A review of the role of apolipoprotein C-II in lipoprotein metabolism and cardiovascular disease.
The focus of this review is on the role of apolipoprotein C-II (apoC-II) in lipoprotein metabolism and the potential effects on the risk of cardiovascular disease (CVD). We searched PubMed/Scopus for articles regarding apoC-II and its role in lipoprotein metabolism and the risk of CVD. Apolipoprotein C-II is a constituent of chylomicrons, very low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein (HDL). Apolipoprotein C-II contains 3 amphipathic α-helices. The lipid-binding domain of apoC-II is located in the N-terminal, whereas the C-terminal helix of apoC-II is responsible for the interaction with lipoprotein lipase (LPL). At intermediate concentrations (approximately 4 mg/dL) and in normolipidemic subjects, apoC-II activates LPL. In contrast, both an excess and a deficiency of apoC-II are associated with reduced LPL activity and hypertriglyceridemia. Furthermore, excess apoC-II has been associated with increased triglyceride-rich particles and alterations in HDL particle distribution, factors that may increase the risk of CVD. However, there is not enough current evidence to clarify whether increased apoC-II causes hypertriglyceridemia or is an epiphenomenon reflecting hypertriglyceridemia. A number of pharmaceutical interventions, including statins, fibrates, ezetimibe, nicotinic acid, and orlistat, have been shown to reduce the increased apoC-II concentrations. An excess of apoC-II is associated with increased triglyceride-rich particles and alterations in HDL particle distribution. However, prospective trials are needed to assess if apoC-II is a CVD marker or a risk factor in high-risk patients.
Department of Internal Medicine, School of Medicine, University of Ioannina, 45 110 Ioannina, Greece.
Anastazia A
AA
Kei
Theodosios D
TD
Filippatos
Vasilios
V
Tsimihodimos
Moses S
MS
Elisaf
D000818:Animals; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D053304:Apolipoprotein C-II / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000378:metabolism* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000097:blood / Q000378:metabolism; D008074:Lipoproteins / Q000378:metabolism*; D008297:Male; D051379:Mice; D009154:Mutation; D051381:Rats
D000924:Anticholesteremic Agents; D053304:Apolipoprotein C-II; D008074:Lipoproteins