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Small, dense, low-density lipoprotein and atherosclerosis

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Abstract

Disorders of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subclass distribution are more common contributors to coronary artery disease (CAD) than is elevated low-density lipoprotein cholesterol (LDLC). Recent research has emphasized the importance of LDL and HDL subclass distribution in patient management and response to treatments. Laboratory determination of LDL and HDL subclass distribution involves analytic ultracentrifugation or polyacrylalmide gradient gel electrophoresis. If subclass distribution is to be used for patient management, research quality control and standards are necessary in order to assure that the patient’s values accurately reflect the metabolic disorder. The importance of this topic for patient care has been recognized by the medical insurance industry. Investigations employing electron beam computed tomography in asymptomatic individuals has revealed that 50% with established CAD have normal lipids by National Cholesterol Education Program (NCEP) criteria. However, a large proportion of other metabolic contributors to CAD are not revealed by routine blood tests.

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References and Recommended Reading

  1. Superko HR: The atherogenic lipoprotein profile. Sci Med 1997:4: 36–45.

    CAS  Google Scholar 

  2. Superko HR: Did grandma give you heart disease? The new battle against coronary artery disease. Am J Card 1998, 82: 34–46.

    Article  Google Scholar 

  3. Krauss RM: Heterogeneity of plasma low-density lipoproteins and atherosclerosis risk. Curr Opin Lipidol 1994, 5: 339–349.

    Article  PubMed  CAS  Google Scholar 

  4. Lamarche B, Tchernof A, Moorjani S, et al.: Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men: perspective results from the Quebec cardiovascular study. Circulation 1997, 95: 69–75.

    PubMed  CAS  Google Scholar 

  5. Miller BD, Alderman EL, Haskell WL, et al.: Predominance of dense low-density lipoprotein particles predicts angiographic benefit or therapy in the Stanford Coronary Risk Intervention project. Circulation 1996, 94: 2146–2153.

    PubMed  CAS  Google Scholar 

  6. Watts GF, Mandalia S, Brunt JN, et al.: Independent associations between plasma lipoprotein subfraction levels and the course of coronary artery disease in the St Thomas’ Atherosclerosis Regression Study (STARS). Metabolism 1993, 42: 1461–1467.

    Article  PubMed  CAS  Google Scholar 

  7. Zambon A, Hokanson JE, Brown BG, Brunzell JD: Evidence for a new pathophysiological mechanism for coronary artery disease regression. Circulation 1999, 99: 1959–1964.

    PubMed  CAS  Google Scholar 

  8. Superko HR, Krauss RM, Miller B: Prediction of LDL subclass pattern from Trig, HDLC, LDLC, apoB. Cardiovasc Health Feb 19, 1998. San Francisco.

  9. Lindgren FT, Jensen LC, Hatach FT: The isolation and quantitative analysis of serum lipoproteins. In Blood lipids and lipoproteins: quantitation, composition, and metabolism. Edited by Nelson GJ. New York: Wiley-Interscience; 1972:181–274.

    Google Scholar 

  10. Gofman JW, Lindgren FT, Elliott H, et al.: The role of lipids and lipoproteins in atherosclerosis. Science 1950, 111: 166–171.

    Article  PubMed  CAS  Google Scholar 

  11. Krauss RM, Blanche PJ: Detection and quantitation of LDL subfractions. Curr Opin Lipidol 1992, 3: 377–383.

    Article  CAS  Google Scholar 

  12. Williams PT, Krauss RM, Vranizan KM, Wood PD: Changes in lipoprotein subfractions during diet-induced and exercise-induced weight loss in moderately overweight men. Circulation 1990, 81: 1293–1304.

    PubMed  CAS  Google Scholar 

  13. Austin MA, Kamigaki A, Hokanson JE: Low-density lipoprotein particle size is a risk factor for coronary heart disease independent of triglyceride and HDL cholesterol: a meta-analysis of three prospective studies in men. Circulation 1999, 99: 1124.

    Google Scholar 

  14. Austin MA, Mykkanen L, Kuusisto J, et al.: Prospective study of small LDLs as a risk factor for non-insulin dependent diabetes mellitus in elderly men and women. Circulation 1995, 92: 1770–1778.

    PubMed  CAS  Google Scholar 

  15. Medicare Part B Bulletin: Lipid Panels, LDL Direct, and LDL subfractions. December 1999, 8:6–9.

    Google Scholar 

  16. Dreon DM, Fernstrom H, Miller B, Krauss RM: Low-density lipoprotein subclass patterns and lipoprotein response to a reduced-fat diet in men. FASEB J 1994, 8: 121–126.

    PubMed  CAS  Google Scholar 

  17. Superko HR, Krauss RM: Garlic Powder, Effect on Plasma Lipids, Post prandial lipemia, LDL particle size, HDL subclass distribution, and Lp(a). J Am Coll Cardiol 2000, 35: 321–326.

    Article  PubMed  CAS  Google Scholar 

  18. Guerci AD, Spadaro LA, Goodman KJ, et al.: Comparison of electron beam computed tomography scanning and conventional risk factor assessment for the prediction of angiographic coronary. J Am Coll Cardiol 1998 Sep, 32(3): 673–679.

    Article  PubMed  CAS  Google Scholar 

  19. Hecht HS, Superko HR, Smith LK, McColgan B: National cholesterol education program guidelines fail to identify coronary artery disease as detected by electron beam computerized tomography. Circulation 1999, 100:I-239.

  20. Superko HR, Hecht HS: Small, dense LDL, Lp(a), homocysteine are common abnormalities in patients with coronary calcification who are at both low and high risk by National Cholesterol Education Program Criteria. Circulation 1999, 100:I-800.

    Google Scholar 

  21. Hodis HN, Mack WJ, Dunn M, et al.: Intermediate-density lipoproteins and progression of carotid arterial wall intima-media thickness. Circulation 1997, 95: 2022–2026.

    PubMed  CAS  Google Scholar 

  22. Skoglund-Anderson C, Tang R, Bond MG, et al.: LDL particle size distribution is associated with carotid intima-media thickness in healthy 50-year old men. Arterioscler Thromb Vasc Biol 1999, 19: 2422–2430.

    Google Scholar 

  23. Superko HR, Wood PD, Krauss RM: Effect of alpha- and selective beta-blockade for hypertension control on plasma lipoproteins, apoproteins, lipoprotein subclasses, and postprandial lipemia. Am J Med 1989, 86 (suppl 1B): 26–31.

    PubMed  CAS  Google Scholar 

  24. Superko HR, KOS investigators: Effect of nicotinic acid on LDL subcalss patterns. Circulation 1994, 90:I-504.

  25. Superko HR, Blanche P, Holl L, et al.: Reduction of plasma LDL and apo B leveles with combined estrogen and progestin therapy in post-menopausal women is greater in women with dense rather than buoyant LDL. Circulation 1998, 98:I-7.

    Google Scholar 

  26. Superko HR, Krauss RM: Differential effects of nicotinic acid in subjects with different LDL subclass patterns. Atherosclerosis 1992, 95: 69–76.

    Article  PubMed  CAS  Google Scholar 

  27. Franceschini G, Lovati MR, Manzoni C, et al.: Effect of gemfibrozil treatment in hypercholesterolemia on low density lipoprotein (LDL) subclass distribution and LDL-cell interaction. Atherosclerosis 1995, 114: 61–71.

    Article  PubMed  CAS  Google Scholar 

  28. Rubins, Robins SJ, Collins D, et al.: Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol: Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med 1999, 341: 410–418.

    Article  PubMed  CAS  Google Scholar 

  29. Superko HR, Krauss RM, DiRicco C: Effect of HMGCoA Reductase Inhibitor (Fluvastatin) on LDL Peak Particle Diameter. Am J Cardiol 1997, 80: 78–81.

    Article  PubMed  CAS  Google Scholar 

  30. Superko HR: Inclusion of lipoprotein subfractions among efficacy parameters. Am J Cardiol 1998, 14: 20–23.

    Google Scholar 

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Superko, H.R. Small, dense, low-density lipoprotein and atherosclerosis. Curr Atheroscler Rep 2, 226–231 (2000). https://doi.org/10.1007/s11883-000-0024-1

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