On the atherogenicity of triglyceride-rich lipoproteins and novel markers for the assessment of their atherogenic potentials

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