Low-density Lipoprotein Cholesterol - A Good Biomarker or a Historical Leftover?

Mei-Teng Kao ； Din-I Wang

《Formosan Journal of Endocrinology and Metabolism》 8卷2期 (2017/12) Pp. 49-54

https://doi.org/10.6856/FJEM.201712_8(2).0001

摘要

Background. In many studies, low-density lipoprotein (LDL) cholesterol levels were found to be uncorrelated with whether people had coronary heart disease (CHD) or not. Findings. Elevated serum total and LDL cholesterol are considered to be major risk factors for CHD. However, it has been shown that subjects with high levels of small dense low-density lipoprotein particles have increased risk of CHD, independent of LDL cholesterol concentration. There are potential shortcomings of using LDL level to identify subjects with subclinical atherosclerosis or to detect how much that risk will be reduced by a statin. Results from dietary interventions showed that cardiovascular protective effects offered by diets could have no association with LDL cholesterol concentration. There is a huge medical heterogeneity among patients in routine practice and not all drugs that improve lipid profiles reduce patient risk for CHD. Conclusion. The medical community is not ought to just focusing on ＂cholesterol values＂. Moving beyond LDL cholesterol and statins to new areas such as emerging risk markers and novel adjunctive therapies is crucial for further reduction of residual cardiovascular risk.

關鍵字

low-density lipoproteins ； coronary heart disease ； statins ； surrogate marker