Jin Xiao, Yang Shengjie, Lu Jing, Wu Min
General Department of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Beijing University of Chinese Medicine, Beijing, China.
Front Cardiovasc Med. 2022 Feb 10;8:804214. doi: 10.3389/fcvm.2021.804214. eCollection 2021.
Low-density lipoprotein cholesterol (LDL-C) plays an important role in the formation, incidence, and development of atherosclerosis (AS). Low-density lipoproteins can be divided into two categories: large and light LDL-C and small, dense low-density lipoprotein cholesterol (sdLDL-C). In recent years, an increasing number of studies have shown that sdLDL-C has a strong ability to cause AS because of its unique characteristics, such as having small-sized particles and low density. Therefore, this has become the focus of further research. However, the specific mechanisms regarding the involvement of sdLDL-C in AS have not been fully explained. This paper reviews the possible mechanisms of sdLDL-C in AS by reviewing relevant literature in recent years. It was found that sdLDL-C can increase the atherogenic effect by regulating the activity of gene networks, monocytes, and enzymes. This article also reviews the research progress on the effects of sdLDL-C on endothelial function, lipid metabolism, and inflammation; it also discusses its intervention effect. Diet, exercise, and other non-drug interventions can improve sdLDL-C levels. Further, drug interventions such as statins, fibrates, ezetimibe, and niacin have also been found to improve sdLDL-C levels.
低密度脂蛋白胆固醇（LDL-C）在动脉粥样硬化（AS）的形成、发病及发展过程中起重要作用。低密度脂蛋白可分为两类：大而轻的LDL-C和小而密的低密度脂蛋白胆固醇（sdLDL-C）。近年来，越来越多的研究表明，sdLDL-C因其颗粒小、密度低等独特特性而具有很强的致AS能力。因此，这已成为进一步研究的焦点。然而，sdLDL-C参与AS的具体机制尚未完全阐明。本文通过回顾近年来的相关文献，综述了sdLDL-C在AS中的可能机制。研究发现，sdLDL-C可通过调节基因网络、单核细胞及酶的活性来增强致动脉粥样硬化作用。本文还综述了sdLDL-C对内皮功能、脂质代谢及炎症影响的研究进展；并讨论了其干预作用。饮食、运动等非药物干预可改善sdLDL-C水平。此外，他汀类药物、贝特类药物、依折麦布及烟酸等药物干预也已被发现可改善sdLDL-C水平。
