Metabolism of atherogenic lipoproteins

Early development of atherosclerosis results from a complex multifactorial process where lipoprotein anomalies play a predominant role. The metabolism of lipoproteins is regulated by numerous reactions between the structural components of the lipoproteins and the receptors and/or enzymes with which they interact, Among the well-characterized anomalies, the elevation of sma ll and dense LDL and/or the diminution of HDL levels are in First line of t he factors involved in the formation of atheromatous plaques. LDL play a di rect role by penetrating the intima or the arteries and HDL play an reverse transport of cholesterol from cells to the liver, There has been a long de bate concerning risk related to triglyceride rich lipoproteins (TGRL), and more particularly the increase in VLDL, However, a large number of studies have demonstrated that these ephemeral lipoproteins can acquire major ather ogenic potential when their level is increased and/or they are associated w ith perturbed metabolism leading to an accumulation of remnants. Current investigation methods have shown that LDL and HDL-cholesterol level s are excellent markers of LDL and HDL concentrations, Inversely, triglycer ide levels provide little information concerning the nature of the elevated TGRL and lasting hypertriglyceridemia, even If moderate, should therefore be considered as a warning sign of persistent atherogeneous remnants in the fasting state.