Oxidative modification of lipids contained in lipoproteins may contribute to initiation of local inflammation in the vascular endothelium and ultimately to the atherosclerotic plaque formation. Therefore, in patients with high cardiovascular risk in primary as well as in secondary prevention, it is recommended that the serum low-density lipoprotein (LDL) cholesterol be reduced. However, the management of patients with LDL level at goal is still a matter of debate. Various parameters have been proposed for predicting increased cardiovascular risk. It was found that among known indicators of lipid metabolism deregulation the ratio of total cholesterol/apoB100 associates with the severity of coronary arteriosclerosis in population of individuals with LDL levels < 100 mg/dL. There are several possible hypotheses for this phenomenon (impaired reduction of apoB100 expression by statins or increased triglyceride content of apoB100 containing lipoproteins compatible with oxidized LDL phenotype in subjects with high cardiovascular burden). In this paper, we discuss the increased susceptibility of plasma lipoproteins to oxidation. To verify this hypothesis, we undertook to determine, in the susceptible population described previously, whether there is a relation of total cholesterol (TC) ratio to apoB100 with known oxidative stress exponents such as protein and lipid oxidation products (LPP). TC/apoB100 was found to have a significant association with the level of LPPs in most examined subgroups (except subjects on statins with LDL > 100 mg/dL).
See commentary by Grabowski http://dx.doi.org/10.1002/ejlt.201200295