Summary :It is generally accepted that cholesterol-rich low density lipoproteins are more significantly associated with atherosclerotic disease than triglyceride-rich very low density lipoproteins. This paper addresses two aspects of the atherogenic potentials of apoB-containing lipoproteins, the first of which relates to the differential atherogenicity of apoB-containing lipoproteins and the second to the adequacy of plasma triglycerides as a marker for atherogenic capacity of triglyceride-rich lipoproteins. These topics are explored and discussed on the basis of the lipoprotein family concept that classifies plasma lipoproteins on the basis of their unique apolipoprotein composition rather than density properties. A brief presentation of the lipoprotein family concept is followed by a review of recent epidemiologic and clinical studies from this and other laboratories showing that some intact or partially delipidized triglyceride-rich lipoproteins possess atherogenic capacities equal, to if not greater than, those of cholesterol-rich lipoproteins. Furthermore, the concept of differential atherogenicity of apoB-containing lipoprotein families is introduced and the evidence is presented that the apoC-III levels associated with apoB-containing lipoproteins are a more consistent independent marker for the atherogenicity of triglyceride-rich lipoproteins than plasma triglycerides.Keywords : lipids, apolipoproteins, lipoprotein families, atherogenicity.
ARTICLEProspective epidemiologic studies have demonstrated that hypercholesterolemia is more significantly associated with atherosclerotic disease than hypertriglyceridemia and that cholesterol (CHOL)-rich low density lipoprotein (LDL) particles have a greater atherogenic potential than triglyceride (TG)-rich lipoproteins [1][2][3]. Furthermore, a number of prospective clinical trials have established that the lowering of LDL-C levels has a beneficial effect on the progression and stabilization of atherosclerotic lesions and reduction of coronary events [4,5]. However, despite aggressive LDL-C reduction, 20-50% of patients continue to show progression of atherosclerosis [6]. Clearly, factors in addition to CHOL-rich LDL particles contribute to the progression of atherosclerosis in these patients. Since hypertriglyceridemia with or without hypercholesterolemia occurs more frequently in patients with premature coronary artery disease (CAD) [7], one of these possible factors may be increased levels of intact or modified TG-rich lipoproteins [8][9][10].Although most case-control studies have shown a strong univariate association between plasma TG levels and CAD, prospective studies have provided little evidence that TG levels represent an independent risk factor for CAD after adjustments are made for other traditional risk factors such as Article disponible sur le site http://www.ocl-journal.org ou http://dx