Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention

Vasc Health Risk Manag. 2009;5:757-65. Epub 2009 Sep 18.

Abstract

Low-density lipoprotein (LDL) cholesterol concentration has been the prime index of cardiovascular disease risk and the main target for therapy. However, several lipoprotein ratios or "atherogenic indices" have been defined in an attempt to optimize the predictive capacity of the lipid profile. In this review, we summarize their pathophysiological aspects, and highlight the rationale for using these lipoprotein ratios as cardiovascular risk factors in clinical practice, specifying their cut-off risk levels and a target for lipid-lowering therapy. Total/high-density lipoprotein (HDL) cholesterol and LDL/HDL cholesterol ratios are risk indicators with greater predictive value than isolated parameters used independently, particularly LDL. Future recommendations regarding the diagnosis and treatment of dyslipidemia, including instruments for calculating cardiovascular risk or action guidelines, should include the lipoprotein ratios with greater predictive power which, in view of the evidence-based results, are none other than those which include HDL cholesterol.

Keywords: apolipoproteins; cardiovascular disorders; cholesterol ratios; predictive power.

Publication types

  • Review

MeSH terms

  • Apolipoprotein A-I / blood
  • Apolipoproteins B / blood
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Dyslipidemias / blood
  • Dyslipidemias / complications
  • Dyslipidemias / diagnosis
  • Dyslipidemias / drug therapy*
  • Evidence-Based Medicine
  • Female
  • Humans
  • Hypolipidemic Agents / therapeutic use*
  • Lipoproteins / blood*
  • Male
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Triglycerides / blood

Substances

  • APOA1 protein, human
  • Apolipoprotein A-I
  • Apolipoproteins B
  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hypolipidemic Agents
  • Lipoproteins
  • Triglycerides