Fig. 5.

A possible association of LCAT activity and LDL-Rm value, an indicator of LDL-particle size, with the development of ASCVD in this study. In an atherogenic state, RCT system might be activated. Accordingly, increased LCAT activity measured as a serum cholesterol esterification rate by the endogenous substrate method might be associated with altering HDL metabolism, resulting in an increase in the serum levels of TRL-related markers and a decrease in LDL-particle size (i.e. an increase in LDL-Rm value), leading to the development of ASCVD. However, further investigations are necessary for the elucidation of the precise mechanism involved in atherosclerosis associated with increased LCAT activity and decreased LDL particle size. LCAT = lecithin-cholesterol acyltransferase, LDL = low-density lipoprotein, LDL-Rm = relative LDL migration, ASCVD = atherosclerotic cardiovascular disease, RCT = reverse cholesterol transport, HDL = high-density lipoprotein, TRL = triglyceride–rich lipoprotein