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A recent study in the journal Nutrients provides a comprehensive review of the lipoprotein pathway's role in healthy metabolism. Lipoproteins are lipid-protein complexes with a core of cholesterol esters and triacylglycerol, surrounded by phospholipids and free cholesterol. Examples include HDL, LDL, VLDL, and LP(a), their density inversely related to size.
Dietary lipids form chylomicrons in the intestines, transporting triacylglycerols to the blood. The liver synthesizes VLDL, which converts to LDL or LP(a) after processing. LDL delivers cholesterol to tissues, contributing to atherosclerosis and cardiovascular disease (CVD) risk, while HDL transports cholesterol to the liver for excretion.
High LDL levels exacerbate atherosclerosis via macrophage uptake and foam cell formation, promoting plaque instability and inflammation. Dyslipidemia, prevalent in obesity and diabetes, heightens CVD risk. Genetic and dietary factors influence dyslipidemia, with promising therapies like gene editing under investigation.
Novel drugs such as PCSK9 inhibitors, statins, and anti-diabetic medications manage dyslipidemia. Research on lipid metabolism and gut microbes may yield new treatments, with potential in reverse cholesterol transport (RCT) and apoE analogs for CVD prevention.
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