This JAMA Insights explains how recent studies have clarified the role of lipids and lipoproteins in the development of atherosclerotic cardiovascular disease (ASCVD) and led to changes in clinical practice guidelines for the management of dyslipidemia.1
Cholesterol and triglycerides are the major lipids in humans and are transported in plasma by lipoproteins. A lipoprotein is composed of cholesterol, triglycerides, and a single apolipoprotein B100 molecule (apoB) when secreted into plasma by the liver, and is referred to as a very low-density lipoprotein (VLDL). The triglycerides are rapidly removed by the enzyme lipoprotein lipase and used for energy consumption and storage. As triglycerides are being progressively removed, the lipoprotein is referred to as a VLDL remnant particle. After most of the triglycerides have been removed, the lipoprotein becomes denser and is referred to as a low-density lipoprotein (LDL). However, it is important to recognize that a VLDL particle, a remnant particle, and an LDL particle are merely different names for the same circulating apoB lipoprotein at different stages in its lifecycle, depending on the lipid content that it carries.
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Ference BA, Kastelein JJP, Catapano AL. Lipids and Lipoproteins in 2020. JAMA. Published online July 22, 2020. doi:10.1001/jama.2020.5685
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