Should we routinely measure low-density and high-density lipoprotein subclasses?

Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) plasma populations are composed of heterogeneous subfractions that are different in size, density and protein/lipid content. There is increasing evidence that small, dense LDL particles are strongly associated with higher cardiovascular disease risk. Similarly, several studies have investigated whether smaller HDL particles are more protective than their larger counterparts and more recent findings suggest that small, dense HDL has significantly higher atheroprotective activity than larger L HDL. Yet, certain impairments of the protein/lipid content in small, dense HDL may decrease its antiatherogenic capacity or even induce p…