Conclusions Study -level data from this systemic review establish that different lipid lowering agents can lead to discordance between LDL-P and LDL-C , therefore , basing LDL-lowering therapy only on the achievement of cholesterol goals may result in a treatment gap .
Therefore , the use of LDL-P for monitoring lipid-lowering therapy , particularly for statins , can provide a more accurate assessment of residual cardiovascular risk
Purpose This systematic review was performed to summarize published experience using low density lipoprotein particle number ( LDL-P ) to monitor the efficacy of  lipid-lowering pharmacotherapies .
Treatment of obesity with diet/exercise versus pioglitazone has distinct effects on lipoprotein particle size.
OBJECTIVE We compared the effects of diet/exercise induce weight loss versus pioglitazone on lipoprotein particle characteristics in non-diabetic , insulin resistant adults to determine whether the responses and potential mechanisms for improvement are similar between these two insulin sensitizing regimens . METHODS AND RESULTS Thirty-seven obese , insulin resistant volunteers were r and omized to 19 weeks of either pioglitazone or diet/exercise treatment .  Insulin sensitivity ( Si ) by IVGTT and lipoprotein subclass particle profiles by NMR was measured . Only diet/exercise lowered TG ( -40+/-11 mg/dL ) , total ( -29+/-4 mg/dL ) and LDL cholesterol ( -20+/-4 mg/dL ; all p<0.01 ) . Both diet/exercise and pioglitazone improved Si ( p<0.05 ) , decreased total LDL particles ( -227+/-40 and -149+/-21 nmol/L , respectively , both p<0.001 ) and small LDL particles ( -242+/-58 and -226+/-36 , respectively , both p<0.001 ) . Large LDL particle concentrations increased with both treatments . LDL particle subclasses changes correlated with changes in Si only in the diet/exercise group . CONCLUSION In obese , insulin resistant non-diabetic adults , pioglitazone improved LDL particle characteristics in a manner similar to diet/exercise without changing TG , diabetic control , total or LDL cholesterol . This effect could have implication s for atherosclerotic risk
Conclusions Study -level data from this systemic review establish that different lipid lowering agents can lead to discordance between LDL-P and LDL-C , therefore , basing LDL-lowering therapy only on the achievement of cholesterol goals may result in a treatment gap .
Therefore , the use of LDL-P for monitoring lipid-lowering therapy , particularly for statins , can provide a more accurate assessment of residual cardiovascular risk
Purpose This systematic review was performed to summarize published experience using low density lipoprotein particle number ( LDL-P ) to monitor the efficacy of  lipid-lowering pharmacotherapies .