Lipoprotein Subfractions in Metabolic Syndrome and Obesity: Clinical Significance and Therapeutic Approaches

Abstract

Small, dense low density lipoprotein (sdLDL) represents an emerging cardiovascular risk factor, since these particles can be associated with cardiovascular disease (CVD) independently of established risk factors, including plasma lipids. Obese subjects frequently have atherogenic dyslipidaemia, including elevated sdLDL levels, in addition to elevated triglycerides (TG), very low density lipoprotein (VLDL) and apolipoprotein-B, as well as decreased high density lipoprotein cholesterol (HDL-C) levels. Obesity-related co-morbidities, such as metabolic syndrome (MetS) are also characterized by dyslipidaemia. Therefore, agents that favourably modulate LDL subclasses may be of clinical value in these subjects. Statins are the lipid-lowering drug of choice. Also, anti-obesity and lipid lowering drugs other than statins could be useful in these patients. However, the effects of anti-obesity drugs on CVD risk factors remain unclear. We review the clinical significance of sdLDL in being overweight and obesity, as well as the efficacy of anti-obesity drugs on LDL subfractions in these individuals; a short comment on HDL subclasses is also included. Our literature search was based on PubMed and Scopus listings. Further research is required to fully explore both the significance of sdLDL and the efficacy of anti-obesity drugs on LDL subfractions in being overweight, obesity and MetS. Improving the lipoprotein profile in these patients may represent an efficient approach for reducing cardiovascular risk.

Polymorphisms in PPARG and APOE: relationships with lipid profile of adolescents with cardiovascular risk factors

“…The presence of dyslipidemia in childhood and adolescence may indicate a higher risk of developing CVD, since there is a tendency for these young people to maintain similar profiles in adulthood [18,19]. Lower levels of HDL-C observed in overweight adolescents are consistent with published reports that show secondary dyslipidemia arising from obesity, with reduction in HDL-C [20]. The frequency of Ala allele for PPARG polymorphism among our adolescents was similar to those found in studies with other populations, such as Polish (15.5%) [21], Chinese (10.7%) [22], and Hungarian obese children and adolescents (14.6%) [23].…”

The Proportion of Nervonic Acid in Serum Lipids is Associated with Serum Plasmalogen Levels and Metabolic Syndrome

“…2 . The results suggest that these VLCFAs are a potential indicator of MetS, because the dyslipidemia of MetS is characterized by the low level of HDL-C and high levels of TG and sdLDL 29 .…”

The Effects of Anti-Diabetic Drugs on LDL Subclasses: Any Role for Colesevelam?

“…Smaller, more dense LDL are those more strongly associated with cardiovascular risk, as shown in the last years in more than a hundred studies, including epidemiological and cross-sectional studies, clinical intervention trials as well as angiographic studies [5]. Recently, Hoogeveen et al [6] have measured sdLDL-cholesterol in 11,419 men and women of the Atherosclerosis Risk in Communities study.…”