Qualitative and quantitative characteristics of low-density lipoproteins in atherosclerosisrelated diseases

Abstract

Elevated serum low-density lipoprotein cholesterol (LDLcholesterol) concentration is firmly established as a risk factor for atherosclerosis and cardiovascular disease (CVD). Yet, a number of CVD patients have LDL-cholesterol levels within the recommended range, suggesting the need for advanced lipid testing to determine residual risk. In this manner, further improvement of risk assessment might be accomplished through a more detailed insight into qualitative and quantitative characteristics of LDL particles. Plasma LDL population comprise complex spectrum of particles of different size, density and lipid composition. There is now ample of evidence that certain LDL subclasses, particularly small, dense LDL particles, are superior to LDLcholesterol in terms of CVD risk prediction. Furthermore, elevation of small, dense LDL particles is also observed in various atherosclerosisrelated conditions, such as end-stage renal disease or ischemic stroke. Whereas the measurement of LDL-cholesterol concentrations has proven clinical utility, the usefulness of LDL particles characterisation in clinical practice needs to be further explored. Understanding of structural complexity of LDL particles and their functional consequences might improve prevention and prognosis of atherosclerosis-related diseases, leading toward more specialized therapeutic approaches. Therefore, the questions of whom, when and how to asses small, dense LDL particles still remain open.