For decades, LDL-C (Low-Density Lipoprotein Cholesterol) has been considered the primary risk factor for heart disease. However, recent research from 2022 to 2025 has highlighted another, more predictive “actor”: Remnant Lipoproteins (RLP) or Remnant Cholesterol. Remnant lipoproteins are triglyceride-rich particles left over from the metabolism of VLDL and chylomicrons. These particles penetrate arterial walls more easily, trigger inflammation, and form unstable atherosclerotic plaques. Modern studies show that remnant cholesterol can predict heart disease risk even when LDL-C levels are within the normal range. Accurate lipid profiling is essential for identifying this risk. The Sinocare iCARE-2100 Lipid Profile Reagent Kit (TC/TG/HDL-C/LDL-C) provides a complete solution for measuring HDL, LDL, total cholesterol, and triglycerides with fast and accurate results.
1. What Are Remnant Lipoproteins and Why Are They Dangerous?
Remnant lipoproteins are triglyceride-rich lipoprotein particles derived from:
- VLDL remnants
- IDL (Intermediate-Density Lipoproteins)
- Chylomicron remnants
Unlike LDL, RLPs are more atherogenic and inflammatory, significantly increasing the risk of heart disease.
2. Evidence 2022–2025: Remnant Lipoproteins Are More Predictive Than LDL-C
- Large Population Study (2023): Individuals with normal LDL but high remnant cholesterol had a 2–3 times higher risk of heart attacks.
- Mendelian Randomization Data: Gene variations that increase remnant cholesterol show stronger associations with heart disease than LDL-related gene variations.
- Intervention Studies: Reducing remnant cholesterol through diet or triglyceride-lowering drugs provides added benefit even when LDL is controlled.
- Diabetes & Obesity Populations: Remnants often remain high despite normal LDL, explaining their disproportionate cardiovascular risk.
Complete lipid profiling is crucial to support accurate risk detection.
3. Why LDL-C Is No Longer Enough
- LDL-C does not account for all atherogenic particles.
- High triglycerides often indicate elevated remnant lipoproteins.
- Many patients with “normal LDL” remain at high risk if remnant cholesterol is elevated.
More informative alternative parameters include remnant cholesterol, non-HDL-C, and ApoB.
4. How to Measure Remnant Lipoproteins
Practical method:
Remnant Cholesterol = Total Cholesterol – LDL-C – HDL-C
High values:
- ≥30 mg/dL → moderate risk
- ≥40 mg/dL → high risk
- ≥50 mg/dL → very high risk
This test can be performed in clinical laboratories using high-quality reagents.
5. Advantages of the Sinocare iCARE-2100 Lipid Profile Reagent Kit (TC/TG/HDL-C/LDL-C)
1. Each reagent kit contains:
- QC solution (2 pcs)
- Diluent (2 pcs)
- Reagent kit for 30 tests
- Pipette
2. Automated operation: Speeds up and simplifies the testing process
3. Short measurement time (15 minutes), delivering fast results and improving efficiency
4. Small sample volume (150 µL): Easier sample collection
5. Includes QC materials: Simplifies quality control and reduces costs
6. Measures four parameters in a single test (Total Cholesterol, Triglycerides, HDL-C, and LDL-C): Provides an economical solution for patients and clinics/hospitals, saving time while obtaining a full lipid profile.
6. Strategies to Reduce Remnant Lipoproteins
1. Dietary Interventions
- Low simple carbohydrates
- High fiber and protein
- Omega-3 (pure EPA)
- Intermittent fasting
2. Pharmacotherapy
- Fibrates → reduce TG & remnants by 30–50%
- Pure EPA → reduces heart disease risk by 25%
- Statins → slight reduction in remnants
3. Physical Activity
Moderate-to-high intensity exercise lowers triglycerides and increases remnant lipoprotein clearance.
To evaluate the effectiveness of these interventions, consistent lipid profile monitoring is essential. The Sinocare iCARE-2100 Lipid Profile Reagent Kit makes it easy for laboratories and clinics to obtain accurate, fast, and reliable data.
Lipid science has shifted from focusing solely on LDL-C to a more comprehensive view including remnant lipoproteins. RLPs are proven to be more atherogenic and more predictive of heart attacks, especially in patients with diabetes, obesity, and high triglycerides. Routine comprehensive lipid profiling supported by the highly accurate, fast, stable, and user-friendly Sinocare iCARE-2100 Lipid Profile Reagent Kit helps healthcare professionals detect risks earlier.
References
- Nordestgaard BG. Triglyceride-Rich Lipoproteins and Atherosclerotic Cardiovascular Disease. Circulation, 2023.
- Varbo A, Nordestgaard BG. Remnant Cholesterol and Cardiovascular Disease: Causal Evidence and Clinical Implications. Atherosclerosis, 2022.
- Silverman MG et al. Association of Remnant Cholesterol with Incident Coronary Heart Disease. JACC, 2022.
- Ference BA et al. Mendelian Randomization Studies of Remnant Lipoproteins. European Heart Journal, 2023.
- Toth PP et al. Role of Triglyceride-Rich Lipoproteins in Atherosclerosis Risk. Journal of Clinical Lipidology, 2024.
- Bhatt DL et al. Cardiovascular Risk Reduction with Icosapent Ethyl. NEJM, 2022–2024 update.
- 2019 ESC/EAS Guidelines for the Management of Dyslipidemias (2022–2023 supplements).
