Abstract
Small, dense LDL particles are typical for FCHL. Intravascular lipid exchange and net transfer among HDL, LDL, and triglyceride-rich lipoproteins as well as lipolysis in the VLDL-IDL-LDL cascade regulate properties of LDL. We investigated postheparin plasma activities of hepatic lipase (HL) and LPL, and plasma activities of CETP and phospholipid transfer protein (PLTP) in 191 individuals from 37 Finnish FCHL families. LDL peak particle diameter (LDL size) was measured with 2–10% gradient polyacrylamide gel electrophoresis. LDL size was significantly smaller in affected FCHL family members (n = 68) as compared with nonaffected FCHL family members (n = 78) or spouses (n = 45) (25.3 ± 1.5 nm, 26.8 ± 1.2 nm, and 26.6 ± 1.2 nm, respectively, P < 0.001 for both). In affected FCHL family members, serum triglycerides were the strongest correlate for LDL size (r = −0.71, P < 0.001). In univariate correlation analysis LDL size was not associated with HL, LPL, CETP, and PLTP activities. In multivariate stepwise regression analysis, however, serum triglycerides, CETP activity, HL activity, and HDL cholesterol were significant predictors of LDL size in affected FCHL subjects (adjusted r2 = 0.642).▪We conclude that serum triglyceride concentration is strongly correlated with LDL size in affected FCHL subjects. After adjustment for serum triglycerides, HL and CETP activities are associated with LDL size in FCHL.—Vakkilainen, J., M. Jauhiainen, K. Ylitalo, I. O. Nuotio, J. S. A. Viikari, C. Ehnholm, and M-R. Taskinen. LDL particle size in familial combined hyperlipidemia: effects of serum lipids, lipoprotein-modifying enzymes, and lipid transfer proteins. J. Lipid Res. 2002. 43: 598–603.
Highlights
Small, dense LDL particles are typical for FCHL
There were no significant differences in gender distribution among the three groups
LDL size was significantly smaller in affected FCHL family members than in nonaffected FCHL family members or spouses (25.3 Ϯ 1.5 nm, 26.8 Ϯ 1.2 nm, and 26.6 Ϯ 1.2 nm, respectively, P Ͻ 0.001)
Summary
Dense LDL particles are typical for FCHL. Intravascular lipid exchange and net transfer among HDL, LDL, and triglyceride-rich lipoproteins as well as lipolysis in the VLDL-IDL-LDL cascade regulate properties of LDL. In affected FCHL family members, serum triglycerides were the strongest correlate for LDL size (r ؍؊0.71, P Ͻ 0.001). In multivariate stepwise regression analysis, serum triglycerides, CETP activity, HL activity, and HDL cholesterol were significant predictors of LDL size in affected FCHL subjects (adjusted r 2 ؍ 0.642). We conclude that serum triglyceride concentration is strongly correlated with LDL size in affected FCHL subjects. After adjustment for serum triglycerides, HL and CETP activities are associated with LDL size in FCHL.— Vakkilainen, J., M. Dense rather than large, buoyant LDL particles are more common among subjects with coronary artery disease [13,14,15]. It has been suggested that generation of small, dense LDL particles requires that serum triglyceride concentration is increased above the threshold level of approxi-. The diagnosis of FCHL is based on the occurrence of different types of dyslipidemia within the family: high cho-
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