Small Dense Low-density Lipoprotein and Cardiovascular Disease

Sunghwan Suh; Moon-Kyu Lee

doi:10.12997/jla.2012.1.1.1

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Suh and Lee: Small Dense Low-density Lipoprotein and Cardiovascular Disease

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Journal of Lipid and Atherosclerosis 2012; 1(1): 1-9.

Published online: 30 June 2012

DOI: https://doi.org/10.12997/jla.2012.1.1.1

Small Dense Low-density Lipoprotein and Cardiovascular Disease

Sunghwan Suh, Moon-Kyu Lee

Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Corresponding Author: Moon-Kyu Lee, Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-Gu, Seoul 135-710, Republic of Korea. Tel: +82-2-3410-3431, Fax: +82-2-3410-0393, leemk@skku.edu

Received 2 May 2012 Revised 14 May 2012 Accepted 15 May 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cardiovascular disease (CVD) is the leading cause of death worldwide and small dense low-density lipoprotein (sdLDL) has been suggested to be a potential risk factor for cardiovascular disease (CVD). We reviewed published studies on formation and measurement of sdLDL, as well as relationship between LDL subfractions and CVD. sdLDL particle formation is highly dependent on triglycerides (TG) levels, and the physicochemical properties of sdLDL particles provide a potential for increased atherogenicity. Various conditions (e.g. hypertriglyceridemia, diabetes mellitus, metabolic syndrome, chronic renal failure and HIV infections) with increased cardiometabolic risk are associated with increased sdLDLs. Most studies suggest that sdLDL particles are associated with increased prevalence of clinical and subclinical CVDs, as well as non-coronary forms of atherosclerosis. Moreover, LDL size seems to be an important determinant of the progression of CVD. Therapeutic modulation (mostly fibrates, but also some statins, as well as niacin and thiazolidinediones) of small LDL size, number and distribution may decrease CVD risk. However, no definitive causal relationship is yet established, probably due to the close association between sdLDL and triglycerides and other risk factors.

Keywords: Small dense low-density lipoprotein (LDL), LDL particle size, Cardiovascular disease

Figures and Tables

Fig. 1

Formation of small, dense low-density lipoprotein (LDL) particles. Two steps are involved in the formation of small, dense LDL particles. The first is lipid transfer mediated by cholesterol ester transfer protein (CETP); the second is lipid hydrolysis by lipoprotein lipase (LPL) and hepatic lipase (HL). B=apoB100; CE=cholesterol ester; Tg=triglyceride; VLDL=very-low-density lipoprotein. Modified from Sniderman et al.88

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