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LDL Particle Size Subclass LDL
particles can be separated on the basis of size and density into several different
subclasses, as illustrated here. Small dense, triglyceride-rich LDL are believed to be
more atherogenic than the large buoyant variety. A predominance of small LDL is referred
to as the pattern B phenotype. Pattern B phenotype is one manifestation of what has been
termed the Atherogenic Lipid Profile, a Mendelian-dominant inherited condition which also
includes low levels of HDL-C, raised triglycerides, and insulin resistance. The presence
of the pattern B phenotype increases the risk for clinical coronary heart disease by
several fold. Niacin, fibrates, and bile-acid binding resins (but not statins) can cause
favorable shifts in the LDL particle size subclass distribution from small towards large. |