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Clinical importance and therapeutic modulation of small dense low-density lipoprotein particles.

Gazi IF, Tsimihodimos V, Tselepis AD, Elisaf M, Mikhailidis DP

Royal Free Hospital (and University College of Medicine), Department of Clinical Biochemistry, Pond St, London, NW3 2QG, UK.

The National Cholesterol Education Programme Adult Treatment Panel III accepted the predominance of small dense low-density lipoprotein (sdLDL) as an emerging cardiovascular disease (CVD) risk factor. Most studies suggest that measuring low-density lipoprotein (LDL) particle size, sdLDL cholesterol content and LDL particle number provides additional assessment of CVD risk. Therapeutic modulation of small LDL size, number and distribution may decrease CVD risk; however, no definitive causal relationship is established, probably due to the close association between sdLDL and triglycerides and other risk factors (e.g., high-density lipoprotein, insulin resistance and diabetes). This review addresses the formation and measurement of sdLDL, as well as the relationship between sdLDL particles and CVD. The effect of hypolipidaemic (statins, fibrates and ezetimibe) and hypoglycaemic (glitazones) agents on LDL size and distribution is also discussed.

Published 7 December 2006 in Expert Opin Biol Ther, 7(1): 53-72.
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