Krauss R M
Am Heart J. 1987 Feb;113(2 Pt 2):578-82. doi: 10.1016/0002-8703(87)90636-3.
Recent studies have shown that heterogeneity of human plasma low-density lipoproteins (LDL) is, in part, the result of production of different LDL products from two subspecies of intermediate-density lipoproteins (IDL). Cholesterol-enriched forms of both IDL species are found in plasma of patients with atherogenic dyslipidemias (familial hypercholesterolemia and type 3 hyperlipoproteinemia) and have physical properties similar to the major species in plasma of cholesterol-fed monkeys. Patients with familial combined hyperlipidemia have been shown to have increased plasma levels of IDL and of a smaller, denser LDL subclass (LDL-IIIA) that appears to be a metabolic product of the smaller IDL subspecies. Results from the NHLBI Type II Coronary Intervention study have supported a link between the small IDL-LDL pathway and coronary disease, in that 2-year changes in levels of these species were associated with disease progression. Furthermore, therapeutic reductions in IDL levels were correlated with increases in high-density lipoprotein cholesterol. Thus variation in IDL levels might influence coronary disease risk by both a direct effect and indirectly by affecting LDL particle number and possibly high-density lipoprotein metabolism.
近期研究表明，人类血浆低密度脂蛋白（LDL）的异质性部分源于中密度脂蛋白（IDL）的两个亚类产生了不同的LDL产物。富含胆固醇的两种IDL类型均存在于致动脉粥样硬化血脂异常（家族性高胆固醇血症和Ⅲ型高脂蛋白血症）患者的血浆中，其物理性质与喂食胆固醇的猴子血浆中的主要类型相似。已证实，家族性混合性高脂血症患者血浆中IDL以及一种更小、密度更高的LDL亚类（LDL-IIIA）水平升高，后者似乎是较小IDL亚类的代谢产物。美国国立心肺血液研究所（NHLBI）II型冠状动脉干预研究的结果支持了小IDL-LDL途径与冠状动脉疾病之间的联系，因为这些类型的水平在2年中的变化与疾病进展相关。此外，IDL水平的治疗性降低与高密度脂蛋白胆固醇的升高相关。因此，IDL水平的变化可能通过直接作用以及间接影响LDL颗粒数量和可能的高密度脂蛋白代谢来影响冠状动脉疾病风险。
