroke, and heart failure, among adults aged ≥20 years. Dyslipidemia was identified based on the International Classification of Diseases, 10th Revision code E78 and/or the use of lipid-lowering agents. Prescription patterns for statins categorized by intensity, fibrates, and ezetimibe were analyzed.</p><p><strong>Results: </strong>The overall age-standardized incidence of CVD among individuals with dyslipidemia declined markedly from 36.9 to 20.9 per 1,000 person-years. This downward trend was largely driven by substantial reductions in ischemic heart disease (from 29.2 to 15.0; a 48.6% decrease) and ischemic stroke (from 12.5 to 6.6; a 47.2% decrease). Meanwhile, the incidence of heart failure increased slightly, rising from 6.4 to 8.5 per 1,000 person-years. Statin use reached 95.3% by 2019 among dyslipidemic patients, but high-intensity statin use remained limited (4.7% of statin users). Ezetimibe use increased approximately four-fold, while fibrate use remained relatively unchanged.</p><p><strong>Conclusion: </strong>CVD incidence declined substantially in the dyslipidemic population over the past decade. During the study period, lipid-lowering treatment patterns were characterized by widespread statin use and a substantial increase in ezetimibe prescriptions, although the use of high-intensity statins remained persistently low. These findings highlight opportunities to further optimize lipid-lowering strategies in high-risk populations.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 3","pages":"471-483"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Remnant Cholesterol Levels With Kidney Replacement Therapy Initiation in Korean Patients With Chronic Kidney Disease: A Prospective Cohort Study.","authors":"Minsang Kim, Semin Cho, Jayoun Kim, Geonjoo Kang, Eunjeong Kang, Sue Kyung Park, Seung Hyeok Han, Yaeni Kim, Soo Wan Kim, Kook-Hwan Oh","doi":"10.12997/jla.2026.15.3.484","DOIUrl":"10.12997/jla.2026.15.3.484","url":null,"abstract":"<p><strong>Objective: </strong>Although remnant cholesterol (RC) is an established risk factor for atherosclerotic cardiovascular diseases, its role in chronic kidney disease (CKD) progression remains unclear. We aimed to investigate the association between RC levels and adverse kidney outcomes in patients with CKD.</p><p><strong>Methods: </strong>We analyzed data from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease, a prospective multicenter cohort study. Patients were categorized into quartiles according to their RC levels, calculated as total cholesterol level minus low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels. The primary outcome was the initiation of kidney replacement therapy (KRT).</p><p><strong>Results: </strong>Among 2,087 patients, 31% underwent KRT during a median follow-up of 8.0 years. Higher RC levels were significantly associated with an increased risk of KRT initiation. Compared with the lowest quartile (Q1), the adjusted hazard ratios (aHRs) for KRT initiation were 1.22 (95% confidence interval [CI], 0.95-1.57) for Q2, 1.32 (95% CI, 1.03-1.70) for Q3, and 1.42 (95% CI, 1.07-1.89) for Q4. A 1-standard deviation increase in RC level was associated with 16% higher risk of KRT initiation (aHR, 1.16; 95% CI, 1.05-1.29). This association remained significant, particularly among patients with diabetes and those with early-stage CKD.</p><p><strong>Conclusion: </strong>Elevated RC levels were independently associated with a higher risk of KRT initiation in CKD patients. These findings suggest that RC is a risk factor for CKD progression and underscore the need for further studies to evaluate the potential benefits of RC-targeted lipid-modifying strategies for preserving kidney function.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 3","pages":"484-497"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Smoking Status and Urinary Cotinine Levels With Lipoprotein(a) in Korean Adults.","authors":"Byung Jin Kim, Youngwoo Jang, Jeong-Gyu Kang","doi":"10.12997/jla.2026.15.2.317","DOIUrl":"10.12997/jla.2026.15.2.317","url":null,"abstract":"<p><strong>Objective: </strong>Lipoprotein(a) (LP(a)) is a genetically regulated lipoprotein associated with cardiovascular disease. Although primarily heritable, the impact of modifiable factors such as smoking on LP(a) remains unclear, particularly when assessed using objective biomarkers like urinary cotinine. This study examined the association between smoking status-based on both self-reported and cotinine-verified measures-and LP(a) concentrations in Korean adults.</p><p><strong>Methods: </strong>We analyzed 146,129 participants (mean age, 37.1 years; 59.2% men) from the Kangbuk Samsung Health Study from 2011 to 2013. Smoking was defined by self-report (never, former, current) and urinary cotinine ≥50 ng/mL. Serum LP(a) was measured using an immunoturbidimetric assay, with high LP(a) defined as ≥50 mg/dL. Multivariable regression analyses adjusted for relevant covariates.</p><p><strong>Results: </strong>The median LP(a) level was 23.3 mg/dL (interquartile range, 13.4-39.2), and 16.0% of participants had high LP(a). Both cotinine-verified and self-reported current smokers had significantly lower LP(a) levels compared with non-smokers (<i>p</i><0.001). Urinary cotinine levels were inversely associated with continuous LP(a) concentrations (β=-0.147, <i>p</i><0.001), demonstrating an inverse dose-dependent trend. Among categorical smoking variables, only total smoking duration showed a significant inverse association (<i>p</i>=0.029), while daily amount (<i>p</i>=0.089) and pack-years (<i>p</i>=0.068) demonstrated non-significant trends. No sex interaction was observed.</p><p><strong>Conclusion: </strong>Both self-reported and cotinine-verified smoking status were inversely associated with serum LP(a) levels. Although causality cannot be established due to the cross-sectional design, these findings suggest a possible interaction between tobacco exposure and genetically determined LP(a) concentrations, highlighting the need for future longitudinal investigations.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"317-327"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular and Genetic Aspects of Lipid Metabolism Disorders and Potential Targets for Gene Therapy.","authors":"Elvira R Akhmetzyanova, Anna V Timofeeva, Danil R Gallyamov, Albert A Rizvanov, Yana O Mukhamedshina","doi":"10.12997/jla.2026.15.2.195","DOIUrl":"10.12997/jla.2026.15.2.195","url":null,"abstract":"<p><p>Diseases associated with impaired lipid metabolism are major contributors to the rising global burden of cardiovascular disease. Over the past several decades, cardiovascular diseases have consistently remained the leading cause of mortality and disability worldwide. Many of these conditions are linked to mutations in genes encoding proteins that regulate lipid metabolism. At the same time, secondary lipid metabolism disorders can arise from unhealthy lifestyles and harmful habits that initiate pathological processes. Understanding the mechanisms underlying these processes is essential for developing new therapeutic strategies for both primary and secondary lipid metabolism disorders. The rapid advancement of innovative gene therapy approaches has introduced novel strategies for treating a wide range of diseases, and further progress in these technologies is expected to broaden the spectrum of target conditions. This review will examine potential therapeutic targets for lipid metabolism disorders and summarize existing gene therapy approaches.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"195-215"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Risk Reduction With Tirzepatide, a Dual GIP/GLP-1 Agonist, in Patients With Type 2 Diabetes Mellitus.","authors":"Sakiko Terui, Taichi Minami, Keita Nakamura, Yasuo Terauchi","doi":"10.12997/jla.2026.15.2.249","DOIUrl":"10.12997/jla.2026.15.2.249","url":null,"abstract":"<p><p>Tirzepatide is the first dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GLP-1) receptor agonist to be approved for the treatment of diabetes mellitus. The SURPASS trials investigated the efficacy and safety of tirzepatide, both as monotherapy and as add-on therapy, in comparison with placebo, basal insulin, semaglutide, or dulaglutide in patients with type 2 diabetes. Tirzepatide at doses of 5 mg, 10 mg, or 15 mg produced significant reductions in hemoglobin A1c levels (-1.87% to -2.58%) and body weight (-6.2 to -12.9 kg) in patients with type 2 diabetes, without increasing the risk of serious hypoglycemia. Tirzepatide also improved lipid parameters and lowered blood pressure. Most of the observed adverse events were mild gastrointestinal symptoms, and the occurrence rate of these events was comparable to that associated with GLP-1 receptor agonists such as semaglutide (1 mg) or dulaglutide (0.75 mg). In this review, we summarize the pharmacodynamics and pharmacokinetics of tirzepatide, review the findings from the phase III SURPASS clinical trials, and discuss the anticipated beneficial effects of tirzepatide on the prevention and management of atherosclerosis and dyslipidemia in patients with type 2 diabetes mellitus.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"249-260"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins, LDL-C and Beyond: A Contemporary Review of Atherosclerotic Cardiovascular Risk Assessment and Management.","authors":"Andrew Fancher, Angel Lopez-Candales, Khalid Sawalha","doi":"10.12997/jla.2026.15.2.216","DOIUrl":"10.12997/jla.2026.15.2.216","url":null,"abstract":"<p><p>Cardiovascular disease has been the leading cause of death in the United States since 1921 and remains a substantial cause of morbidity and mortality worldwide. Since the discovery of statins, significant improvements in outcomes have been achieved as these drugs have direct atherogenic lipid lowering properties as well as pleiotropic effects on atherosclerotic cardiovascular disease (ASCVD). In recent years, the American Heart Association and the American College of Cardiology published a 10-year ASCVD event risk calculator to standardized risk assessment and guide statin therapy. Over the last quarter century statins have become a cornerstone of primary and secondary ASCVD management. Our review explores the evolution of statin therapy from early groundbreaking trials to shaping current ASCVD guidelines. We investigate the mechanism of action of statins, their lesser-known side effects, and their impact on other lipid particles, coronary artery calcium scoring, and C-reactive protein levels. We examine how the current understanding of ASCVD risk factors and risk enhancers provides new insights to guide indeterminate treatment decisions in individuals with intermediate ASCVD risk profiles. Additionally, we explore the evolving landscape of ASCVD therapy as new targets like proprotein convertase subtilisin/kexin 9, Lp(a), and specific inflammatory markers have garnered interest. Our comprehensive review provides an in-depth discussion of statins and novel therapies in their clinical applications for healthcare providers in the management of ASCVD.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"216-239"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of Fimasartan and Statins in Patients With Hypertension and Dyslipidemia.","authors":"Kyung Hoon Cho, Sang-Hyun Kim, Sang Rok Lee, Jin-Bae Lee, Jae Hyoung Park, Chan Joo Lee, Gwangsil Kim, Sung Uk Kwon, Min Chul Kim, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong","doi":"10.12997/jla.2026.15.2.361","DOIUrl":"10.12997/jla.2026.15.2.361","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the efficacy and safety of a combination of fimasartan 30 mg and moderate-intensity statins in patients with hypertension and dyslipidemia in a real-world setting.</p><p><strong>Methods: </strong>This non-interventional, multicenter, prospective observational study included 5,264 patients receiving a combination of fimasartan 30 mg and moderate-intensity statins with 12-week follow-up data. Co-primary efficacy outcomes were the percentage of patients that achieved target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) control. Safety outcomes included adverse drug reactions and treatment-emergent adverse events.</p><p><strong>Results: </strong>At 12 weeks, the proportion of patients individually achieving target BP and LDL-C was 74.4% (95% confidence interval [CI], 73.2-75.5) and 85.6% (95% CI, 84.5-86.8), respectively. The proportion of patients achieving simultaneous control of target BP and LDL-C was 65.6% (95% CI, 64.1-67.2). The median (interquartile range; IQR) differences in systolic and diastolic BPs from baseline to 12 weeks were -8.0 mmHg (-19.0 to 0.0) and -4.0 mmHg (-11.0 to 0.0), respectively (both <i>p</i>-values <0.0001). The median (IQR) percentage change in LDL-C from baseline to 12 weeks was -11.5% (-33.5 to 4.8) (<i>p</i><0.0001). No significant adverse drug reactions or serious treatment-emergent adverse events were reported during the study period.</p><p><strong>Conclusion: </strong>Findings of this study demonstrate that a combination of fimasartan 30 mg and moderate-intensity statins results in excellent control of BP and LDL-C levels without any safety issues.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"361-373"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-Processed Food Consumption Is Associated With an Unfavorable Nutrient Profile and a Higher Likelihood of Hypertension Among Women Living in Brazilian Favelas.","authors":"Laysa de Almeida Espíndola Cardoso de Barros, Terezinha da Rocha Ataide, Thays Lane Ferreira Dos Santos, Telma Maria de Menezes Toledo Florêncio, Ana Paula Grotti Clemente, João Eudes Dos Santos Neto, Edward Araujo Júnior, Lucas Almeida das Chagas, Luiz Gonzaga Ribeiro Silva-Neto","doi":"10.12997/jla.2026.15.2.272","DOIUrl":"10.12997/jla.2026.15.2.272","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine the associations between ultra-processed foods (UPF) consumption, systemic arterial hypertension (SAH), and cardiovascular risk-related nutrient intake among women living in favelas.</p><p><strong>Methods: </strong>This cross-sectional study was conducted with 1,702 adult women of reproductive age (20-44 years) residing in 40 favelas in a capital city in Northeast Brazil. The presence of SAH was determined based on a previous medical diagnosis. Food consumption was assessed using a 24-hour dietary recall. Logistic regression models were applied to evaluate the associations.</p><p><strong>Results: </strong>SAH was present in 11.5% of the participants. A total of 33.8% of total caloric intake was derived from UPF, with mean sodium and potassium intakes of 1,747.9 mg and 1,507.6 mg, respectively. Women with SAH had a 14% higher odds of consuming greater amounts of UPF. Higher UPF consumption was characterized by increased intakes of cholesterol, sodium, and potassium, with each 100 mg increment associated with 15%, 37%, and 33% higher odds of higher UPF consumption, respectively. In contrast, increases of 10% in protein, polyunsaturated fatty acid (PUFA), and monounsaturated fatty acid intake were associated with reductions of 23%, 10%, and 9%, respectively, in the odds of higher UPF consumption.</p><p><strong>Conclusion: </strong>Higher UPF consumption was associated with an unfavorable nutrient profile, characterized by increased intakes of cholesterol, sodium, and potassium and decreased intakes of protein, and monounsaturated and PUFAs, reflecting a dietary pattern linked to increased cardiovascular risk in socioeconomically vulnerable populations.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"272-285"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Types of Soy Foods Are Differently Associated With Lipid Abnormalities in Korean Adults.","authors":"Bo Hwi Kim, Hye Ran Shin, SuJin Song","doi":"10.12997/jla.2026.15.2.345","DOIUrl":"10.12997/jla.2026.15.2.345","url":null,"abstract":"<p><strong>Objective: </strong>The association between soy foods and lipid profiles remains unclear. We examined the relationship between types of soy foods and lipid abnormalities in Korean adults.</p><p><strong>Methods: </strong>The baseline data of 42,126 men and 75,400 women aged 40-79 years from the Korean Genome and Epidemiology Study were analyzed. The frequency of soybean, tofu, soymilk, and fermented soy paste consumption was determined using a food frequency questionnaire. According to the Korean guidelines for the management of dyslipidemia, lipid abnormalities were defined. The association between soy foods consumption and lipid abnormalities was evaluated using multiple logistic regression analysis.</p><p><strong>Results: </strong>In men, consuming ≥7 servings/week of total soy foods was inversely associated with an elevated low-density lipoprotein cholesterol (LDL-C) (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.73-0.95; <i>p</i>-trend<0.001 vs. non-consumers). Higher tofu consumption was inversely associated with a low high-density lipoprotein (HDL)-cholesterol (<i>p</i>-trend=0.009 in men; <i>p</i>-trend=0.003 in women). Consuming ≥2 servings/week of soymilk was inversely associated with an elevated LDL-C in men (OR, 0.88; 95% CI, 0.80-0.98; <i>p</i>-trend=0.005) and a low HDL-cholesterol in women (OR, 0.78; 95% CI, 0.68-0.90, <i>p</i>-trend=0.001 vs. non-consumers). In men, frequent fermented soy paste consumption was inversely associated with an elevated total and LDL-C, but positively associated with an elevated triglycerides and a low HDL-cholesterol. Regardless of menopausal status, tofu and soymilk intake was inversely associated with a low HDL-cholesterol in women.</p><p><strong>Conclusion: </strong>Types of soy foods are differently associated with lipid abnormalities. Frequent consumption of non-fermented soy foods can improve lipid profiles in Korean adults.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"345-360"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of LDL-Cholesterol Levels and Their Associations With Cardiovascular Outcomes in Young Adults Under 40 Years in South Korea: A Nationwide Cohort Study.","authors":"You-Bin Lee, Kyu-Na Lee, Kyungdo Han","doi":"10.12997/jla.2026.15.2.328","DOIUrl":"10.12997/jla.2026.15.2.328","url":null,"abstract":"<p><strong>Objective: </strong>We examined the distribution of low-density lipoprotein cholesterol (LDL-C) levels and compared the hazards of myocardial infarction (MI), stroke, and their composite according to LDL-C concentration in young adults.</p><p><strong>Methods: </strong>This was a nationwide, population-based study. From the Korean National Health Insurance Service database (2002-2022), we identified adults aged 20-39 years without prior MI or stroke who underwent at least 1 health examination between 2009 and 2012 (n=6,458,006). The hazards of MI, stroke, and their composite were evaluated across LDL-C levels.</p><p><strong>Results: </strong>During a median follow-up of 12.6 years, 47,107 MIs, 28,536 strokes, and 73,897 composite events occurred. The hazard of outcomes showed a J-shaped association with LDL-C levels, with the lowest hazard observed around 90-110 mg/dL. Above this range, the hazard increased progressively with rising LDL-C levels. In analyses based on LDL-C categories, levels ≥130 mg/dL were associated with significantly increased hazards of outcomes, with the highest hazards observed at ≥160 mg/dL. The elevated hazards in the higher LDL-C categories were more pronounced in individuals with abdominal obesity and current smokers for all 3 outcomes, and in those with higher body mass index categories, low high-density lipoprotein-cholesterol, and hypertriglyceridemia for MI and the composite outcome.</p><p><strong>Conclusion: </strong>Among young adults, cardiovascular risk demonstrated a J-shaped association with LDL-C levels. Risks increased progressively beyond approximately 90-110 mg/dL, especially in the presence of other cardiometabolic risk factors. These findings underscore the importance of lipid monitoring and cardiovascular risk assessment even in young adults, particularly those with concurrent risk factors.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"15 2","pages":"328-344"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}