Lipids and Lipoproteins: Analysis and Assessment in Models of Atherosclerosis

摘要

Lipids and lipoproteins play a central role in the pathogenesis of atherosclerosis and its clinical sequale, coronary heart disease, stroke, and peripheral vascular disease. Since lipids are insoluble in water the bulk of the lipids in the blood are transported as part of a complex with specific proteins, called lipoproteins. Knowledge of an individual's lipoprotein profile is essential to the evaluation of risk of developing atherosclerosis, and of efficacy of treatment. In addition, some lipoproteins [LDL, VLDL, Lp(a)] promote the development of atherosclerosis, while others (HDL), are protective. Although a number of risk factors have been identified (hypertension, smoking, diabetes, etc.), hypercholesterolemia is the only risk factor that by itself will produce atherosclerosis in animal models and man. In human beings this is seen most clearly in the disease, Familial Hypercholesterolemia. In 1985, the National Cholesterol Education Program (NCEP) established plasma total cholesterol concentrations of 200-240 mg/dl (5.17-6.21 mmol/l), as the level above which a medical decision is made. They also established that medical decisions would be based on specific LDL-Cholesterol (LDLC) concentrations. For this to be effective, a national cholesterolstandardization program was established to monitor accuracy and precision of lipid and lipoprotein measurements. Cholesterol was the first clinical analyte for which national performance standards were established. For more information on the CDC-Lipidand lipoprotein standardization programs see (www.cdc.aov/nceh/dls/crmln/crmln.htm). Only commercial labs and chemistry analyzers that meet this level of performance should be used for cholesterol, triglyceride, LDLC, HDLC and other lipid and lipoproteinmeasurements. The same standards should apply for these measurements in animals. Caution is needed, however, for the measurement of lipoproteins using antibody-based methods [e.g. direct HDL, LDL, Lp(a)] for animals in which verification of specificityof the antibody has not been established for that animal species.