Although we may be entering an era of waning cardiovascular risk attributable to LDL cholesterol, the recurrent event rate even with the best of current therapies remains unacceptably high. In his Keynote presentation, “Triglycerides on the Rise: Should We Swap Seats on the Seesaw?” Dr. Peter Libby will discuss the increasing prevalence of other cardiovascular risk factors, including triglycerides and specifically, the apolipoprotein constituent of many triglyceride-rich lipoproteins, apoC3. According to Dr. Libby, “We have a growing need for novel therapies that address the global shift in the risk factor profile we currently confront. Treatments that target triglyceride-rich lipoproteins, inflammation, diabetes, obesity, and other contributors to residual risk in the statin era now urgently require rigorous assessment in clinical trials.”
It is known that diabetes, obesity, and metabolic syndrome are the result of gene/environment interactions but a newly recognized component of the gene/environment interaction is the gut microbiome. In the Keynote presentation, “The Gut Microbiome as a Modifier of Insulin Resistance and Metabolic Syndrome,” Dr. Ronald Kahn will discuss results of his research in mice which have shown that given different diets, different mice adapt with different microbiomes, some of which are more or less likely to produce insulin resistance and the metabolic syndrome. Thus, the microbiome interacts with the genetics of the mouse, and by shifting the microbiome, a mouse genetically at the borderline of becoming insulin resistant, for example, may become less insulin resistant. Dr. Kahn will explain how the gut microbiome is an important mediator of the gene/environment interaction, some of the mechanisms by which the gut microbiome works, and ultimately what the implications are in terms of how we treat patients.