Relationship of LDL-C & LDL-P

Lipoprotein Particles LipoScience 2007 NON-POLAR LIPID CORE Cholesterol Ester Triglyceride POLAR SURFACE COAT Phospholipid Free cholesterol Apolipoprotein

At the same LDL cholesterol, with the same-size LDL particles (at any triglyceride level) Up to 40% More Particles Less Cholesterol Carried Per Particle Normal Cholesterol Carried Per Particle 100 mg/dL Otvos JD et al. Am J Cardiol 2002;90(suppl):22i-29i Among Individuals With The Same LDL-C Level, The Number of LDL Particles Varies Cromwell WC et al. J Clin Lipidology. 2007;1(6): Cholesterol Balance

HDL Cholesterol (mg/dL) LDL Cholesterol LDL Particles LDL Particles (nmol/L) Triglycerides (mg/dL) LDL Particles LDL Cholesterol LDL Cholesterol (mg/dL) Relations of LDL Particles and LDL Cholesterol to Levels of HDL Cholesterol and Triglycerides Framingham Offspring Study Cromwell WC and Otvos JD. Curr Athero Reports 2004;6:

<5 th 20 th 50 th 80 th LDL-C (mg/dL) Framingham 1 < Measured ApoB (mg/dL) Framingham 1 < NMR LDL-P (nmol/L) Framingham 1 < MESA 2 < Population Equivalent Cutpoints for Alternate LDL Measures (LDL-C, Measured Apo B and NMR LDL-P) 1 Contois, et al. Clinical Chemistry 2009;55: Cromwell WC. Clinical Challenges in Lipid Disorders. Oxford:Clinical Publishing, 2008:

The cholesterol in LDL (LDL-C) does not equate to the number of LDL particles (LDL-P) because the cholesterol content per LDL particle is highly variable. Concordance and discordance refer to when LDL-C and LDL-P levels agree or disagree. – When LDL-C and LDL-P are concordant (ie., equally high or low), either LDL measure is an equally good guide to LDL treatment decision-making. – When LDL-C and LDL-P are discordant (ie., one is lower or higher than the other), LDL-P may be considered to aid in clinical management of LDL related risk for CVD. Alternate Measures of LDL Quantity are Not Equivalent 1 Davidson, et al. J Clin Lipidol 2011;5: