title: Reassessing lipid metabolism and its potentialities in the prediction of cardiovascular risk.
abstract: There are numerous particles, enzymes, and mechanisms in the lipid metabolism that are involved in the genesis of cardiovascular disease (CVD). Given its prevalence in populations and its impact on mortality, it is relevant to review the lipid metabolism as it may potentially provide subsidies to better prediction. This article reviews the importance of traditional cardiovascular risk factors and comments on the potential of novel lipid biomarkers involved in the physiopathology of CVD. The Framingham cohorts proved the role of traditional risk factors (physical inactivity, smoking, blood pressure, total cholesterol, LDL-C, HDL-C, plasma glucose) in the prediction of cardiovascular events. However, a significant number of individuals that suffer from a cardiovascular event has few or none of these factors. Such finding indicates the need for new biomarkers able to identify plaques that are more susceptible to rupture. Some of bloodstream biomarkers related to lipid metabolism are modified LDL particles, apolipoprotein AI (apo AI), apolipoprotein B, lipoprotein (a) [Lp (a)], cholesteryl ester transfer protein (CETP), subtypes of LDL and HDL particles, and lipoprotein-associated phospholipase A2 (Lp-PLA2). These factors participate in the atherosclerotic process, and are abnormal in individuals at high risk, or in those who suffered from a cardiovascular event. Lp (a) determination is already employed in clinical practice and should be included as a reference parameter for CVD monitoring. Furthermore, there are expectations for wider use of apo B, non-HDL cholesterol and total cholesterol / HDL-C determination to improve cardiovascular risk assessment.
authors.affiliation: Department of Epidemiology, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Isis Tande da
authors.initials: IT
authors.lastname: Silva
authors.affiliation: Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Bianca de
authors.initials: Bd
authors.lastname: Almeida-Pititto
authors.affiliation: Department of Epidemiology, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Sandra Roberta G
authors.initials: SR
authors.lastname: Ferreira
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood; D001053:Apolipoproteins / Q000097:blood*; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D053480:Cholesterol Ester Transfer Proteins / Q000097:blood; D006801:Humans; D050356:Lipid Metabolism; D012307:Risk Factors
chemical_list: D001053:Apolipoproteins; D015415:Biomarkers; D053480:Cholesterol Ester Transfer Proteins; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase