Recent advances in lipoprotein metabolism and the genetic dyslipoproteinemias

The elucidation of the structure and function of the plasma apolipoproteins has provided the unique opportunity to understand the physiological pathways for the transport and cellular metabolism of the plasma lipoproteins. The complexity of the individual density classes of plasma lipoproteins has been revealed by a detailed analysis of the apolipoprotein composition of the individual lipoprotein particles. In addition, the elucidation of the molecular defects in patients with dyslipoproteinemias has now permitted the understanding of the defects at the level of the apolipoprotein gene. The ability to define the genetic defect in individuals at risk for the development of premature cardiovascular disease provides the unique opportunity to now identify these individuals at an earlier age, and to initiate therapy to prevent the development of early heart disease.