The role of non-LDL:non-HDL particles in atherosclerosis |
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Authors: | Segrest Jere P |
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Institution: | (1) Atherosclerosis Research Unit, Department of Medicine and Biochemistry and Molecular Biology, University of Alabama Medical Center, 630 Boshell Building, 35294-0012 Birmingham, AL, USA |
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Abstract: | Elevated concentrations of circulating apolipoprotein B (apoB)-containing lipoproteins, other than low-density lipoprotein
(LDL), have been implicated as causative agents for the development of atherosclerosis. A form of dyslipidemia, the atherogenic
lipoprotein profile, that consists of elevated intermediate-density lipoprotein (IDL), triglycerides (TGs), dense LDL and
dense very low density lipoprotein (VLDL), and low high density lipoprotein-2, occurs in 40% to 50% of patients with coronary
artery disease (CAD). The recently released Adult Treatment Panel III guidelines suggest that because elevated TGs are an
independent CAD risk factor, some TG-rich lipoproteins, commonly called remnant lipoproteins, must be atherogenic.
Relevant to this series on diabetes, a number of studies have shown that in type 2 diabetes, the severity of CAD is positively
related to the numbers of TG-rich particles in the plasma. Although less clear, other studies in type 2 diabetes suggest that
elevated levels of lipoprotein (a) Lp(a)] may also be independently associated with CAD. In this article, we summarize evidence
for the role of apoB-containing lipoprotein particles other than LDL in the development of atherosclerosis and discuss methods
of quantification and possible pharmacologic interventions for lowering their plasma concentrations. The particles reviewed
include the TG-rich lipoproteins: VLDL and its remnants, chylomicron remnants and IDL, and the C-rich lipoprotein: Lp(a). |
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