581-P: Remnant Cholesterol: Association to Components of the Metabolic Syndrome or Triglyceride-Glucose Index in the LUPS Cohort
Authors: BRANDTS JULIA , KNEBEL BIRGIT , KOTZKA JORG , SCHUETT KATHARINA , MARX NIKOLAUS , RAY KAUSIK K. , MÜLLER-WIELAND DIRK , CONSORTIUM LUPS 
Published: June 2020

Aims: Cardiovascular risk increases with the number of components of the Metabolic Syndrome (MetS) and with extent of insulin resistance. Remnant Cholesterol (RC) represents the amount of cholesterol transported in triglyceride (TG)-rich lipoproteins and genetic studies support a causal relationship to cardiovascular disease. RC may be abnormal in individuals with insulin resistance (IR) or MetS. We assessed the relationship between RC and the number of components of MetS and 2 markers of insulin resistance (IR) (Triglyceride-Glucose-Index (TyG) and Metabolic Score for Insulin Resistance (METS-IR)) Methods: The Lufthansa Prevention Study (LUPS) is a prospective occupational cohort, that comprises 1880 workers aged 25-60 years, without cardiovascular disease (CVD) or diabetes mellitus. RC was calculated as Non-HDL-Cholesterol minus directly measured LDL-Cholesterol. (MetS) was defined to the updated modified NCEP adult treatment panel III report (2009). We assessed the relationship between RC-levels and the number of MetS components using Mann-Whitney-U and Kruskal-Wallis tests. The correlation between RC and TyG or METS-IR was assessed using Spearman’s correlation.
Results: Median (IQR) RC levels increased with number of components of MetS. In the absence of any MetS component RC levels were 11.0 mg/dl [7-16 mg/dl] vs. 42.0 mg/dl [32.5-53.5 mg/dl] when all 5 MetS components were present (p&lt;0.001). RC was significantly and positively correlated with indicators of IR; TyG (Spearman’s correlation coefficient (rs) =0.764; p&lt;0.001) and METS-IR (rs=0.55; p&lt;0.001), suggesting that 58% and 30% of the variance in RC respectively are explained by measures of insulin resistance.
Conclusion: In a cohort free from CVD and diabetes, RC significantly correlated with the number of components of the MetS and measures of insulin resistance. Elevated RC may explain in part the excess cardiovascular risk among individuals associated with MetS or IR.

Disclosure
J. Brandts: None. B. Knebel: None. J. Kotzka: None. K. Schuett: Advisory Panel; Self; Amgen, AstraZeneca, Boehringer Ingelheim International GmbH. Speaker’s Bureau; Self; Lilly Diabetes, Merck & Co., Inc., Novartis Pharma K.K., Novo Nordisk Inc. N. Marx: Other Relationship; Self; Amgen, AstraZeneca, Bayer Vital, Boehringer Ingelheim International GmbH, Daiichi Sankyo, Kowa Research Institute, Inc., Medtronic, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. K.K. Ray: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Esperion Therapeutics, Inc., Novo Nordisk Inc., Sanofi. D. Müller-Wieland: Advisory Panel; Self; Amarin Corporation, AstraZeneca, Bayer Vital, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk Inc., Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH. Speaker’s Bureau; Self; Amgen, AstraZeneca, Bayer Vital, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk Inc., Sanofi-Aventis Deutschland GmbH.