Cardiology pp 347-354 | Cite as

Regulation of Plasma High Density Lipoprotein Concentration by Lipoprotein Lipase and Hepatic Endothelial Lipase

  • Esko A. Nikkilä


A number of epidemiologic and angiographic studies have established that the risk of developing ischemic heart disease (IHD) and the extent of coronary atherosclerosis bear a direct relationship to plasma LDL cholesterol concentration but are inversely correlated to HDL cholesterol.1,2 The latter association seems to be mostly mediated by the HDL2 subfraction.3 The question on the possible additional role of elevated plasma triglyceride and VLDL levels in increasing the risk of IHD has remained controversial.4 Many authors agree that hypertriglyceridemia is common among patients with IHD and alsopredicts the risk of developing new IHD5, 6 but multivariate HDL analyses considering also plasma HDL have consistently eliminated triglycerides as an independent risk factor.4 In other words, elevated VLDL indicates an increased risk of IHD only because of its close inverse association with HDL. Thus, high VLDL is not atherogenic if not accompanied by low HDL. It is also evident that the significance of HDL as a protective factor of IHD increases with increasing LDL cholesterol concentration. Accordingly, among populations with low LDL levels (usually due to diet) a simultaneous low HDL cholesterol is not atherogenic.


Ischemic Heart Disease Lipoprotein Lipase High Density Lipoprotein2 Hepatic Lipase Lipoprotein Lipase Activity 
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© Springer Science+Business Media New York 1984

Authors and Affiliations

  • Esko A. Nikkilä
    • 1
  1. 1.Third Department of MedicineUniversity of HelsinkiHelsinki 29Finland

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