Conclusions Study -level data from this systemic review establish that different lipid lowering agents can lead to discordance between LDL-P and LDL-C , therefore , basing LDL-lowering therapy only on the achievement of cholesterol goals may result in a treatment gap .
Therefore , the use of LDL-P for monitoring lipid-lowering therapy , particularly for statins , can provide a more accurate assessment of residual cardiovascular risk
Purpose This systematic review was performed to summarize published experience using low density lipoprotein particle number ( LDL-P ) to monitor the efficacy of  lipid-lowering pharmacotherapies .
Initial combination therapy with metformin plus colesevelam improves lipoprotein particles in patients with early type 2 diabetes mellitus.
BACKGROUND The bile acid sequestrant colesevelam has been shown to significantly reduce low-density lipoprotein particle concentration ( LDL-P ) in adults with primary hyperlipidemia or type 2 diabetes mellitus ( T2DM ) . OBJECTIVE To assess the effect of initial combination therapy with metformin plus colesevelam on lipoprotein particles in patients with T2DM ( secondary efficacy variables ) . METHODS This 16-week , r and omized , double-blind , placebo-controlled study enrolled drug-naïve adults with T2DM , glycated hemoglobin 6.5%-10.0 % , low-density lipoprotein cholesterol ( LDL-C ) ≥100 mg/dL , and triglycerides < 500 mg/dL. Patients were r and omized 1:1 to either open-label metformin ( titrated to 1700 mg/day ) plus double-blind colesevelam 3.75 g/day or open-label metformin plus double-blind placebo . RESULTS In total , 286 patients were r and omized  ( metformin plus colesevelam [ n = 145 ] ; metformin plus placebo [ n = 141 ] ) . Compared with metformin plus placebo , the combination of metformin plus colesevelam significantly reduced LDL-C ( mean treatment difference : -16.3 % ) , total cholesterol ( -6.1 % ) , non-high-density lipoprotein cholesterol ( -8.3 % ) , and apolipoprotein ( apo ) B ( -8.0 % ) and significantly increased triglycerides ( median treatment difference : 18.6 % ) and apoA-I ( mean treatment difference : 4.4 % ; all P < .001 ) . Metformin plus colesevelam significantly reduced total LDL-P ( mean treatment difference : absolute change -186 nmol/L [ percent change -11.7 % ] ; both P < .0001 ) , largely attributable to a reduction in small LDL-P , and increased total very-low-density lipoprotein particle concentration ( mean treatment difference : absolute change 6 nmol/L ; P = .03 [ percent change 8.3 % ; P = .06 ] ) and total high-density lipoprotein particle concentration ( 1.0 μmol/L ; P = .03 [ 4.5 % ; P = .01 ] ) versus metformin plus placebo . CONCLUSION Initial combination therapy with metformin plus colesevelam improved the atherogenic lipoprotein profile of patients with early T2DM by significantly reducing LDL-P. Clinical Trials.gov identifier : NCT00570739
Conclusions Study -level data from this systemic review establish that different lipid lowering agents can lead to discordance between LDL-P and LDL-C , therefore , basing LDL-lowering therapy only on the achievement of cholesterol goals may result in a treatment gap .
Therefore , the use of LDL-P for monitoring lipid-lowering therapy , particularly for statins , can provide a more accurate assessment of residual cardiovascular risk
Purpose This systematic review was performed to summarize published experience using low density lipoprotein particle number ( LDL-P ) to monitor the efficacy of  lipid-lowering pharmacotherapies .