Small, Dense Low-Density Lipoprotein-Cholesterol and Atherosclerosis: Relationship and Therapeutic Strategies.

Xiao Jin,Jing Lu,Shengjie Yang,Min Wu

doi:10.3389/fcvm.2021.804214

Abstract

Low-density lipoprotein cholesterol (LDL-C) plays an important role in the formation, incidence, and development of atherosclerosis (AS). Low-density lipoproteins can be divided into two categories: large and light LDL-C and small, dense low-density lipoprotein cholesterol (sdLDL-C). In recent years, an increasing number of studies have shown that sdLDL-C has a strong ability to cause AS because of its unique characteristics, such as having small-sized particles and low density. Therefore, this has become the focus of further research. However, the specific mechanisms regarding the involvement of sdLDL-C in AS have not been fully explained. This paper reviews the possible mechanisms of sdLDL-C in AS by reviewing relevant literature in recent years. It was found that sdLDL-C can increase the atherogenic effect by regulating the activity of gene networks, monocytes, and enzymes. This article also reviews the research progress on the effects of sdLDL-C on endothelial function, lipid metabolism, and inflammation; it also discusses its intervention effect. Diet, exercise, and other non-drug interventions can improve sdLDL-C levels. Further, drug interventions such as statins, fibrates, ezetimibe, and niacin have also been found to improve sdLDL-C levels.

Highlights

Atherosclerosis (AS) is the formation of fibrofatty lesions within the arterial wall, and it causes widespread morbidity and mortality worldwide together with heart muscle infarction, stroke, and disabling peripheral artery illness [1]
MO) kits can quickly detect the concentrations of sdLDL-C but do not rule out the possibility of cross-reactions, so it remains to be verified whether they can be used in clinical settings [10]
The results showed that compared with Low-density lipoprotein cholesterol (LDL-C), sdLDL-C had a stronger correlation with the progress of carotid intimal medial thickness (cIMT)

Summary

Introduction

Atherosclerosis (AS) is the formation of fibrofatty lesions within the arterial wall, and it causes widespread morbidity and mortality worldwide together with heart muscle infarction, stroke, and disabling peripheral artery illness [1]. AS could be a major condition that seriously harms human health and is understood as the major cause of mortality in developed countries, but globally [2]. In the field of lipid metabolism, a number of irrefutable pieces of evidence have proven the pathogenic role of low-density lipoprotein cholesterol (LDL-C) in AS, so we have extremely effective tools to reduce LDL-C levels, reducing the occurrence of cardiovascular events [2]. Some studies have shown the correlation between different low-density lipoprotein (LDL) subgroups and the occurrence of AS, in which small, dense low-density lipoprotein cholesterol (sdLDL-C) is closely related to and has a stronger effect on AS [6]. This study aimed to explore the relationship between sdLDL-C levels and AS

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Conclusion