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Updated: May 1, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Impact of short-term low-dose atorvastatin on low-density lipoprotein and high-density lipoprotein subfraction
Rui-Xia Xu1, Yuan-Lin Guo, Xiao-Lin Li
1Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Insights
Low-dose atorvastatin significantly reduces LDL-C and alters LDL subfractions, increasing mean LDL particle size. Higher doses may favorably modify HDL subfractions in atherosclerosis patients.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Lipid Metabolism
Background:
- Statins are primary agents for lowering low-density lipoprotein-cholesterol (LDL-C).
- Their effects on high-density lipoprotein (HDL) and low-density lipoprotein (LDL) subfractions are less understood.
- Investigating these subfractions is crucial for understanding statin efficacy.
Purpose of the Study:
- To evaluate the short-term effects of low-dose atorvastatin on HDL and LDL subfractions.
- To compare the impact of 10 mg/day versus 20 mg/day atorvastatin.
- To assess changes in patients with atherosclerosis.
Main Methods:
- Randomized controlled study involving 52 subjects (37 with atherosclerosis, 15 healthy controls).
- Atherosclerosis patients received atorvastatin 10 mg/day or 20 mg/day for 8 weeks.
- Lipid profiles and lipoprotein subfractions were analyzed using the Lipoprint system at baseline and 8 weeks.
Main Results:
- Atorvastatin (10 and 20 mg/day) significantly decreased LDL-C and all LDL subfractions.
- A mean increase in LDL particle size was observed.
- 20 mg/day atorvastatin increased large HDL particles and decreased small HDL particles, without altering total HDL-C.
Conclusions:
- Low-dose atorvastatin effectively reduces LDL-C and improves LDL subfraction profiles.
- 20 mg/day atorvastatin demonstrates a beneficial shift in HDL subfractions in patients with atherosclerosis.
- These findings suggest a more nuanced understanding of statin's impact beyond total cholesterol levels.
Abstract:
Statins can significantly reduce low-density lipoprotein-cholesterol (LDL-C) and modestly raise or not alter high-density lipoprotein-cholesterol (HDL-C). However, their impact on high-density lipoprotein (HDL) and low-density lipoprotein (LDL) subfractions has been less examined. The aim of the present study was to investigate the short-term impact of low-dose atorvastatin on HDL and LDL subfractions in humans. In this randomized study, data from 52 subjects were analysed. Thirty-seven patients with atherosclerosis were randomized to treatment with atorvastatin 10 mg/day (n = 17) or 20 mg/day (n = 20) for 8 weeks, with 15 healthy subjects without therapy used as a control group. The lipid profile and lipoprotein subfractions were determined using the Lipoprint system at baseline and at 8 weeks. The data suggest that atorvastatin treatment (10 and 20 mg/day) for 8 weeks significantly decreases LDL-C levels and reduces the cholesterol concentration of all LDL subfractions, which is accompanied by an increase of the mean LDL particle size. Although 10 mg/day atorvastatin treatment for 8 weeks had no impact on the HDL subfraction, 20 mg/day atorvastatin for 8 weeks significantly increased the cholesterol concentration of large HDL particles and decreased the cholesterol concentration of small HDL particles without changing serum HDL-C levels in patients with atherosclerosis. Therefore, the results suggest that 20 mg/day atorvastatin treatment for 8 weeks may result in a favourable modification of the HDL subfraction phenotype in addition to its effects on the cholesterol concentration of all LDL subfractions and mean LDL particle size.
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