New Data Suggests a More Expansive View of Heart Health Lipids

By Deb Borfitz 

November 4, 2024 | The traditional LDL and HDL cholesterol tests may soon be obsolete as new research suggests they provide an incomplete view of heart health compared to other lipid molecules circulating in the blood. This shift stems from a recent study led by Dr. Cristina Legido-Quigley, a systems medicine expert at King’s College London and Steno Diabetes Centre, which analyzed lipids in children with obesity. Using advanced mass spectrometry-based lipidomics, researchers identified lipids that impact cardiometabolic risk and metabolic diseases beyond simple weight factors, marking a breakthrough in understanding health risks associated with obesity in youth. 

Key findings from the study, published in Nature Medicine, revealed that certain lipid types—such as ceramides (Cers), phosphatidylethanolamines (PEs), and phosphatidylinositols (PIs)—correlate with conditions like fatty liver disease, insulin resistance, and cardiometabolic risk. Interestingly, sphingomyelins (SMs) were inversely associated with these risks, indicating they may play a protective role, particularly in brain health. Machine learning techniques identified Cers, PEs, and PIs as predictive markers for fatty liver disease, potentially matching the accuracy of traditional liver enzyme tests. 

The study also found that children with obesity had lower omega-3 fatty acids, a lipid deficiency previously observed in obese adults. The ceramide family of lipids, although less known, shows potential as a marker for predicting cardiovascular events and is already under consideration in clinical settings, such as at the Mayo and Cleveland clinics. 

Beyond lipid correlations, the study underscores the potential of systems medicine to personalize treatment plans by combining diverse molecular data, including lipidomics and genomics. The research analyzed over 1,300 children from the HOLBAEK study in Denmark, utilizing plasma lipidomics and comprehensive clinical profiling to assess the impact of a nonpharmacological obesity management program. Although BMI didn’t significantly improve for some participants, the lipid levels tied to diabetes and cardiovascular risks decreased. 

This growing body of research points to a future where lipid profiling could replace traditional cholesterol tests, offering deeper insights into cardiometabolic risk, especially for pediatric populations. For more on these advances in cholesterol testing, read the full article at Diagnostics World News.