Identification of Multiple Dense LDL Subfractions With Enhanced Susceptibility to In Vitro Oxidation Among Hypertriglyceridemic Subjects Normalization After Clofibrate Treatment

The influence of different plasma triglyceride concentrations on the heterogeneity of low density lipoprotein (LDL) and on the susceptibility of LDL to copper oxidation was investigated. By density gradient ultracentrifugation, LDL subfractions were isolated from the plasma of 10 normolipidemic control subjects and 12 hypertriglyceridemic patients both before and after clofibrate treatment. In the plasma of control subjects three LDL subfractions were present: LDL1 (d= 1.030-1.033 g/mL), LDL2 (d=1.033-1.040 g/mL), and LDL3 (d= 1.040-1.045 g/mL). In the plasma of nine moderately hypertriglyceridemic subjects up to five LDL subfractions could be detected: LDL1-LDL3, LDL4 (d= 1.045-1.049 g/mL), and LDL5 (4= 1.049-1.054 g/mL). This polydispersity of LDL was replaced by monodispersity with increasing plasma triglyceride concentrations in three subjects with chylomicronemia, in whom LDL was concentrated in the narrow LDL5 density range. Clofibrate treatment resulted in a lighter LDL subfraction pattern (LDL1-LDL4). In both the control and the moderately hypertriglyceridemic subjects, the small dense LDL subfractions appeared more prone to oxidative modification in vitro than the light LDL subfractions, as measured by the decreased lag time preceding the onset of lipid peroxidation. Furthermore, the dense LDL subfractions were more extensively modified over time, as shown by an increased oxidation rate and a greater number of dienes formed after 6 hours of oxidation. These results suggest an enhanced atherogenic potential of the small, dense LDL subfractions within each LDL subfraction profile. The hypertriglyceridemic LDL subfractions before therapy (LDL3LDL5) were less resistant to in vitro oxidation than the light, control LDL subfractions (LDL1-LDL3). This lower resistance was probably related to the decrease in the vitamin E content from LDL1 to LDL5. After clofibrate treatment both the vitamin E content of the LDL subfractions and the lag time increased, indicating an enhanced resistance against oxidation. (Arteriosclerosis and Thrombosis 1993;13:712-719)