Hyperlipidaemia and cardiovascular disease: Edited by Paul N. DurringtonLipoprotein subfractions and cardiovascular disease riskKrauss, Ronald M Author Information Children's Hospital Oakland Research Institute, Oakland, California, USA Correspondence to Ronald M. Krauss, MD, Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr. Way, Oakland CA, 94609, USA Tel: +1 510 450 7908; fax: +1 510 450 7909; e-mail: [email protected] Current Opinion in Lipidology 21(4):p 305-311, August 2010. | DOI: 10.1097/MOL.0b013e32833b7756 Buy Metrics Abstract Purpose of review Subfractions of LDL and HDL defined by differences in particle size and density have been associated to varying degrees with risk of cardiovascular disease (CVD). Assessment of these relationships has been clouded by lack of standardization among the various analytic methodologies as well as the strong correlations of the subfractions with each other and with standard lipid and lipoprotein risk markers. This review summarizes the properties of the major LDL and HDL particle subclasses, and recent evidence linking their measurement with risk of atheroscierosis and CVD. Recent findings Several recent studies have shown independent relationships of levels of LDL and HDL-size subclasses to risk of both coronary artery and cerebrovascular disease. However, the two largest studies, employing nuclear magnetic resonance and ion mobility, respectively, did not find evidence that these measurements improved risk assessment compared with standard lipoprotein assays. In the latter study, principal component analysis was used to group multiple subfraction measurements into three distinct and statistically independent clusters that were related both to cardiovascular outcomes and to genotypes that may reflect underlying metabolic determinants. Summary Although there is as yet inconclusive evidence as to the extent to which LDL and HDL subfraction measurements improve clinical assessment of CVD risk beyond standard lipid risk markers, recent studies suggest that more refined analyses of lipoprotein subspecies may lead to further improvements in CVD risk evaluation and particularly in identification of appropriate targets for therapeutic intervention in individual patients. © 2010 Lippincott Williams & Wilkins, Inc.