The dynamic, continuous exchange and fluctuation of triglyceride content within the Low-Density Lipoprotein particles in the circulation, influencing their density, size, and potential for contributing to arterial plaque formation. This cycling process is a key determinant of the metabolic quality of circulating LDL.
Origin
This concept originates from advanced lipoprotein metabolism research, specifically the understanding of how lipid transfer proteins mediate the movement of triglycerides and cholesterol esters between the various lipoprotein classes. It defines a dynamic aspect of dyslipidemia that goes beyond simple total cholesterol measurements.
Mechanism
Cholesterol Ester Transfer Protein (CETP) facilitates the exchange of triglycerides from triglyceride-rich lipoproteins for cholesterol esters in LDL and High-Density Lipoprotein (HDL). This exchange often leads to the formation of smaller, denser, and generally more pro-atherogenic LDL particles, a state highly sensitive to metabolic dysfunction like insulin resistance.
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