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Familial combined hyperlipidemia (FCH) is characterized by a familial occurrence of a multiple-type hyperlipidemia, associated with coronary risk. The latter may be related to increased levels of small, dense LDL particles that have been found to be more prone to oxidative modification. We isolated total LDL as fresh as possible from 12 normolipidemic relatives with a buoyant LDL subfraction profile (group 1), 7 normolipidemic subjects with a dense LDL subfraction profile (group 2), and 16 hyperlipidemic FCH subjects with a dense LDL subfraction profile (group 3). In these nonobese and normotensive men, we studied the resistance of total LDL against Cu(2+)-oxidation in vitro. In addition, we analyzed the alpha-tocopherol and the coenzyme Q10 contents of LDL and determined their relation to LDL oxidizability. LDL isolated from group 3 subjects was more susceptible to oxidative modification than LDL from group 1 subjects (lag time: 60.4 +/- 8.1 versus 70.4 +/- 11.4 minutes; P < .05). For the combined groups, the ratio of ubiquinol-10 to polyunsaturated fatty acids in LDL, together with the basal amount of dienes in LDL, were good predictors of the rate of LDL oxidation (R2 = .73, P = .0001). In groups 2 and 3, the redox status of coenzyme Q10 (ubiquinol-10/ubiquinone-10) and the ratio of ubiquinol-10 to alpha-tocopherol in LDL were reduced compared with group 1 (P < .05). The K-value a measure of the LDL density, correlated with the the redox status (r = .37, P < .05). We conclude that in subjects with FCH total LDL is more prone to oxidation, due to the predominance of dense LDL particles. In addition, the decreased redox status of coenzyme Q10 in LDL from subjects with a dense LDL subfraction profile suggests that the LDL in the circulation has already undergone some oxidation.

We investigated the effect of different interventions on aortic atherosclerosis in Watanabe rabbits. Four groups of rabbits were fed either an oleic acid-enriched diet (80% of total fat intake) with or without vitamin E supplementation (250 IU/kg) or a diet enriched in linoleic acid with or without vitamin E supplementation for 6 months. At the start of the study, plasma cholesterol concentration was 21.4 +/- 3.6 mmol/L (n = 32). The diets did not influence the mean plasma lipids and lipoprotein concentrations except for HDL cholesterol, which was increased more on the oleic acid-enriched diets than on the linoleic acid-enriched diets. Vitamin E levels in plasma and LDL were increased on the oleic acid diet and reduced on the linoleic acid diet. On the latter diet, supplementation of vitamin E was quantitatively less effective in raising plasma or LDL vitamin E levels. The susceptibility of LDL to oxidation was determined in vitro. Both oleic acid-enriched diets increased the lag time by 140% from baseline. The linoleic acid diet supplemented with vitamin E increased lag time by 59%. Linoleic acid alone, however, decreased the lag time by 30%. Similar but inverse effects were seen on LDL oxidation rate. Thus, intervention protected LDL to oxidation in the following order: oleic acid plus vitamin E > oleic acid > linoleic acid plus vitamin E > linoleic acid. Despite the differences in LDL oxidizability induced by the four experimental diets, assessment of aortic atherosclerosis at the end of the 6-month dietary study period revealed no differences among the four study groups.(ABSTRACT TRUNCATED AT 250 WORDS)