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September 18, 1996

Small, Dense Low-Density Lipoprotein Particles and Coronary Heart Disease RiskA Clear Association With Uncertain Implications

Author Affiliations

From the Departments of Epidemiology and Medicine and the Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins Medical Institutions, Baltimore, Md.

JAMA. 1996;276(11):914-915. doi:10.1001/jama.1996.03540110068034

Two articles in this issue of The Journal1,2 examine prospectively whether smaller low-density lipoprotein (LDL) particle size predicts coronary heart disease (CHD) incidence. The heterogeneity of LDL particles with respect to size, density, and composition is well recognized. A predominance of small LDL particles in the plasma is often accompanied by hepatic overproduction of very low-density lipoproteins (VLDLs) and hypertriglyceridemia. Exchange of triglycerides from the VLDL core with cholesteryl esters from the LDL core and subsequent hydrolysis of the triglycerides result in smaller LDL particles. These smaller LDL particles are denser since they still contain the same amount of protein (apolipoprotein B [apo B]) as other LDL particles but a smaller amount of lipids, which are more buoyant. Thus, the LDL apo B level measures the number of LDL particles, while LDL cholesterol (LDL-C) is a measure which combines the number of particles and their cholesterol content.

See also

Stampfer MJ, Krauss RM, Ma J, et al.  A prospective study of triglycerides, LDL particle diameter, and risk of myocardial infarction . JAMA . 1996;276:882-888.Article
Gardner CD, Fortmann SP, Krauss RM.  Association of small low-density lipoprotein particles with the incidence of coronary artery disease in men and women . JAMA . 1996;276:875-881.Article
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