Abstract
Increased frequency of small, dense LDL is associated with the risk of coronary heart disease (CHD). Possible mechanisms include increased susceptibility of small, dense LDL to oxidation and its high affinity for LDL-receptor-independent cell surface binding sites. Although more than 30% of adult men in USA has been reported to have small, dense LDL, only 5.4% of young Japanese men had small, dense LDL. However, more than 70% of Japanese subjects with CHD had small, dense LDL, indicating a clinical importance of LDL size in the development of CHD in Japan. Furthermore, almost half of obese women (BMI>35kg/m2) had small, dense LDL. Our previous observation revealed that type 2 diabetics had smaller LDL even if they were apparently normolipidemic. There was also a close relationship between LDL size and plasma triglyceride even in the population with normotriglyceridemia, which may suggest that the plasma triglyceride is“the lower the better”from the stand point of LDL size. Finally, weight reduction of obese women by strict diet control, treatment of diabetics by acarbose or troglitazone and treatment of hyperlipidemia by a new statins, fluvastatin, were all successful in increasing LDL size associated with decreased plasma triglyceride.
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