Dove Medical Press (Taylor and Francis Group) · 2009 · 131 citations · 0 references
Open access
MedicineCardiologyClinical CardiologyLipid BiochemistryPreventive CardiologyCardiovascular DiseaseCardiovascular Disease PreventionCardiovascular RiskLipid-lowering TherapyLipoprotein AnalysisLipoprotein MetabolismAtherogenic Lipoprotein AssessmentCardiovascular Risk MarkersCardiovascular Risk Stratification Using LipoproteinsLipid Risk AssessmentLow-density Lipoprotein Cholesterol TargetsLow-density Lipoprotein ParticlesPlasma Cholesterol LevelsTreatment Targets In Dyslipidemia
Low‑density lipoprotein cholesterol has long been the primary index of cardiovascular risk, yet several lipoprotein ratios have been proposed to enhance predictive accuracy. This review summarizes the pathophysiology of lipoprotein ratios and argues for their use as risk factors in clinical practice, outlining cut‑off levels and lipid‑lowering targets. Total/HDL and LDL/HDL ratios outperform isolated lipid measures, particularly LDL, and future dyslipidemia guidelines should incorporate HDL‑containing ratios. Keywords: apolipoproteins, cholesterol ratios, predictive power, cardiovascular disorders.
Abstract: Low-density lipoprotein (LDL) cholesterol concentration has been the prime index of cardiovascular disease risk and the main target for therapy. However, several lipoprotein ratios or “atherogenic indices” have been defined in an attempt to optimize the predictive capacity of the lipid profile. In this review, we summarize their pathophysiological aspects, and highlight the rationale for using these lipoprotein ratios as cardiovascular risk factors in clinical practice, specifying their cut-off risk levels and a target for lipid-lowering therapy. Total/high-density lipoprotein (HDL) cholesterol and LDL/HDL cholesterol ratios are risk indicators with greater predictive value than isolated parameters used independently, particularly LDL. Future recommendations regarding the diagnosis and treatment of dyslipidemia, including instruments for calculating cardiovascular risk or action guidelines, should include the lipoprotein ratios with greater predictive power which, in view of the evidence-based results, are none other than those which include HDL cholesterol. Keywords: apolipoproteins, cholesterol ratios, predictive power, cardiovascular disorders