Figure 2.

Comparison of pathways of cholesteryl ester transfer protein-mediated heterotransfer of neutral core lipids between lipoprotein particles in normotriglyceridaemia vs. mixed dyslipidaemia involving moderate to marked hypertriglyceridaemia and subnormal levels of triglyceride-enriched high-density lipoprotein. In normotriglyceridaemia, net cholesteryl ester transfer from high-density lipoprotein to low-density lipoprotein predominates, with minor transfer to triglyceride-rich lipoproteins. In hypertriglyceridaemic states, increased numbers of very low-density lipoprotein particles constitute preferential cholesteryl ester acceptors giving rise to elevated acceptor capacity for cholesteryl ester transfer protein; high net mass transfer rates of cholesteryl ester from high-density lipoprotein to triglyceride-rich lipoproteins and of triglyceride from triglyceride-rich lipoproteins to both high- and low-density lipoproteins result. Triglyceride enrichment of both high- and low-density lipoproteins by this mechanism gives rise to formation of small dense low-density lipoprotein and small dense high-density lipoprotein.⁴⁵ Modified from Barter et al.⁴⁹ (with permission from Lippincott Williams and Wilkins).