Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis
Despite the numerous risk factors for atherosclerotic cardiovascular diseases (ASCVD), cumulative evidence shows that electronegative low-density lipoprotein (L5 LDL) cholesterol is a promising biomarker. Its toxicity may contribute to atherothrombotic events. Notably, plasma L5 LDL levels positivel...
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MDPI AG
2020-07-01
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| Online Access: | https://www.mdpi.com/2227-9059/8/8/254 |
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| author | Chih-Sheng Chu Shi Hui Law David Lenzen Yong-Hong Tan Shih-Feng Weng Etsuro Ito Jung-Chou Wu Chu-Huang Chen Hua-Chen Chan Liang-Yin Ke |
| author_facet | Chih-Sheng Chu Shi Hui Law David Lenzen Yong-Hong Tan Shih-Feng Weng Etsuro Ito Jung-Chou Wu Chu-Huang Chen Hua-Chen Chan Liang-Yin Ke |
| author_sort | Chih-Sheng Chu |
| collection | DOAJ |
| description | Despite the numerous risk factors for atherosclerotic cardiovascular diseases (ASCVD), cumulative evidence shows that electronegative low-density lipoprotein (L5 LDL) cholesterol is a promising biomarker. Its toxicity may contribute to atherothrombotic events. Notably, plasma L5 LDL levels positively correlate with the increasing severity of cardiovascular diseases. In contrast, traditional markers such as LDL-cholesterol and triglyceride are the therapeutic goals in secondary prevention for ASCVD, but that is controversial in primary prevention for patients with low risk. In this review, we point out the clinical significance and pathophysiological mechanisms of L5 LDL, and the clinical applications of L5 LDL levels in ASCVD can be confidently addressed. Based on the previously defined cut-off value by receiver operating characteristic curve, the acceptable physiological range of L5 concentration is proposed to be below 1.7 mg/dL. When L5 LDL level surpass this threshold, clinically relevant ASCVD might be present, and further exams such as carotid intima-media thickness, pulse wave velocity, exercise stress test, or multidetector computed tomography are required. Notably, the ultimate goal of L5 LDL concentration is lower than 1.7 mg/dL. Instead, with L5 LDL greater than 1.7 mg/dL, lipid-lowering treatment may be required, including statin, ezetimibe or PCSK9 inhibitor, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Since L5 LDL could be a promising biomarker, we propose that a high throughput, clinically feasible methodology is urgently required not only for conducting a prospective, large population study but for developing therapeutics strategies to decrease L5 LDL in the blood. |
| first_indexed | 2024-03-10T18:05:52Z |
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| language | English |
| last_indexed | 2024-03-10T18:05:52Z |
| publishDate | 2020-07-01 |
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| series | Biomedicines |
| spelling | doaj.art-2501fc44a0f043fbae3d3b48c6c6f1772023-11-20T08:28:08ZengMDPI AGBiomedicines2227-90592020-07-018825410.3390/biomedicines8080254Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in AtherothrombosisChih-Sheng Chu0Shi Hui Law1David Lenzen2Yong-Hong Tan3Shih-Feng Weng4Etsuro Ito5Jung-Chou Wu6Chu-Huang Chen7Hua-Chen Chan8Liang-Yin Ke9Center for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807377, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, TaiwanDepartment of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, TaiwanDivision of Cardiology, Department of Internal Medicine, Pingtung Christian Hospital, Pingtung 90059, TaiwanVascular and Medicinal Research, Texas Heart Institute, Houston, TX 77030, USACenter for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807377, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, TaiwanDespite the numerous risk factors for atherosclerotic cardiovascular diseases (ASCVD), cumulative evidence shows that electronegative low-density lipoprotein (L5 LDL) cholesterol is a promising biomarker. Its toxicity may contribute to atherothrombotic events. Notably, plasma L5 LDL levels positively correlate with the increasing severity of cardiovascular diseases. In contrast, traditional markers such as LDL-cholesterol and triglyceride are the therapeutic goals in secondary prevention for ASCVD, but that is controversial in primary prevention for patients with low risk. In this review, we point out the clinical significance and pathophysiological mechanisms of L5 LDL, and the clinical applications of L5 LDL levels in ASCVD can be confidently addressed. Based on the previously defined cut-off value by receiver operating characteristic curve, the acceptable physiological range of L5 concentration is proposed to be below 1.7 mg/dL. When L5 LDL level surpass this threshold, clinically relevant ASCVD might be present, and further exams such as carotid intima-media thickness, pulse wave velocity, exercise stress test, or multidetector computed tomography are required. Notably, the ultimate goal of L5 LDL concentration is lower than 1.7 mg/dL. Instead, with L5 LDL greater than 1.7 mg/dL, lipid-lowering treatment may be required, including statin, ezetimibe or PCSK9 inhibitor, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Since L5 LDL could be a promising biomarker, we propose that a high throughput, clinically feasible methodology is urgently required not only for conducting a prospective, large population study but for developing therapeutics strategies to decrease L5 LDL in the blood.https://www.mdpi.com/2227-9059/8/8/254electronegative low-density lipoproteinLDL(–)L5 LDLoxidized LDLoxLDLcardiovascular disease |
| spellingShingle | Chih-Sheng Chu Shi Hui Law David Lenzen Yong-Hong Tan Shih-Feng Weng Etsuro Ito Jung-Chou Wu Chu-Huang Chen Hua-Chen Chan Liang-Yin Ke Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis Biomedicines electronegative low-density lipoprotein LDL(–) L5 LDL oxidized LDL oxLDL cardiovascular disease |
| title | Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis |
| title_full | Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis |
| title_fullStr | Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis |
| title_full_unstemmed | Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis |
| title_short | Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis |
| title_sort | clinical significance of electronegative low density lipoprotein cholesterol in atherothrombosis |
| topic | electronegative low-density lipoprotein LDL(–) L5 LDL oxidized LDL oxLDL cardiovascular disease |
| url | https://www.mdpi.com/2227-9059/8/8/254 |
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