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IDL, VLDL, chylomicrons and atherosclerosis
B G Nordestgaard1, A Tybjaerg-Hansen
1Department of Medicine B, Rigshospitalet, University of Copenhagen, Denmark.
European Journal of Epidemiology
|May 1, 1992
Summary
Large lipoproteins like chylomicrons and very-low-density lipoprotein (VLDL) do not accelerate atherosclerosis. Instead, remnant lipoproteins (intermediate density lipoprotein and smaller VLDL) are implicated in promoting cardiovascular disease.
Area of Science:
- Cardiovascular Science
- Lipid Metabolism
- Atherosclerosis Research
Background:
- Lipoprotein lipase deficiency is characterized by high levels of chylomicrons and large very-low-density lipoprotein (VLDL), yet atherosclerosis does not accelerate.
- Dysbetalipoproteinemia involves elevated remnant lipoproteins (intermediate density lipoprotein (IDL) and beta-VLDL), which are associated with accelerated atherosclerosis.
Purpose of the Study:
- To investigate the role of different lipoprotein particles in the development of atherosclerosis.
- To determine which lipoprotein fractions are most atherogenic.
Main Methods:
- Review of human epidemiological studies and animal models (St. Thomas' Hospital rabbit strain).
- Analysis of lipoprotein/arterial wall interaction studies concerning particle size and intima penetration.
- Comparison of atherogenic potential between chylomicrons, VLDL, IDL, and low-density lipoprotein (LDL).
Main Results:
- Very large VLDL and chylomicrons show limited entry into the arterial intima.
- Remnant lipoproteins (IDL and smaller VLDL) and LDL demonstrate potential for promoting atherosclerosis.
- Studies in rabbits indicate IDL/remnant lipoproteins are stronger atherosclerosis predictors than LDL or VLDL.
Conclusions:
- Remnant lipoproteins (IDL and smaller VLDL), along with LDL, possess atherogenic potential.
- Very large VLDL and chylomicrons appear to be non-atherogenic.
- Lipoprotein particle size and composition are critical determinants of their role in atherosclerosis.