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class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#LDL_size_patterns"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>LDL size patterns</span> </div> </a> <ul id="toc-LDL_size_patterns-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Oxidized_LDL" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Oxidized_LDL"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4</span> <span>Oxidized LDL</span> </div> </a> <ul id="toc-Oxidized_LDL-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Testing" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Testing"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Testing</span> </div> </a> <button aria-controls="toc-Testing-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Testing subsection</span> </button> <ul id="toc-Testing-sublist" class="vector-toc-list"> <li id="toc-Estimation_of_LDL_particles_via_cholesterol_content" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Estimation_of_LDL_particles_via_cholesterol_content"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Estimation of LDL particles via cholesterol content</span> </div> </a> <ul id="toc-Estimation_of_LDL_particles_via_cholesterol_content-sublist" class="vector-toc-list"> <li id="toc-Normal_ranges" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Normal_ranges"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1.1</span> <span>Normal ranges</span> </div> </a> <ul id="toc-Normal_ranges-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Direct_measurement_of_LDL_particle_concentrations" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Direct_measurement_of_LDL_particle_concentrations"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Direct measurement of LDL particle concentrations</span> </div> </a> <ul id="toc-Direct_measurement_of_LDL_particle_concentrations-sublist" class="vector-toc-list"> <li id="toc-Optimal_ranges" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Optimal_ranges"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.1</span> <span>Optimal ranges</span> </div> </a> <ul id="toc-Optimal_ranges-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Lowering_LDL-cholesterol" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Lowering_LDL-cholesterol"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Lowering LDL-cholesterol</span> </div> </a> <button aria-controls="toc-Lowering_LDL-cholesterol-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Lowering LDL-cholesterol subsection</span> </button> <ul id="toc-Lowering_LDL-cholesterol-sublist" class="vector-toc-list"> <li id="toc-Pharmaceutical" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pharmaceutical"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Pharmaceutical</span> </div> </a> <ul id="toc-Pharmaceutical-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lifestyle" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lifestyle"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>Lifestyle</span> </div> </a> <ul id="toc-Lifestyle-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Research</span> </div> </a> <button aria-controls="toc-Research-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Research subsection</span> </button> <ul id="toc-Research-sublist" class="vector-toc-list"> <li id="toc-Gene_editing" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gene_editing"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Gene editing</span> </div> </a> <ul id="toc-Gene_editing-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Notes_and_references" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Notes_and_references"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Notes and references</span> </div> </a> <ul id="toc-Notes_and_references-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Low-density lipoprotein</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 36 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-36" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">36 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A8%D8%B1%D9%88%D8%AA%D9%8A%D9%86_%D8%AF%D9%87%D9%86%D9%8A_%D9%85%D9%86%D8%AE%D9%81%D8%B6_%D8%A7%D9%84%D9%83%D8%AB%D8%A7%D9%81%D8%A9" title="بروتين دهني منخفض الكثافة – Arabic" lang="ar" hreflang="ar" data-title="بروتين دهني منخفض الكثافة" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/A%C5%9Fa%C4%9F%C4%B1_s%C4%B1xl%C4%B1ql%C4%B1_lipoproteinl%C9%99r" title="Aşağı sıxlıqlı lipoproteinlər – Azerbaijani" lang="az" hreflang="az" data-title="Aşağı sıxlıqlı lipoproteinlər" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%9B%D0%B8%D0%BF%D0%BE%D0%BF%D1%80%D0%BE%D1%82%D0%B5%D0%B8%D0%BD%D0%B8_%D1%81_%D0%BD%D0%B8%D1%81%D0%BA%D0%B0_%D0%BF%D0%BB%D1%8A%D1%82%D0%BD%D0%BE%D1%81%D1%82" title="Липопротеини с ниска плътност – Bulgarian" lang="bg" hreflang="bg" data-title="Липопротеини с ниска плътност" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Lipoprotein_niske_gustine" title="Lipoprotein niske gustine – Bosnian" lang="bs" hreflang="bs" data-title="Lipoprotein niske gustine" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca badge-Q70893996 mw-list-item" title=""><a href="https://ca.wikipedia.org/wiki/Lipoprote%C3%AFnes_de_baixa_densitat" title="Lipoproteïnes de baixa densitat – Catalan" lang="ca" hreflang="ca" data-title="Lipoproteïnes de baixa densitat" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/N%C3%ADzkodenzitn%C3%AD_lipoprotein" title="Nízkodenzitní lipoprotein – Czech" lang="cs" hreflang="cs" data-title="Nízkodenzitní lipoprotein" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Low_Density_Lipoprotein" title="Low Density Lipoprotein – German" lang="de" hreflang="de" data-title="Low Density Lipoprotein" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%9B%CE%B9%CF%80%CE%BF%CF%80%CF%81%CF%89%CF%84%CE%B5%CE%90%CE%BD%CE%B7_%CF%87%CE%B1%CE%BC%CE%B7%CE%BB%CE%AE%CF%82_%CF%80%CF%85%CE%BA%CE%BD%CF%8C%CF%84%CE%B7%CF%84%CE%B1%CF%82" title="Λιποπρωτεΐνη χαμηλής πυκνότητας – Greek" lang="el" hreflang="el" data-title="Λιποπρωτεΐνη χαμηλής πυκνότητας" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Lipoprote%C3%ADna_de_baja_densidad" title="Lipoproteína de baja densidad – Spanish" lang="es" hreflang="es" data-title="Lipoproteína de baja densidad" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Dentsitate_txikiko_lipoproteina" title="Dentsitate txikiko lipoproteina – Basque" lang="eu" hreflang="eu" data-title="Dentsitate txikiko lipoproteina" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%84%DB%8C%D9%BE%D9%88%D9%BE%D8%B1%D9%88%D8%AA%D8%A6%DB%8C%D9%86_%DA%A9%D9%85%E2%80%8C%DA%86%DA%AF%D8%A7%D9%84%DB%8C" title="لیپوپروتئین کم‌چگالی – Persian" lang="fa" hreflang="fa" data-title="لیپوپروتئین کم‌چگالی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Lipoprot%C3%A9ine_de_basse_densit%C3%A9" title="Lipoprotéine de basse densité – French" lang="fr" hreflang="fr" data-title="Lipoprotéine de basse densité" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Lipeapr%C3%B3it%C3%A9in_%C3%ADsealdl%C3%BAis" title="Lipeapróitéin ísealdlúis – Irish" lang="ga" hreflang="ga" data-title="Lipeapróitéin ísealdlúis" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Lipoprote%C3%ADna_de_baixa_densidade" title="Lipoproteína de baixa densidade – Galician" lang="gl" hreflang="gl" data-title="Lipoproteína de baixa densidade" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%A0%80%EB%B0%80%EB%8F%84_%EC%A7%80%EC%A7%88%EB%8B%A8%EB%B0%B1%EC%A7%88" title="저밀도 지질단백질 – Korean" lang="ko" hreflang="ko" data-title="저밀도 지질단백질" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%A8%E0%A4%BF%E0%A4%AE%E0%A5%8D%E0%A4%A8_%E0%A4%98%E0%A4%A8%E0%A4%A4%E0%A5%8D%E0%A4%B5_%E0%A4%95%E0%A5%8B%E0%A4%B2%E0%A5%87%E0%A4%B8%E0%A5%8D%E0%A4%9F%E0%A5%8D%E0%A4%B0%E0%A5%89%E0%A4%B2" title="निम्न घनत्व कोलेस्ट्रॉल – Hindi" lang="hi" hreflang="hi" data-title="निम्न घनत्व कोलेस्ट्रॉल" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Lipoprotein_densitas_rendah" title="Lipoprotein densitas rendah – Indonesian" lang="id" hreflang="id" data-title="Lipoprotein densitas rendah" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Lipoproteine_a_bassa_densit%C3%A0" title="Lipoproteine a bassa densità – Italian" lang="it" hreflang="it" data-title="Lipoproteine a bassa densità" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9B%D0%B8%D0%BF%D0%BE%D0%B1%D0%B5%D0%BB%D0%BA%D0%BE%D0%B2%D0%B8%D0%BD%D0%B0_%D1%81%D0%BE_%D0%BC%D0%B0%D0%BB%D0%B0_%D0%B3%D1%83%D1%81%D1%82%D0%B8%D0%BD%D0%B0" title="Липобелковина со мала густина – Macedonian" lang="mk" hreflang="mk" data-title="Липобелковина со мала густина" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Lagedichtheidlipoprote%C3%AFne" title="Lagedichtheidlipoproteïne – Dutch" lang="nl" hreflang="nl" data-title="Lagedichtheidlipoproteïne" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Low_density_lipoprotein" title="Low density lipoprotein – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Low density lipoprotein" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Lipoproteina_o_niskiej_g%C4%99sto%C5%9Bci" title="Lipoproteina o niskiej gęstości – Polish" lang="pl" hreflang="pl" data-title="Lipoproteina o niskiej gęstości" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Lipoprote%C3%ADna_de_baixa_densidade" title="Lipoproteína de baixa densidade – Portuguese" lang="pt" hreflang="pt" data-title="Lipoproteína de baixa densidade" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Lipoproteine_de_densitate_mic%C4%83" title="Lipoproteine de densitate mică – Romanian" lang="ro" hreflang="ro" data-title="Lipoproteine de densitate mică" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9B%D0%B8%D0%BF%D0%BE%D0%BF%D1%80%D0%BE%D1%82%D0%B5%D0%B8%D0%BD%D1%8B_%D0%BD%D0%B8%D0%B7%D0%BA%D0%BE%D0%B9_%D0%BF%D0%BB%D0%BE%D1%82%D0%BD%D0%BE%D1%81%D1%82%D0%B8" title="Липопротеины низкой плотности – Russian" lang="ru" hreflang="ru" data-title="Липопротеины низкой плотности" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Lipoprotein_majhne_gostote" title="Lipoprotein majhne gostote – Slovenian" lang="sl" hreflang="sl" data-title="Lipoprotein majhne gostote" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9B%D0%B8%D0%BF%D0%BE%D0%BF%D1%80%D0%BE%D1%82%D0%B5%D0%B8%D0%BD%D0%B8_%D0%BD%D0%B8%D1%81%D0%BA%D0%B5_%D0%B3%D1%83%D1%81%D1%82%D0%B8%D0%BD%D0%B5" title="Липопротеини ниске густине – Serbian" lang="sr" hreflang="sr" data-title="Липопротеини ниске густине" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/LDL-kolesteroli" title="LDL-kolesteroli – Finnish" lang="fi" hreflang="fi" data-title="LDL-kolesteroli" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/LDL-kolesterol" title="LDL-kolesterol – Swedish" lang="sv" hreflang="sv" data-title="LDL-kolesterol" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%95%E0%AF%81%E0%AE%B1%E0%AF%88%E0%AE%AF%E0%AE%9F%E0%AE%B0%E0%AF%8D%E0%AE%A4%E0%AF%8D%E0%AE%A4%E0%AE%BF_%E0%AE%95%E0%AF%8A%E0%AE%B4%E0%AF%81%E0%AE%AE%E0%AE%BF%E0%AE%AF%E0%AE%AA%E0%AF%8D%E0%AE%AA%E0%AF%81%E0%AE%B0%E0%AE%A4%E0%AE%AE%E0%AF%8D" title="குறையடர்த்தி கொழுமியப்புரதம் – Tamil" lang="ta" hreflang="ta" data-title="குறையடர்த்தி கொழுமியப்புரதம்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%84%E0%B8%A5%E0%B9%82%E0%B8%9E%E0%B9%82%E0%B8%9B%E0%B8%A3%E0%B8%95%E0%B8%B5%E0%B8%99%E0%B8%AB%E0%B8%99%E0%B8%B2%E0%B9%81%E0%B8%99%E0%B9%88%E0%B8%99%E0%B8%95%E0%B9%88%E0%B8%B3" title="ไลโพโปรตีนหนาแน่นต่ำ – Thai" lang="th" hreflang="th" data-title="ไลโพโปรตีนหนาแน่นต่ำ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/D%C3%BC%C5%9F%C3%BCk_yo%C4%9Funluklu_lipoprotein" title="Düşük yoğunluklu lipoprotein – Turkish" lang="tr" hreflang="tr" data-title="Düşük yoğunluklu lipoprotein" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9B%D1%96%D0%BF%D0%BE%D0%BF%D1%80%D0%BE%D1%82%D0%B5%D1%97%D0%BD%D0%B8_%D0%BD%D0%B8%D0%B7%D1%8C%D0%BA%D0%BE%D1%97_%D0%B3%D1%83%D1%81%D1%82%D0%B8%D0%BD%D0%B8" title="Ліпопротеїни низької густини – Ukrainian" lang="uk" hreflang="uk" data-title="Ліпопротеїни низької густини" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Lipoprotein_m%E1%BA%ADt_%C4%91%E1%BB%99_th%E1%BA%A5p" title="Lipoprotein mật độ thấp – Vietnamese" lang="vi" hreflang="vi" data-title="Lipoprotein mật độ thấp" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E4%BD%8E%E5%AF%86%E5%BA%A6%E8%84%82%E8%9B%8B%E7%99%BD" title="低密度脂蛋白 – Wu" lang="wuu" hreflang="wuu" data-title="低密度脂蛋白" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target"><span>吴语</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E4%BD%8E%E5%AF%86%E5%BA%A6%E8%84%82%E8%9B%8B%E7%99%BD" title="低密度脂蛋白 – Chinese" lang="zh" hreflang="zh" data-title="低密度脂蛋白" data-language-autonym="中文" data-language-local-name="Chinese" 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<div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">One of the five major groups of lipoprotein</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"LDL" redirects here. For other uses, see <a href="/wiki/LDL_(disambiguation)" class="mw-disambig" title="LDL (disambiguation)">LDL (disambiguation)</a>.</div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Atheroma.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Atheroma.jpg/256px-Atheroma.jpg" decoding="async" width="256" height="144" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Atheroma.jpg/384px-Atheroma.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Atheroma.jpg/512px-Atheroma.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>LDL has been associated with the progression of atherosclerosis and blockage of the artery lumen, because it can carry cholesterol into smaller vessels. But LDL is also essential for carrying lipids that keep the human body alive, including in those small vessels.</figcaption></figure> <p><b>Low-density lipoprotein</b> (<b>LDL</b>) is one of the five major groups of <a href="/wiki/Lipoprotein" title="Lipoprotein">lipoprotein</a> that transport all <a href="/wiki/Fat" title="Fat">fat</a> molecules around the body in extracellular water.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> These groups, from least dense to most dense, are <a href="/wiki/Chylomicron" title="Chylomicron">chylomicrons</a> (aka <a href="/wiki/ULDL" class="mw-redirect" title="ULDL">ULDL</a> by the overall density naming convention), <a href="/wiki/Very_low-density_lipoprotein" title="Very low-density lipoprotein">very low-density lipoprotein</a> (VLDL), <a href="/wiki/Intermediate-density_lipoprotein" title="Intermediate-density lipoprotein">intermediate-density lipoprotein</a> (IDL), low-density lipoprotein (LDL) and <a href="/wiki/High-density_lipoprotein" title="High-density lipoprotein">high-density lipoprotein</a> (HDL). LDL delivers fat molecules to <a href="/wiki/Cell_(biology)" title="Cell (biology)">cells</a>. LDL has been associated with the progression of <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerosis</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Overview">Overview</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=1" title="Edit section: Overview"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Lipoproteins transfer <a href="/wiki/Lipid" title="Lipid">lipids</a> (<a href="/wiki/Fat" title="Fat">fats</a>) around the body in the <a href="/wiki/Extracellular_fluid" title="Extracellular fluid">extracellular fluid</a>, making fats available to body cells for <a href="/wiki/Receptor-mediated_endocytosis" title="Receptor-mediated endocytosis">receptor-mediated endocytosis</a>.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Lipoproteins are complex particles composed of multiple <a href="/wiki/Protein" title="Protein">proteins</a>, typically 80–100 proteins per particle (organized by a single <a href="/wiki/Apolipoprotein_B" title="Apolipoprotein B">apolipoprotein B</a> for LDL and the larger particles). A single LDL particle is about 220–275 <a href="/wiki/Angstroms" class="mw-redirect" title="Angstroms">angstroms</a> in diameter, typically transporting 3,000 to 6,000 fat molecules per particle, and varying in size according to the number and mix of fat molecules contained within.<sup id="cite_ref-Segrest_JP,_Jones_MK,_De_Loof_H,_Dashti_N_1346–67_4-0" class="reference"><a href="#cite_note-Segrest_JP,_Jones_MK,_De_Loof_H,_Dashti_N_1346–67-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> The lipids carried include all fat molecules with <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a>, <a href="/wiki/Phospholipids" class="mw-redirect" title="Phospholipids">phospholipids</a>, and <a href="/wiki/Triglycerides" class="mw-redirect" title="Triglycerides">triglycerides</a> dominant; amounts of each vary considerably.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>A good clinical interpretation of blood lipid levels is that high LDL, in combination with a high amount of triglycerides, which indicates a high likelihood of the LDL being oxidised, is associated with increased risk of <a href="/wiki/Cardiovascular_diseases" class="mw-redirect" title="Cardiovascular diseases">cardiovascular diseases</a>.<sup id="cite_ref-Carson-AHA_6-0" class="reference"><a href="#cite_note-Carson-AHA-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Biochemistry">Biochemistry</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=2" title="Edit section: Biochemistry"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Structure">Structure</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=3" title="Edit section: Structure"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Each native LDL particle enables emulsification, i.e. surrounding the fatty acids being carried, enabling these fats to move around the body within the water outside cells. Each particle contains a single <a href="/wiki/Apolipoprotein" title="Apolipoprotein">apolipoprotein</a> B-100 molecule (<a href="/wiki/Apolipoprotein_B" title="Apolipoprotein B">Apo B-100</a>, a protein that has 4536 <a href="/wiki/Amino_acid" title="Amino acid">amino acid</a> residues and a mass of 514 <a href="/wiki/Atomic_mass_unit" class="mw-redirect" title="Atomic mass unit">kDa</a>), along with 80 to 100 additional ancillary proteins. Each LDL has a highly hydrophobic core consisting of <a href="/wiki/Polyunsaturated_fat" title="Polyunsaturated fat">polyunsaturated fatty acid</a> known as <a href="/wiki/Linoleic_acid" title="Linoleic acid">linoleate</a> and hundreds to thousands (about 1500 commonly cited as an average) of <a href="/wiki/Ester" title="Ester">esterified</a> and unesterified cholesterol molecules. This core also carries varying numbers of triglycerides and other fats and is surrounded by a shell of phospholipids and unesterified cholesterol, as well as the single copy of Apo B-100. LDL particles are approximately 22 nm (0.00000087 in.) to 27.5 nm in diameter and have a mass of about 3 million daltons.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Since LDL particles contain a variable and changing number of fatty acid molecules, there is a distribution of LDL particle mass and size.<sup id="cite_ref-Segrest_JP,_Jones_MK,_De_Loof_H,_Dashti_N_1346–67_4-1" class="reference"><a href="#cite_note-Segrest_JP,_Jones_MK,_De_Loof_H,_Dashti_N_1346–67-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Determining the structure of LDL has been difficult for biochemists because of its heterogeneous structure. However, the structure of LDL at human body temperature in native condition, with a resolution of about 16 <a href="/wiki/Angstroms" class="mw-redirect" title="Angstroms">Angstroms</a> using <a href="/wiki/Cryogenic_electron_microscopy" title="Cryogenic electron microscopy">cryogenic electron microscopy</a>, has been described in 2011.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Physiology">Physiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=4" title="Edit section: Physiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>LDL particles are formed when triglycerides are removed from VLDL by the <a href="/wiki/Lipoprotein_lipase" title="Lipoprotein lipase">lipoprotein lipase</a> enzyme (LPL) and they become smaller and denser (i.e. fewer fat molecules with same protein transport shell), containing a higher proportion of cholesterol esters.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Transport_into_the_cell">Transport into the cell</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=5" title="Edit section: Transport into the cell"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>When a cell requires additional cholesterol (beyond its current internal <a href="/wiki/HMG-CoA_reductase" title="HMG-CoA reductase">HMGCoA</a> production pathway), it synthesizes the necessary <a href="/wiki/LDL_receptor" title="LDL receptor">LDL receptors</a> as well as <a href="/wiki/PCSK9" title="PCSK9">PCSK9</a>, a <a href="/wiki/Proprotein_convertase" title="Proprotein convertase">proprotein convertase</a> that marks the LDL receptor for degradation.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> LDL receptors are inserted into the plasma membrane and diffuse freely until they associate with <a href="/wiki/Clathrin" title="Clathrin">clathrin</a>-coated pits. When LDL receptors bind LDL particles in the bloodstream, the clathrin-coated pits are endocytosed into the cell.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2024)">citation needed</span></a></i>]</sup> </p><p>Vesicles containing LDL receptors bound to LDL are delivered to the <a href="/wiki/Endosome" title="Endosome">endosome</a>. In the presence of low <a href="/wiki/PH" title="PH">pH</a>, such as that found in the endosome, LDL receptors undergo a conformation change, releasing LDL. LDL is then shipped to the <a href="/wiki/Lysosome" title="Lysosome">lysosome</a>, where <a href="/wiki/Cholesterol_ester" class="mw-redirect" title="Cholesterol ester">cholesterol esters</a> in the LDL are <a href="/wiki/Hydrolysis" title="Hydrolysis">hydrolysed</a>. LDL receptors are typically returned to the plasma membrane, where they repeat this cycle. If LDL receptors bind to PCSK9, however, transport of LDL receptors is redirected to the lysosome, where they are degraded.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Role_in_the_innate_immune_system">Role in the innate immune system</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=6" title="Edit section: Role in the innate immune system"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>LDL interferes with the <a href="/wiki/Quorum_sensing" title="Quorum sensing">quorum sensing</a> system that upregulates genes required for invasive <i><a href="/wiki/Staphylococcus_aureus" title="Staphylococcus aureus">Staphylococcus aureus</a></i> infection. The mechanism of antagonism entails binding apolipoprotein B to a <i>S. aureus</i> <a href="/wiki/Autoinducer" title="Autoinducer">autoinducer</a> pheromone, preventing signaling through its receptor. Mice deficient in apolipoprotein B are more susceptible to invasive bacterial infection.<sup id="cite_ref-Apolipoprotein_B_Is_an_innate_barrier_against_invasive_Staphylococcus_aureus_infection_13-0" class="reference"><a href="#cite_note-Apolipoprotein_B_Is_an_innate_barrier_against_invasive_Staphylococcus_aureus_infection-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="LDL_size_patterns">LDL size patterns</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=7" title="Edit section: LDL size patterns"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>LDL can be grouped based on its size: large low density LDL particles are described as <i>pattern A</i>, and small high density LDL particles are <i>pattern B</i>.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> <i>Pattern B</i> has been associated by some with a higher risk for <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary heart disease</a>.<sup id="cite_ref-pmid28572872_15-0" class="reference"><a href="#cite_note-pmid28572872-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup class="reference nowrap"><span title="Page / location: 1–10">: 1–10 </span></sup> This is thought to be because the smaller particles are more easily able to penetrate the <a href="/wiki/Endothelium" title="Endothelium">endothelium</a> of <a href="/wiki/Artery" title="Artery">arterial walls</a>. <i>Pattern I</i>, for <i>intermediate</i>, indicates that most LDL particles are very close in size to the normal gaps in the endothelium (26 nm). According to one study, sizes 19.0–20.5 nm were designated as pattern B and LDL sizes 20.6–22 nm were designated as pattern A.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Other studies have shown no such correlation at all.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>Some evidence suggests the correlation between Pattern B and coronary heart disease is stronger than the correspondence between the LDL number measured in the standard lipid profile test. Tests to measure these LDL subtype patterns have been more expensive and not widely available, so the common lipid profile test is used more often.<sup id="cite_ref-pmid28572872_15-1" class="reference"><a href="#cite_note-pmid28572872-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>There has also been noted a correspondence between higher triglyceride levels and higher levels of smaller, denser LDL particles and alternately lower triglyceride levels and higher levels of the larger, less dense ("buoyant") LDL.<sup id="cite_ref-pmid12417832_18-0" class="reference"><a href="#cite_note-pmid12417832-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Warnick_19-0" class="reference"><a href="#cite_note-Warnick-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>With continued research, decreasing cost, greater availability and wider acceptance of other <i>lipoprotein subclass analysis</i> assay methods, including <a href="/wiki/NMR_spectroscopy" class="mw-redirect" title="NMR spectroscopy">NMR spectroscopy</a>, research studies have continued to show a stronger correlation between human clinically obvious cardiovascular events and quantitatively measured particle concentrations.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Oxidized_LDL">Oxidized LDL</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=8" title="Edit section: Oxidized LDL"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Oxidized LDL is a general term for LDL particles with oxidatively modified structural components. As a result, from <a href="/wiki/Free_radical" class="mw-redirect" title="Free radical">free radical</a> attack, both lipid and protein parts of LDL can be oxidized in the vascular wall. Besides the oxidative reactions taking place in vascular wall, oxidized lipids in LDL can also be derived from oxidized dietary lipids.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ahotupa_22-0" class="reference"><a href="#cite_note-Ahotupa-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> Oxidized LDL is known to associate with the development of <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerosis</a>, and it is therefore widely studied as a potential risk factor of <a href="/wiki/Cardiovascular_diseases" class="mw-redirect" title="Cardiovascular diseases">cardiovascular diseases</a>.<sup id="cite_ref-Stocker_23-0" class="reference"><a href="#cite_note-Stocker-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Atherogenicity of oxidized LDL has been explained by lack of recognition of oxidation-modified LDL structures by the LDL receptors, preventing the normal metabolism of LDL particles and leading eventually to development of atherosclerotic plaques.<sup id="cite_ref-Stocker_23-1" class="reference"><a href="#cite_note-Stocker-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Of the lipid material contained in LDL, various lipid oxidation products are known as the ultimate atherogenic species.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> Acting as a transporter of these injurious molecules is another mechanism by which LDL can increase the risk of atherosclerosis.<sup id="cite_ref-Ahotupa_22-1" class="reference"><a href="#cite_note-Ahotupa-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Testing">Testing</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=9" title="Edit section: Testing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Blood_tests" class="mw-redirect" title="Blood tests">Blood tests</a> commonly report LDL-C: the amount of cholesterol which is estimated to be contained with LDL particles, on average, using a formula, the <a href="/wiki/Friedewald_equation" class="mw-redirect" title="Friedewald equation">Friedewald equation</a>. In clinical context, mathematically calculated estimates of LDL-C are commonly used as an estimate of how much low density lipoproteins are driving progression of atherosclerosis. The problem with this approach is that LDL-C values are commonly discordant with both direct measurements of LDL particles and actual rates of atherosclerosis progression.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2024)">citation needed</span></a></i>]</sup> </p><p>Direct LDL measurements are also available and better reveal individual issues but are less often promoted or done due to slightly higher costs and being available from only a couple of laboratories in the <a href="/wiki/United_States" title="United States">United States</a>. In 2008, the <a href="/wiki/American_Diabetes_Association" title="American Diabetes Association">ADA</a> and <a href="/wiki/American_College_of_Cardiology" title="American College of Cardiology">ACC</a> recognized direct LDL particle measurement by NMR as superior for assessing individual risk of cardiovascular events.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Estimation_of_LDL_particles_via_cholesterol_content">Estimation of LDL particles via cholesterol content</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=10" title="Edit section: Estimation of LDL particles via cholesterol content"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chemical measures of lipid concentration have long been the most-used clinical measurement, not because they have the best correlation with individual outcome, but because these lab methods are less expensive and more widely available. </p><p>The lipid profile does not measure LDL particles. It only estimates them using the Friedewald equation<sup id="cite_ref-Warnick_19-1" class="reference"><a href="#cite_note-Warnick-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid4337382_27-0" class="reference"><a href="#cite_note-pmid4337382-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> by subtracting the amount of cholesterol associated with other particles, such as <a href="/wiki/High_density_lipoprotein" class="mw-redirect" title="High density lipoprotein">HDL</a> and VLDL, assuming a prolonged fasting state, etc.: </p> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle L\approx C-H-kT}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>L</mi> <mo>≈</mo> <mi>C</mi> <mo>−</mo> <mi>H</mi> <mo>−</mo> <mi>k</mi> <mi>T</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle L\approx C-H-kT}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/8f2c26d930deb1b8e4a840625a6c3d31f6bec473" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.505ex; width:17.04ex; height:2.343ex;" alt="{\displaystyle L\approx C-H-kT}"></span></dd> <dd>where <i>H</i> is HDL cholesterol, <i>L</i> is LDL cholesterol, <i>C</i> is total cholesterol, <i>T</i> are triglycerides, and k is 0.20 if the quantities are measured in mg/dL and 0.45 if in mmol/L.</dd></dl> <p>There are limitations to this method, most notably that samples must be obtained after a 12 to 14 h fast and that LDL-C cannot be calculated if plasma triglyceride is >4.52 mmol/L (400 mg/dL). Even at triglyceride levels 2.5 to 4.5 mmol/L, this formula is considered inaccurate.<sup id="cite_ref-Sniderman_28-0" class="reference"><a href="#cite_note-Sniderman-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> If both total cholesterol and triglyceride levels are elevated then a modified formula, with quantities in mg/dL, may be used </p> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle L=C-H-0.16T}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>L</mi> <mo>=</mo> <mi>C</mi> <mo>−</mo> <mi>H</mi> <mo>−</mo> <mn>0.16</mn> <mi>T</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle L=C-H-0.16T}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/5457b5084357650d4ca71363612e31067c905f04" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.505ex; width:19.963ex; height:2.343ex;" alt="{\displaystyle L=C-H-0.16T}"></span></dd></dl> <p>This formula provides an approximation with fair accuracy for most people, assuming the blood was drawn after fasting for about 14 hours or longer, but does not reveal the actual LDL particle concentration because the percentage of fat molecules within the LDL particles which are cholesterol varies, as much as 8:1 variation. There are several formulas published addressing the inaccuracy in LDL-C estimation.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> The inaccuracy is based on the assumption that VLDL-C (Very low density lipoprotein cholesterol) is always one-fifth of the triglyceride concentration. Another formulae addresses this issue by using an adjustable factor <sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> or by using a regression equation.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> There are few studies which have compared the LDL-C values derived from this formula and values obtained by direct enzymatic method.<sup id="cite_ref-Ramasamy_1486–1493_34-0" class="reference"><a href="#cite_note-Ramasamy_1486–1493-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> Direct enzymatic method are found to be accurate and it has to be the test of choice in clinical situations. In the resource poor settings, the option of using the formula has to be considered.<sup id="cite_ref-Ramasamy_1486–1493_34-1" class="reference"><a href="#cite_note-Ramasamy_1486–1493-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p><p>However, the concentration of LDL particles, and to a lesser extent their size, has a stronger and consistent correlation with individual clinical outcome than the amount of cholesterol within LDL particles, even if the LDL-C estimation is approximately correct. There is increasing evidence and recognition of the value of more targeted and accurate measurements of LDL particles. Specifically, LDL particle number (concentration), and to a lesser extent size, have shown slightly stronger correlations with atherosclerotic progression and cardiovascular events than obtained using chemical measures of the amount of cholesterol carried by the LDL particles.<sup id="cite_ref-snid_35-0" class="reference"><a href="#cite_note-snid-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> It is possible that the LDL cholesterol concentration can be low, yet LDL particle number high and cardiovascular events rates are high. Correspondingly, it is possible that LDL cholesterol concentration can be relatively high, yet LDL particle number low and cardiovascular events are also low.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Normal_ranges">Normal ranges</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=11" title="Edit section: Normal ranges"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the US, the <a href="/wiki/American_Heart_Association" title="American Heart Association">American Heart Association</a>, <a href="/wiki/National_Institutes_of_Health" title="National Institutes of Health">NIH</a>, and <a href="/wiki/National_Cholesterol_Education_Program" title="National Cholesterol Education Program">NCEP</a> provide a set of guidelines for fasting LDL-Cholesterol levels, estimated or measured, and risk for heart disease. As of about 2005, these guidelines were:<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <tbody><tr> <th>Level <a href="/wiki/Kilogram" title="Kilogram">mg</a>/<a href="/wiki/Litre" title="Litre">dL</a> </th> <th>Level <a href="/wiki/Mole_(unit)" title="Mole (unit)">mmol</a>/L </th> <th>Interpretation </th></tr> <tr> <td>25 to <50 </td> <td><1.3 </td> <td>Optimal LDL cholesterol, levels in healthy young children before onset of atherosclerotic plaque in heart artery walls </td></tr> <tr> <td><70 </td> <td><1.8 </td> <td>Optimal LDL cholesterol, corresponding to lower rates of progression, promoted as a target option for those known to clearly have advanced symptomatic cardiovascular disease </td></tr> <tr> <td><100 </td> <td><2.6 </td> <td>Optimal LDL cholesterol, corresponding to lower, but not zero, rates for symptomatic cardiovascular disease events </td></tr> <tr> <td>100 to 129 </td> <td>2.6 to 3.3 </td> <td>Near optimal LDL level, corresponding to higher rates for developing symptomatic cardiovascular disease events </td></tr> <tr> <td>130 to 159 </td> <td>3.3 to 4.1 </td> <td>Borderline high LDL level, corresponding to even higher rates for developing symptomatic cardiovascular disease events </td></tr> <tr> <td>160 to 199 </td> <td>4.1 to 4.9 </td> <td>High LDL level, corresponding to much higher rates for developing symptomatic cardiovascular disease events </td></tr> <tr> <td>>200 </td> <td>>4.9 </td> <td>Very high LDL level, corresponding to highest increased rates of symptomatic cardiovascular disease events </td></tr></tbody></table> <p>Over time, with more clinical research, these recommended levels keep being reduced because LDL reduction, including to abnormally low levels, was the most effective strategy for reducing cardiovascular death rates in one large <a href="/wiki/Double_blind" class="mw-redirect" title="Double blind">double blind</a>, randomized clinical trial of men with <a href="/wiki/Hypercholesterolemia" title="Hypercholesterolemia">hypercholesterolemia</a>;<sup id="cite_ref-pmid7566020_39-0" class="reference"><a href="#cite_note-pmid7566020-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> far more effective than coronary angioplasty/stenting or bypass surgery.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p><p>For instance, for people with known atherosclerosis diseases, the 2004 updated American Heart Association, NIH and NCEP recommendations are for LDL levels to be lowered to less than 70 mg/dL. This low level of less than 70 mg/dL was recommended for primary prevention of 'very-high risk patients' and in secondary prevention as a 'reasonable further reduction'. This position was disputed.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> Statin drugs involved in such clinical trials have <a href="/wiki/Pleiotropy_(drugs)" title="Pleiotropy (drugs)">numerous physiological effects</a> beyond simply the reduction of LDL levels. </p><p>From longitudinal population studies following progression of atherosclerosis-related behaviors from early childhood into adulthood,<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> the usual LDL in childhood, before the development of <a href="/wiki/Fatty_streaks" class="mw-redirect" title="Fatty streaks">fatty streaks</a>, is about 35 mg/dL. However, all the above values refer to chemical measures of lipid/cholesterol concentration within LDL, not measured low-density lipoprotein concentrations, the accurate approach.<sup id="cite_ref-snid_35-1" class="reference"><a href="#cite_note-snid-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>A study was conducted measuring the effects of guideline changes on LDL cholesterol reporting and control for diabetes visits in the US from 1995 to 2004. It was found that although LDL cholesterol reporting and control for diabetes and coronary heart disease visits improved continuously between 1995 and 2004,<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> neither the 1998 ADA guidelines nor the 2001 ATP III guidelines increased LDL cholesterol control for diabetes relative to coronary heart disease.<sup id="cite_ref-wang_45-0" class="reference"><a href="#cite_note-wang-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Direct_measurement_of_LDL_particle_concentrations">Direct measurement of LDL particle concentrations</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=12" title="Edit section: Direct measurement of LDL particle concentrations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are several competing methods for measurement of lipoprotein particle concentrations and size. The evidence is that the NMR methodology (developed, automated & greatly reduced in costs while improving accuracy as pioneered by <a href="/wiki/Jim_Otvos" title="Jim Otvos">Jim Otvos</a> and associates) results in a 22-25% reduction in cardiovascular events within one year,<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> contrary to the longstanding claims by many in the medical industry that the superiority over existing methods was weak, even by statements of some proponents.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p><p>Since the later 1990s, because of the development of NMR measurements, it has been possible to clinically measure lipoprotein particles at lower cost [under $80 US (including shipping) & is decreasing; versus the previous costs of >$400 to >$5,000] and higher accuracy. There are two other assays for LDL particles, however, like LDL-C, most only estimate LDL particle concentrations.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2024)">citation needed</span></a></i>]</sup> </p><p>Direct LDL particle measurement by NMR was mentioned by the ADA and ACC, in a 28 March 2008 joint consensus statement,<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> as having advantages for predicting individual risk of atherosclerosis disease events, but the statement noted that the test is less widely available, is more expensive [about $13.00 US (2015 without insurance coverage) from some labs which use the Vantera Analyzer<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup>]. Debate continues that it is "...unclear whether LDL particle size measurements add value to measurement of LDL-particle concentration", though outcomes have always tracked LDL particle, not LDL-C, concentrations. </p><p>Using NMR, the total LDL particle concentrations, in nmol/L plasma, are typically subdivided by percentiles referenced to the 5,382 men and women, not on any lipid medications, who are participating in the MESA trial.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p><p>LDL particle concentration can also be measured by measuring the concentration of the protein ApoB, based on the generally accepted principle that each LDL or VLDL particle carries one ApoB molecule.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Optimal_ranges">Optimal ranges</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=13" title="Edit section: Optimal ranges"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The LDL particle concentrations are typically categorized by percentiles, <20%, 20–50%, 50th–80th%, 80th–95% and >95% groups of the people participating and being tracked in the <a href="/wiki/Multi-Ethnic_Study_of_Atherosclerosis" title="Multi-Ethnic Study of Atherosclerosis">MESA trial</a>, a medical research study sponsored by the United States National Heart, Lung, and Blood Institute. </p> <table class="wikitable"> <tbody><tr> <th>MESA Percentile </th> <th>LDL particles nmol/L </th> <th>Interpretation </th></tr> <tr> <td>0–20% </td> <td><1,000 </td> <td>Those with lowest rate of cardiovascular disease events & low (optimal) LDL particle concentration </td></tr> <tr> <td>20–50% </td> <td>1,000–1,299 </td> <td>Those with moderate rate of cardiovascular disease events & moderate LDL particle concentration </td></tr> <tr> <td>50–80% </td> <td>1,300–1,599 </td> <td>Those with Borderline-High rate of cardiovascular disease events & higher LDL particle concentration </td></tr> <tr> <td>89–95% </td> <td>1,600–2,000 </td> <td>Those with High rate of cardiovascular disease events and even higher LDL particle concentration </td></tr> <tr> <td>>95% </td> <td>>2,000 </td> <td>Those with very high rate of cardiovascular disease events and highest LDL particle concentration </td></tr> </tbody></table> <p>The lowest incidence of atherosclerotic events over time occurs within the <20% group, with increased rates for the higher groups. <sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title=""by this table, a generally accepted health LDL concentration of 100 mg/dl would be in the 95th MESA percentile" (July 2024)">citation needed</span></a></i>]</sup> Multiple other measures, including particle sizes, small LDL particle concentrations, large total and HDL particle concentrations, along with estimations of <a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a> pattern and standard cholesterol lipid measurements (for comparison of the plasma data with the estimation methods discussed above) are also routinely provided. </p> <div class="mw-heading mw-heading2"><h2 id="Lowering_LDL-cholesterol">Lowering LDL-cholesterol</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=14" title="Edit section: Lowering LDL-cholesterol"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <table class="wikitable" style="float:right; width:40em; border:solid 1px #999999; margin:0 0 1em 1em;"> <tbody><tr> <th colspan="5" style="background-color: #CCEEEE;">Markers indicating a need for LDL-C Reduction <p>(Per 2004 United States Government Minimum Guidelines<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup>) </p> </th></tr> <tr> <th>If the patient's cardiac risk is... </th> <th>then the patient should consider LDL-C reduction if the count in mg/dL is over... </th> <th>and LDL-C reduction is indicated if the count in mg/dL is over... </th></tr> <tr> <td>High, meaning a 20% or greater risk of heart attack within 10 years, or an extreme risk factor </td> <td>70<sup id="cite_ref-BBDstatins_54-0" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td> <td>100<sup id="cite_ref-BBDstatins_54-1" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>moderately high, meaning a 10-20% risk of heart attack within 10 years and more than 2 heart attack risk factors </td> <td>100<sup id="cite_ref-BBDstatins_54-2" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td> <td>130<sup id="cite_ref-BBDstatins_54-3" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>moderate, meaning a 10% risk of heart attack within 10 years and more than 2 heart attack risk factors </td> <td>130<sup id="cite_ref-BBDstatins_54-4" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td> <td>160<sup id="cite_ref-BBDstatins_54-5" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>low, meaning less than 10% risk of heart attack within 10 years and 1 or 0 heart attack risk factors </td> <td>160<sup id="cite_ref-BBDstatins_54-6" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td> <td>190<sup id="cite_ref-BBDstatins_54-7" class="reference"><a href="#cite_note-BBDstatins-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </td></tr> </tbody></table> <p>The <a href="/wiki/Mevalonate_pathway" title="Mevalonate pathway">mevalonate pathway</a> serves as the basis for the biosynthesis of many molecules, including cholesterol. The enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase (<a href="/wiki/HMG_CoA_reductase" class="mw-redirect" title="HMG CoA reductase">HMG CoA reductase</a>) is an essential component and performs the first of 37 steps within the cholesterol production pathway, and is present in every animal cell.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2024)">citation needed</span></a></i>]</sup> </p><p>LDL-C is not a measurement of actual LDL particles. LDL-C is only an estimate (not measured from the individual's blood sample) of how much cholesterol is being transported by all LDL particles, which is either a smaller concentration of large particles or a high concentration of small particles. LDL particles carry many fat molecules (typically 3,000 to 6,000 fat molecules per LDL particle); this includes cholesterol, triglycerides, phospholipids and others. Thus even if the hundreds to thousands of cholesterol molecules within an average LDL particle were measured, this does not reflect the other fat molecules or even the number of LDL particles. </p> <div class="mw-heading mw-heading3"><h3 id="Pharmaceutical">Pharmaceutical</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=15" title="Edit section: Pharmaceutical"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/PCSK9_inhibitor" class="mw-redirect" title="PCSK9 inhibitor">PCSK9 inhibitors</a>, in clinical trials, by several companies, are more effective for LDL reduction than the statins, including statins alone at high dose (though not necessarily the combination of statins plus ezetimibe).</li> <li><a href="/wiki/Statin" title="Statin">Statins</a> reduce high levels of LDL particles by inhibiting the enzyme HMG-CoA reductase in cells, the rate-limiting step of cholesterol synthesis. To compensate for the decreased cholesterol availability, synthesis of LDL receptors (including hepatic) is increased, resulting in an increased clearance of LDL particles from the extracellular water, including of the blood.</li> <li><a href="/wiki/Ezetimibe" title="Ezetimibe">Ezetimibe</a> reduces intestinal absorption of cholesterol, thus can reduce LDL particle concentrations when combined with statins.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Niacin_(substance)" class="mw-redirect" title="Niacin (substance)">Niacin</a> (B<sub>3</sub>), lowers LDL by selectively inhibiting hepatic diacylglycerol acyltransferase 2, reducing <a href="/wiki/Triglyceride" title="Triglyceride">triglyceride</a> synthesis and VLDL secretion through a receptor HM74<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> and HM74A or GPR109A.<sup id="cite_ref-pmid17238156_57-0" class="reference"><a href="#cite_note-pmid17238156-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup></li> <li>Several <a href="/wiki/CETP_inhibitor" title="CETP inhibitor">CETP inhibitors</a> have been researched to improve HDL concentrations, but so far, despite dramatically increasing HDL-C, have not had a consistent track record in reducing atherosclerosis disease events. Some have increased mortality rates compared with placebo.</li> <li><a href="/wiki/Clofibrate" title="Clofibrate">Clofibrate</a> is effective at lowering cholesterol levels, but has been associated with significantly increased cancer and stroke mortality, despite lowered cholesterol levels.<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> Other developed and tested fibrates, e.g. fenofibric acid<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> have had a better track record and are primarily promoted for lowering VLDL particles (triglycerides), not LDL particles, yet can help some in combination with other strategies.</li> <li>Some <a href="/wiki/Tocotrienol" title="Tocotrienol">tocotrienols</a>, especially delta- and gamma-tocotrienols, are being promoted as statin alternative non-prescription agents to treat high cholesterol, having been shown in vitro to have an effect. In particular, gamma-tocotrienol appears to be another HMG-CoA reductase inhibitor, and can reduce cholesterol production.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> As with statins, this decrease in intra-hepatic (liver) LDL levels may induce hepatic LDL receptor up-regulation, also decreasing plasma LDL levels. As always, a key issue is how benefits and complications of such agents compare with statins—molecular tools that have been analyzed in large numbers of human research and clinical trials since the mid-1970s.</li> <li><a href="/wiki/Phytosterol" title="Phytosterol">Phytosterols</a> are widely recognized as having a proven LDL cholesterol lowering efficacy'<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> A 2018 review found a dose-response relationship for phytosterols, with intakes of 1.5 to 3 g/day lowering LDL-C by 7.5% to 12%,<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> but reviews as of 2017 had found no data indicating that the consumption of phytosterols may reduce the risk of CVD.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> Current supplemental guidelines for reducing LDL recommend doses of phytosterols in the 1.6-3.0 grams per day range (Health Canada, EFSA, ATP III, FDA) with a 2009 meta-analysis demonstrating an 8.8% reduction in LDL-cholesterol at a mean dose of 2.15 gram per day.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Lifestyle">Lifestyle</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=16" title="Edit section: Lifestyle"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>LDL cholesterol can be lowered by through dietary intervention by limiting foods with <a href="/wiki/Saturated_fat" title="Saturated fat">saturated fat</a> and avoiding foods with <a href="/wiki/Trans_fat" title="Trans fat">trans fat</a>.<sup id="cite_ref-:0_65-0" class="reference"><a href="#cite_note-:0-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> Saturated fats are found in meat products (including poultry), full-fat dairy, eggs, and refined tropical oils like coconut and palm.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> Added trans fat (in the form of partially hydrogenated oils) has been banned in the US since 2021.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> However, trans fat can still be found in red meat and dairy products as it is produced in small amounts by ruminants such as sheep and cows.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> LDL cholesterol can also be lowered by increasing consumption of soluble fiber and plant-based foods.<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> </p><p>Another lifestyle approach to reduce LDL cholesterol has been minimizing total body fat, in particular fat stored inside the <a href="/wiki/Abdominal_cavity" title="Abdominal cavity">abdominal cavity</a> (<a href="/wiki/Adipose_tissue" title="Adipose tissue">visceral body fat</a>). Visceral fat, which is more metabolically active than subcutaneous fat, has been found to produce many enzymatic signals, e.g. <a href="/wiki/Resistin" title="Resistin">resistin</a>, which increase <a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a> and circulating VLDL particle concentrations, thus both increasing LDL particle concentrations and accelerating the development of diabetes mellitus. </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=17" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Gene_editing">Gene editing</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=18" title="Edit section: Gene editing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2021, scientists demonstrated that <a href="/wiki/CRISPR_gene_editing" title="CRISPR gene editing">CRISPR gene editing</a> can decrease blood levels of LDL cholesterol in <i><a href="/wiki/Macaca_fascicularis" class="mw-redirect" title="Macaca fascicularis">Macaca fascicularis</a></i> monkeys for months by 60% via <a href="/wiki/Gene_knockout" title="Gene knockout">knockout</a> of <a href="/wiki/PCSK9" title="PCSK9">PCSK9</a> in the <a href="/wiki/Liver" title="Liver">liver</a>.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-71" class="reference"><a href="#cite_note-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=19" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 30em;"> <ul><li><a href="/wiki/Catechin" title="Catechin">Catechin</a></li> <li><a href="/wiki/Cholesterol" title="Cholesterol">Cholesterol</a></li> <li><a href="/wiki/Lysosomal_acid_lipase_deficiency" title="Lysosomal acid lipase deficiency">Lysosomal acid lipase deficiency</a></li> <li><a href="/wiki/Cholesteryl_ester_storage_disease" class="mw-redirect" title="Cholesteryl ester storage disease">Cholesteryl ester storage disease</a></li> <li><a href="/wiki/Coenzyme_Q10" title="Coenzyme Q10">Coenzyme Q10</a></li> <li><a href="/wiki/Flavonoid" title="Flavonoid">Flavonoid</a></li> <li><a href="/wiki/Glutathione" title="Glutathione">Glutathione</a></li> <li><a href="/wiki/Health_effects_of_tea" title="Health effects of tea">Health effects of tea</a></li> <li><a href="/wiki/High_density_lipoprotein" class="mw-redirect" title="High density lipoprotein">High density lipoprotein</a></li> <li><a href="/wiki/LDL_receptor" title="LDL receptor">LDL receptor</a></li> <li><a href="/wiki/Lipid_profile" title="Lipid profile">Lipid profile</a></li> <li><a href="/wiki/Lipoprotein(a)" title="Lipoprotein(a)">Lipoprotein(a)</a></li> <li><a href="/wiki/Lipoprotein-X" title="Lipoprotein-X">Lipoprotein-X</a></li> <li><a href="/wiki/Melatonin" title="Melatonin">Melatonin</a></li> <li><a href="/wiki/Polyphenol_antioxidant" class="mw-redirect" title="Polyphenol antioxidant">Polyphenol antioxidant</a></li> <li><a href="/wiki/Saturated_fat" title="Saturated fat">Saturated fat</a></li> <li><a href="/wiki/Stanol_ester" title="Stanol ester">Stanol ester</a></li> <li><a href="/wiki/Sterol_ester" title="Sterol ester">Sterol ester</a></li> <li><a href="/wiki/Triglyceride" title="Triglyceride">Triglyceride</a></li> <li><a href="/wiki/Vitamin_A" title="Vitamin A">Vitamin A</a></li> <li><a href="/wiki/Vitamin_C" title="Vitamin C">Vitamin C</a></li> <li><a href="/wiki/Vitamin_E" title="Vitamin E">Vitamin E</a></li></ul></div> <div class="mw-heading mw-heading2"><h2 id="Notes_and_references">Notes and references</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=20" title="Edit section: Notes and references"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em 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Retrieved <span class="nowrap">13 June</span> 2021</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature&rft.atitle=In+vivo+CRISPR+base+editing+of+PCSK9+durably+lowers+cholesterol+in+primates&rft.volume=593&rft.issue=7859&rft.pages=429-434&rft.date=2021-05&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A234790939%23id-name%3DS2CID&rft_id=info%3Abibcode%2F2021Natur.593..429M&rft.issn=1476-4687&rft_id=info%3Adoi%2F10.1038%2Fs41586-021-03534-y&rft_id=info%3Apmid%2F34012082&rft.aulast=Musunuru&rft.aufirst=Kiran&rft_id=https%3A%2F%2Fwww.nature.com%2Farticles%2Fs41586-021-03534-y&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALow-density+lipoprotein" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Low-density_lipoprotein&action=edit&section=21" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://www.youtube.com/watch?v=XPguYN7dcbE">Fat (LDL) Degradation</a>: PMAP <a href="/wiki/The_Proteolysis_Map" title="The Proteolysis Map">The Proteolysis Map</a>-animation</li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20050524010904/http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3_rpt.htm">Adult Treatment Panel III Full Report</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20140202053506/http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3upd04.htm">ATP III Update 2004</a></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFO'KeefeCordainHarrisMoe2004" class="citation journal cs1">O'Keefe JH, Cordain L, Harris WH, Moe RM, Vogel R (June 2004). "Optimal low-density lipoprotein is 50 to 70 mg/dL: lower is better and physiologically normal". <i>Journal of the American College of Cardiology</i>. <b>43</b> (11): 2142–6. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jacc.2004.03.046">10.1016/j.jacc.2004.03.046</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15172426">15172426</a>.</cite><span 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style="padding:0 0.25em"> <ul><li>delivery of <a href="/wiki/Triglyceride" title="Triglyceride">TGs</a>: <a href="/wiki/Chylomicron" title="Chylomicron">Chylomicron</a></li> <li><a href="/wiki/Very_low-density_lipoprotein" title="Very low-density lipoprotein">VLDL</a></li> <li>delivery of <a href="/wiki/Cholesterol" title="Cholesterol">C</a> and <a href="/wiki/Cholesteryl_ester" title="Cholesteryl ester">CE</a>: <a href="/wiki/Intermediate-density_lipoprotein" title="Intermediate-density lipoprotein">IDL</a></li> <li><a class="mw-selflink selflink">LDL</a></li> <li>lb LDL</li> <li>sd LDL</li> <li><a href="/wiki/Lipoprotein(a)" title="Lipoprotein(a)">Lp(a)</a></li> <li><a href="/wiki/High-density_lipoprotein" title="High-density lipoprotein">HDL</a></li> <li><a href="/wiki/Remnant_cholesterol" title="Remnant cholesterol">Remnant cholesterol</a></li></ul> </div></td><td class="noviewer navbox-image" rowspan="6" style="width:1px;padding:0 0 0 2px"><div><span typeof="mw:File"><a 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class="navbox-group" style="width:1%"><a href="/wiki/Apolipoprotein" title="Apolipoprotein">Apolipoproteins</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>APOA <ul><li><a href="/wiki/Apolipoprotein_AI" title="Apolipoprotein AI">1</a></li> <li><a href="/wiki/APOA2" class="mw-redirect" title="APOA2">2</a></li> <li><a href="/wiki/APOA4" title="APOA4">4</a></li> <li><a href="/wiki/APOA5" title="APOA5">5</a></li></ul></li> <li><a href="/wiki/Apolipoprotein_B" title="Apolipoprotein B">APOB</a></li> <li>APOC <ul><li><a href="/wiki/Apolipoprotein_C1" class="mw-redirect" title="Apolipoprotein C1">1</a></li> <li><a href="/wiki/Apolipoprotein_C2" class="mw-redirect" title="Apolipoprotein C2">2</a></li> <li><a href="/wiki/Apolipoprotein_C3" class="mw-redirect" title="Apolipoprotein C3">3</a></li> <li><a href="/wiki/Apolipoprotein_C4" class="mw-redirect" title="Apolipoprotein C4">4</a></li></ul></li> <li><a href="/wiki/Apolipoprotein_D" title="Apolipoprotein D">APOD</a></li> <li><a href="/wiki/Apolipoprotein_E" title="Apolipoprotein E">APOE</a></li> <li><a href="/wiki/Apolipoprotein_H" title="Apolipoprotein H">APOH</a></li> <li><a href="/wiki/Serum_amyloid_A" title="Serum amyloid A">SAA</a> <ul><li><a href="/wiki/Serum_amyloid_A1" title="Serum amyloid A1">SAA1</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Extracellular <a href="/wiki/Enzyme" title="Enzyme">enzymes</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lecithin%E2%80%94cholesterol_acyltransferase" class="mw-redirect" title="Lecithin—cholesterol acyltransferase">LCAT</a></li> <li><a href="/wiki/Hepatic_lipase" title="Hepatic lipase">LIPC</a></li> <li><a href="/wiki/Lipoprotein_lipase" title="Lipoprotein lipase">LPL</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Plant_lipid_transfer_proteins" title="Plant lipid transfer proteins">Lipid transfer proteins</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholesterylester_transfer_protein" class="mw-redirect" title="Cholesterylester transfer protein">CETP</a></li> <li><a href="/wiki/Microsomal_triglyceride_transfer_protein" title="Microsomal triglyceride transfer protein">MTTP</a></li> <li><a href="/wiki/Phospholipid_transfer_protein" title="Phospholipid transfer protein">PLTP</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cell_surface_receptor" title="Cell surface receptor">Cell surface receptors</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>HDL: <a href="/wiki/SCARB1" title="SCARB1">SCARB1</a></li></ul> <ul><li>IDL: <a href="/wiki/Lipoprotein_receptor-related_protein" title="Lipoprotein receptor-related protein">LRP</a> <ul><li><a href="/wiki/LRP1" title="LRP1">LRP1</a></li> <li><a href="/wiki/LRP1B" title="LRP1B">LRP1B</a></li> <li><a href="/wiki/LRP2" title="LRP2">LRP2</a></li> <li><a href="/wiki/LRP3" title="LRP3">LRP3</a></li> <li><a href="/wiki/Low-density_lipoprotein_receptor-related_protein_4" title="Low-density lipoprotein receptor-related protein 4">LRP4</a></li> <li><a href="/wiki/LRP5" title="LRP5">LRP5</a></li> <li><a href="/w/index.php?title=LRP5L&action=edit&redlink=1" class="new" title="LRP5L (page does not exist)">LRP5L</a></li> <li><a href="/wiki/LRP6" title="LRP6">LRP6</a></li> <li><a href="/wiki/Low-density_lipoprotein_receptor-related_protein_8" title="Low-density lipoprotein receptor-related protein 8">LRP8</a></li> <li><a href="/wiki/LRP10" title="LRP10">LRP10</a></li> <li><a href="/wiki/LRP11" title="LRP11">LRP11</a></li> <li><a href="/w/index.php?title=LRP12&action=edit&redlink=1" class="new" title="LRP12 (page does not exist)">LRP12</a></li></ul></li> <li>LDL: <a href="/wiki/LDL_receptor" title="LDL receptor">LDLR</a></li> <li><a href="/wiki/LDL-receptor-related_protein-associated_protein" title="LDL-receptor-related protein-associated protein">LRPAP1</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/ATP-binding_cassette_transporter" class="mw-redirect" title="ATP-binding cassette transporter">ATP-binding <br />cassette transporter</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/ABCA1" title="ABCA1">ABCA1</a></li> <li><a href="/wiki/ABCG5" title="ABCG5">ABCG5</a></li> <li><a href="/wiki/ABCG8" title="ABCG8">ABCG8</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Cardiovascular_disease_(vessels)" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Vascular_diseases" title="Template:Vascular diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Vascular_diseases" title="Template talk:Vascular diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Vascular_diseases" title="Special:EditPage/Template:Vascular diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Cardiovascular_disease_(vessels)" style="font-size:114%;margin:0 4em"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular disease</a> (vessels)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Artery" title="Artery">Arteries</a>, <a href="/wiki/Arteriole" title="Arteriole">arterioles</a><br /> and <a href="/wiki/Capillary" title="Capillary">capillaries</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Arteritis" title="Arteritis">Arteritis</a> <ul><li><a href="/wiki/Aortitis" title="Aortitis">Aortitis</a></li></ul></li> <li><a href="/wiki/Thromboangiitis_obliterans" title="Thromboangiitis obliterans">Buerger's disease</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Arteriosclerosis" title="Arteriosclerosis">Arteriosclerosis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atherosclerosis" title="Atherosclerosis">Atherosclerosis</a> <ul><li><a href="/wiki/Foam_cell" title="Foam cell">Foam cell</a></li> <li><a href="/wiki/Fatty_streak" title="Fatty streak">Fatty streak</a></li> <li><a href="/wiki/Atheroma" title="Atheroma">Atheroma</a></li> <li><a href="/wiki/Cholesterol" title="Cholesterol">Cholesterol</a></li> <li><a class="mw-selflink selflink">LDL</a></li> <li><a href="/wiki/Oxycholesterol" title="Oxycholesterol">Oxycholesterol</a></li> <li><a href="/wiki/Trans_fat" title="Trans fat">Trans fat</a></li></ul></li> <li><a href="/wiki/Monckeberg%27s_arteriosclerosis" title="Monckeberg's arteriosclerosis">Monckeberg's arteriosclerosis</a></li> <li><a href="/wiki/Hyaline_arteriolosclerosis" class="mw-redirect" title="Hyaline arteriolosclerosis">Hyaline arteriolosclerosis</a></li> <li><a href="/wiki/Hyperplastic_arteriolosclerosis" class="mw-redirect" title="Hyperplastic arteriolosclerosis">Hyperplastic arteriolosclerosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peripheral_artery_disease" title="Peripheral artery disease">Peripheral artery disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Stenosis" title="Stenosis">Stenosis</a> <ul><li><a href="/wiki/Carotid_artery_stenosis" title="Carotid artery stenosis">Carotid artery stenosis</a></li> <li><a href="/wiki/Renal_artery_stenosis" title="Renal artery stenosis">Renal artery stenosis</a></li></ul></li> <li><a href="/wiki/Aortoiliac_occlusive_disease" title="Aortoiliac occlusive disease">Aortoiliac occlusive disease</a></li> <li><a href="/wiki/Critical_limb_ischemia" class="mw-redirect" title="Critical limb ischemia">Critical limb ischemia</a></li> <li><a href="/wiki/Degos_disease" title="Degos disease">Degos disease</a></li> <li><a href="/wiki/Erythromelalgia" title="Erythromelalgia">Erythromelalgia</a></li> <li><a href="/wiki/Fibromuscular_dysplasia" title="Fibromuscular dysplasia">Fibromuscular dysplasia</a></li> <li><a href="/wiki/Hepatic_artery_thrombosis" title="Hepatic artery thrombosis">Hepatic artery thrombosis</a></li> <li><a href="/wiki/Intermittent_claudication" title="Intermittent claudication">Intermittent claudication</a></li> <li><a href="/wiki/Raynaud%27s_phenomenon" class="mw-redirect" title="Raynaud's phenomenon">Raynaud's phenomenon</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aneurysm" title="Aneurysm">Aneurysm</a> / <a href="/wiki/Dissection_(medical)" class="mw-redirect" title="Dissection (medical)">dissection</a> /<br /> <a href="/wiki/Pseudoaneurysm" title="Pseudoaneurysm">pseudoaneurysm</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>torso</i>: <a href="/wiki/Aortic_aneurysm" title="Aortic aneurysm">Aortic aneurysm</a> <ul><li><a href="/wiki/Abdominal_aortic_aneurysm" title="Abdominal aortic aneurysm">Abdominal aortic aneurysm</a></li> <li><a href="/wiki/Thoracic_aortic_aneurysm" title="Thoracic aortic aneurysm">Thoracic aortic aneurysm</a></li> <li><a href="/wiki/Aneurysm_of_sinus_of_Valsalva" title="Aneurysm of sinus of Valsalva">Aneurysm of sinus of Valsalva</a></li></ul></li> <li><a href="/wiki/Aortic_dissection" title="Aortic dissection">Aortic dissection</a></li> <li><a href="/wiki/Aortic_rupture" title="Aortic rupture">Aortic rupture</a></li> <li><a href="/wiki/Coronary_artery_aneurysm" title="Coronary artery aneurysm">Coronary artery aneurysm</a></li> <li><i>head / neck</i> <ul><li><a href="/wiki/Intracranial_aneurysm" title="Intracranial aneurysm">Intracranial aneurysm</a></li> <li><a href="/wiki/Intracranial_berry_aneurysm" class="mw-redirect" title="Intracranial berry aneurysm">Intracranial berry aneurysm</a></li> <li><a href="/wiki/Carotid_artery_dissection" title="Carotid artery dissection">Carotid artery dissection</a></li> <li><a href="/wiki/Vertebral_artery_dissection" title="Vertebral artery dissection">Vertebral artery dissection</a></li> <li><a href="/wiki/Familial_aortic_dissection" title="Familial aortic dissection">Familial aortic dissection</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vascular_malformation" title="Vascular malformation">Vascular malformation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Arteriovenous_fistula" title="Arteriovenous fistula">Arteriovenous fistula</a></li> <li><a href="/wiki/Arteriovenous_malformation" title="Arteriovenous malformation">Arteriovenous malformation</a></li> <li><a href="/wiki/Telangiectasia" title="Telangiectasia">Telangiectasia</a> <ul><li><a href="/wiki/Hereditary_hemorrhagic_telangiectasia" title="Hereditary hemorrhagic telangiectasia">Hereditary hemorrhagic telangiectasia</a></li> <li><a href="/wiki/Generalized_essential_telangiectasia" title="Generalized essential telangiectasia">Generalized essential telangiectasia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nevus#Vascular_nevus" title="Nevus">Vascular nevus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cherry_hemangioma" class="mw-redirect" title="Cherry hemangioma">Cherry hemangioma</a></li> <li><a href="/wiki/Halo_nevus" title="Halo nevus">Halo nevus</a></li> <li><a href="/wiki/Spider_angioma" title="Spider angioma">Spider angioma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vein" title="Vein">Veins</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Phlebitis" title="Phlebitis">Phlebitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Venous_thrombosis" title="Venous thrombosis">Venous thrombosis</a> /<br /> <a href="/wiki/Thrombophlebitis" title="Thrombophlebitis">Thrombophlebitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>primarily lower limb</i> <ul><li><a href="/wiki/Deep_vein_thrombosis" title="Deep vein thrombosis">Deep vein thrombosis</a></li></ul></li> <li><i>abdomen</i> <ul><li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li> <li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li> <li><a href="/wiki/May%E2%80%93Thurner_syndrome" title="May–Thurner syndrome">May–Thurner syndrome</a></li> <li><a href="/wiki/Portal_vein_thrombosis" title="Portal vein thrombosis">Portal vein thrombosis</a></li> <li><a href="/wiki/Renal_vein_thrombosis" title="Renal vein thrombosis">Renal vein thrombosis</a></li></ul></li> <li><i>upper limb / torso</i> <ul><li><a href="/wiki/Mondor%27s_disease" class="mw-redirect" title="Mondor's disease">Mondor's disease</a></li> <li><a href="/wiki/Paget%E2%80%93Schroetter_disease" title="Paget–Schroetter disease">Paget–Schroetter disease</a></li> <li><a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">Pulmonary embolism</a></li></ul></li> <li><i>head</i> <ul><li><a href="/wiki/Cerebral_venous_sinus_thrombosis" title="Cerebral venous sinus thrombosis">Cerebral venous sinus thrombosis</a></li></ul></li> <li><a href="/wiki/Post-thrombotic_syndrome" title="Post-thrombotic syndrome">Post-thrombotic syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Varicose_veins" title="Varicose veins">Varicose veins</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastric_varices" title="Gastric varices">Gastric varices</a></li> <li><a href="/wiki/Portacaval_anastomosis" title="Portacaval anastomosis">Portacaval anastomosis</a> <ul><li><a href="/wiki/Caput_medusae" title="Caput medusae">Caput medusae</a></li> <li><a href="/wiki/Esophageal_varices" title="Esophageal varices">Esophageal varices</a></li> <li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li></ul></li> <li><a href="/wiki/Varicocele" title="Varicocele">Varicocele</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chronic_venous_insufficiency" title="Chronic venous insufficiency">Chronic venous insufficiency</a></li> <li><a href="/wiki/Chronic_cerebrospinal_venous_insufficiency" class="mw-redirect" title="Chronic cerebrospinal venous insufficiency">Chronic cerebrospinal venous insufficiency</a></li> <li><a href="/wiki/Superior_vena_cava_syndrome" title="Superior vena cava syndrome">Superior vena cava syndrome</a></li> <li><a href="/wiki/Inferior_vena_cava_syndrome" title="Inferior vena cava syndrome">Inferior vena cava syndrome</a></li> <li><a href="/wiki/Venous_ulcer" title="Venous ulcer">Venous ulcer</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Arteries or veins</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Angiopathy" title="Angiopathy">Angiopathy</a> <ul><li><a href="/wiki/Macroangiopathy" class="mw-redirect" title="Macroangiopathy">Macroangiopathy</a></li> <li><a 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