LDL-P (the LDL Particle Number) is the direct measure of low density lipoprotein particles.
The causal link between high levels of LDL-P and development of cardiovascular disease (CVD) is well established.
LDL-P (LDL particle number) measures the actual number of LDL particles (particle concentration, nmol/L). It appears that LDL-P may be a stronger predictor of cardiovascular events than LDL-C.
Lipoproteins are particles that transport fats throughout the body. These particles are essential and carry a combination of proteins, vitamins, cholesterol, triglyceride, and phospholipid molecules. The composition of a lipoprotein particle changes as it circulates in the blood. Some molecules are removed and others are added, resulting in lipoprotein particles with variable amounts of cholesterol.
Low-density lipoprotein particles (LDL-P) are bi-products of fat transport that remain in circulation for an extended time. While in circulation, LDL-P can penetrate the artery wall and get stuck, forming a fatty plaque. These plaques can build over time and lead to blockages, resulting in heart attacks and strokes. The likelihood of an LDL-P getting trapped in the artery wall increases when more LDL-P are in the blood.
Traditional lipid testing measures the amount of LDL cholesterol (LDL-C) present in the blood, but it does not evaluate the number of LDL particles (LDL-P). LDL-P is often used to get a more accurate measure of LDL due to the variability of cholesterol content within a given LDL. Studies have shown that LDL-P more accurately predicts risk of cardiovascular disease than LDL-C. Researchers think that increased LDL-P could be one of the reasons that some people have heart attacks even though their total cholesterol and LDL cholesterol levels are not particularly high.
LDL-P test results are typically reported according to the testing method the laboratory uses. The report will usually include results for your total cholesterol, LDL-C and LDL-P. Additional values might include very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), LDL-C and/or HDL cholesterol, particle and size. Since different lab methods separate the subclasses based on different physical properties (particle number, size, density, and/or electrical charge), results cannot be directly compared between methods or laboratories.
In general, the result is interpreted within the framework of a lipid profile and its associated risk. If you have an increased LDL-P, this finding will add to your risk of developing cardiovascular disease above and beyond the risk associated with LDL cholesterol.
It is important to remember that LDL subfraction testing is not diagnostic, not endorsed by any medical societies, and not approved by the FDA. It attempts to evaluate your risk of developing CVD, but it cannot predict the development or severity of disease in a particular person. For this reason, LDL subfraction results should not be considered when making decisions about treatment or lifestyle changes.
LDL-P can be altered by adopting a reduced-calorie diet, losing excess weight, and exercising regularly. The use of lipid-lowering drugs such as statins and PCSK9-inhibitors will significantly reduce LDL-P.
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