Structure and Function of Low-Density Lipoprotein

Lipoprotein particle size in the body varies from 10 to 1000 nm. They usually have a hydrophobic core that contains triglycerides and fatty acids. The largest lipoprotein particle in the body is the chylomicron which measures about 1000 nm and is a minor dense variant of the lipoproteins.

The LDL particles are smaller than the IDL. They have a density of about 1.04 (density of high-density lipoprotein (HDL) is about 1.12). LDL particles consist of the apolipoprotein apo-B100 complex in them. They are made up of proteins (20-22\%20−22%), triglycerides (10-15\%10−15%), phospholipids (20-28\%20−28%), cholesteryl esters (37-48\%37−48%) and cholesterol (8-10\%8−10%).

The primary function of LDL is the transportation of dietary and endogenous cholesterol. In the plasma, LDL is the primary transporter molecule of cholesterol and cholesteryl esters. The LDL molecules are absorbed with their constituent cholesterol into organs like the liver through receptor-mediated endocytosis. The receptors recognize the apo-B100 domain of the LDL. Lowering pH by proton pumps causes LDLs to disassociate and release the contained cholesterol inside the cells. The intracellular lysozyme eventually degrades the LDLs.

Risks of High LDL Levels
The low-density lipoproteins or LDLs contain more proteins as compared to lipids when compared to other lipoprotein molecules. This causes the molecules to have a higher density than molecules like VLDLs. What is unique about LDL is that LDLs makeup about 50% of all lipoproteins in the body and thus take cholesterol to all cells that need it. However, LDL tends to accumulate on the walls of blood vessels forming plaques (atherosclerosis) which links it to several diseases. Thus, LDLs are often referred to as “bad cholesterols”.

Very high LDL levels in the body increase the chance of occurrence of diseases like:

Coronary artery disease (CAD)

Peripheral artery disease (PAD)

Chest pain, and angina

More probability of heart attack or stroke

Diabetes, in some cases

Several factors can affect the LDL levels, and thus the probability of occurrence of these problems in one’s body:

Consuming more saturated fats in one’s diet.

Being overweight increases LDL levels.

Cigarette smoking can lower HDL levels, thus consequently increasing LDL levels.

With the increase in age, levels of LDL may rise too. Women may see a sharp rise in their LDL levels after menopause.

Their genetics may also determine levels of cholesterol produced in a person.

Steroid and hypertension medications may increase LDL levels in the blood.

Diseases like diabetes and chronic kidney diseases may contribute to a rise in LDL levels.

Diagnosis and Treatment of High LDL Levels
A blood test can determine the lipoprotein and cholesterol levels in a person. A blood test for cholesterol is recommended every 4 to 6 years (maybe more often for people with diabetes and heart problems). LDL levels are expected to stay low to confirm a low risk.

In the case of patients with heart diseases, a level below 70 mg/dL is recommended. There are simple steps to ensure a low LDL level in the body. These are as follows:

A healthy diet that has less cholesterol content, sugar, and saturated fats.

Getting regular aerobic (cardio) exercise.

Losing weight in the case of overweight patients.

Quitting tobacco use and smoking.

Taking medications like statins helps the body produce less cholesterol.

If a patient cannot take statins or has severely high levels of cholesterol, PCSK9 inhibitor shots might be prescribed. These help the liver remove excess LDL from the blood.

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