sdLDL Levels Research Articles

Sağlıklı Gönüllülerde Ceviz Tüketiminin Küçük Yoğun Düşük Yoğunluklu Lipoprotein ve Diğer Serum Lipid Faktörleri Üzerine Etkisi

Objective: This study has investigated the effects of walnut consumption on the serum lipids and especially small dense lowdensity lipoprotein (sdLDL) values of healthy volunteers. Material and Methods: Volunteers participating in this study were asked to consume 30 grams of walnuts per day. Walnuts were presented to individuals in packages and were asked to consume at breakfast every morning for 21 days. An short message service (SMS) reminder was made every day so that individuals would not forget to intake walnuts. The blood values of subjects were measured at the beginning and the end of the study. Serums were obtained from the collected blood, and blood lipid parameters were analyzed routinely in the biochemistry laboratory. The sdLDL parameter was analyzed by the ELISA method. Results: The effect of walnut consumption on the lipid parameters was investigated. It was found that regular walnut consumption has significantly decreased the LDL (p<0.001), total cholesterol (p<0.001), sdLDL (p<0.001), and HDL (p=0.008) parameters. A significant change was not observed for the triglyceride levels. Besides, there is a statistically significant difference in carbohydrate, linoleic acid, and a-linolenic acid intake compared to Turkey Nutrition and Health Research. There was no significant difference in the individuals' energy, cholesterol, monounsaturated fatty acid, and saturated fatty acid intakes Also, food consumption record form was obtained from individuals. Conclusion: In this study, supplementation walnut to the healthy volunteers' diet has reduced LDL, sdLDL, and total cholesterol levels. We think that walnut consumption has a protective effect especially on cardiovascular risk factors.

Creation and evaluation of predictive equations for the indirect small-dense LDL level calculation from basics lipid parameters of lipid profile

Background and Aims: Numerous studies based on clinical pathology and epidemiology criteria have shown that larger quantity of small-dense LDL (sdLDL) as a result from change in the lipoprotein metabolism is closely associated with higher cardiovascular disease (CVD) risk. Objectives: Creation and evaluation of predictive equations for the indirect sdLDL level calculation from basics lipid parameters of lipid profile and determination of hyperLDLsd risk (>35mg/dl) in dyslipidemic patients.

Small Dense Low-Density Lipoprotein for Risk Prediction of Acute Coronary Syndrome.

BackgroundElevated Low density Lipoprotein (LDL) levels have been traditionally associated with development of atherosclerotic coronary artery disease (CAD). As LDL-cholesterol levels are not always raised in acute coronary syndrome (ACS) patients, sd-LDL is an emerging risk factor. The purpose of the present study was tri-fold. Firstly, it aimed to investigate the association of sd-LDL as a risk factor in ACS patients. Secondly, it aimed to correlate the presence of sd-LDL with severity of coronary artery disease as determined by coronary angiography. Lastly, it aimed to correlate the presence of sd-LDL with short-term outcomes.MethodsThis was a prospective, hospital-based, cross-sectional, case-control study conducted over a 1-year study duration. Patients above the age of 18 years diagnosed with ACS within 24 h of admission were studied. Blood samples were collected after all patients had undergone coronary angiography and sd-LDL levels were measured.ResultsACS patients had significantly higher sd-LDL levels than non-ACS patients (16.10 ± 1.42 mg/dL vs. 12.67 ± 0.71 mg/dL, P = 0.036). Males had significantly higher sd-LDL levels than females (16.79 ± 1.55 mg/dl vs. 10.77 ± 2.62 mg/dl, P=0.047). Patients with non-left anterior descending coronary artery (LAD) involvement had significantly higher sd-LDL levels compared to patients with LAD involvement (21.92 ± 3.55 mg/dL vs. 14.03 ± 1.35 mg/dL, P = 0.007).ConclusionThese results suggest that sd-LDL is a risk factor for the development of ACS in an Indian population.

Impact of small and dense low-density lipoprotein (sd-LDL)on contrast-induced acute kidney injury in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

To investigate the impact of serum small and dense low-density lipoprotein (sd-LDL) on contrast-induced acute kidney injury (CI-AKI) after emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). From November 2019 to August 2020, 352 patients with STEMI who underwent primary PCI were recruited consecutively. Patients were divided into CI-AKI group (n = 71) and non-CI-AKI group (n = 281). CI-AKI was defined as an increase in serum creatinine (≥ 25% or ≥ 0.5mg/dL) from baseline occurring 72h after PCI. All subjects were tested for sd-LDL. In the 352 eligible patients with STEMI receiving emergency PCI, 71 patients (20.2%) developed CI-AKI. The levels of sd-LDL in CI-AKI group was higher than those in the non-CI-AKI group, and the difference was statistically significant (P < 0.05). The area under the curve (AUC) of the sd-LDL was 0.741 [95% confidence interval (CI) 0.538-0.636] in the STEMI patients receiving emergency PCI. CI-AKI model included the following five predictors: sd-LDL, NLR, Diabetes, Pre-PCI eGFR, and Log NT-proBNP. The AUC of forecast probability was 0.835 [95% confidence interval (CI) 0.786-0.883].The Hosmer-Lemeshow test has a P value of 0.519, which confirms the model's goodness of fit. Increased sd-LDL is independently associated with risk of CI-AKI in STEMI patients treated by primary PCI.

Circulating microRNA-126 &122 in patients with coronary artery disease: Correlation with small dense LDL

BackgroundCoronary artery disease (CAD) and stroke are major causes of cardiovascular diseases related deaths. Conventional risk factors cannot explain the changes in atherosclerosis. New and useful diagnostic markers are required. MicroRNAs are small, noncoding RNA that regulate the gene expression implicated in the pathogenesis of various cardiovascular diseases. Endothelial dysfunction is involved in the early event of the atherosclerosis process. AimsThe current study was designed to evaluate the vascular endothelium-enriched miRNAs would be altered in CAD patients. MethodsCirculating miR-126 & 122 levels were measured in serum from 78 CAD patients and 60 non CDA patients by qRT-PCR analysis. ResultsMiR-122 was significantly down regulated in CAD patients (p = 0.001), however the level of miR-126 did not show any change (p = 0.507). Remarkably, the level of miR-126 was significantly decreased in patients with CAD and high small dense low density lipoprotein (sdLDL) level. The level of miR-126 was significantly increased when sdLDL was higher in patients with risk factors for CAD but did not have angiographically significant CAD. Conclusion. In CAD patient’s, miR-126 level was lowered compared to non CAD patients, however the difference was not significant (0.507). However we found a direct relationship between endothelium-enriched miR-126 and sdLDL in patients with or without CAD. Our finding suggests that miR-126 may have a potential role in sdLDL cholesterol metabolism. Mir-122 plays a role in cholesterol biosynthesis and deteriorates the cardiovascular system through the process of inflammation, apoptosis, oxidative stress and ECM deposition in a number of cardiovascular diseases.

Lp-PLA2 evaluates the severity of carotid artery stenosis and predicts the occurrence of cerebrovascular events in high stroke-risk populations.

BackgroundLipoprotein‐associated phospholipase A2 (Lp‐PLA2) is an independent risk factor for cardiovascular disease. However, relationship between carotid artery stenosis and cerebrovascular events in high stroke‐risk populations is still unclear.MethodsA total of 835 people at a high risk of stroke were screened from 15,933 people aged >40 years in April 2013 and followed at 3, 6, 12, and 24 months. Finally, 823 participants met the screening criteria, and the clinical data and biochemical parameters were investigated.ResultsAmong the 823 participants, 286 had varying degrees of carotid artery stenosis and 18 had cerebrovascular events. The level of Lp‐PLA2 in the carotid artery stenosis group was higher than that in the no stenosis group, and the level in the event group was higher than that in the no event group (p < 0.05). Spearman correlation analysis showed that Lp‐PLA2 was positively correlated with the degree of carotid artery stenosis (r = 0.093, p = 0.07) and stenosis involvement (r = 0.094, p = 0.07). The correlation coefficient between Lp‐PLA2 and lipoprotein was the highest on the levels of sdLDL (r = 0.555, p < 0.001), followed by non‐HDL, LDL, TC, and TG. Cox multivariate regression analysis revealed that, compared with the first quantile of Lp‐PLA2 level (Q1, low level), the risk of cerebrovascular events in the fourth quantile of Lp‐PLA2 was 10.170 times that of the first quantile (OR = 10.170, 95% CI 1.302–79.448, p = 0.027).ConclusionsLp‐PLA2 levels can evaluate carotid artery stenosis and predict the occurrence of cerebrovascular events in high stroke‐risk populations and provide scientific guidance for risk stratification management.

Treatment of Hepatitis C Virus Infection with Direct-acting Antiviral Agents Elevates the Serum Small-dense Low-density Lipoprotein Cholesterol Level.

Objective The low-density lipoprotein cholesterol (LDL) level is known to increase following the treatment of hepatitis C virus (HCV) infection using direct-acting antiviral agents (DAAs). This study aimed to investigate the changes in the lipid profiles, including small-dense LDL cholesterol (sdLDL), in HCV patients treated with DAAs. Patients We retrospectively assessed 67 HCV patients who achieved sustained virological response with DAA administration and were observed for more than 2 years, of whom 32 were on daclatasvir/asunaprevir, 14 were on sofosbuvir/ledipasvir, and 21 were on sofosbuvir/ribavirin. Methods We evaluated the lipid profiles, including sdLDL, every 6 months until 2 years after the start of treatment and analyzed the factors related to changes in the sdLDL level. Results The median sdLDL value at baseline was 12.8 mg/dL, which increased to 19.5 mg/dL at 6 months (p<0.001) and remained elevated at 25.4 mg/dL at 2 years later (p<0.001). The Kaplan-Meier curve indicated that patients with high values of LDL, albumin, muscle attenuation and visceral to subcutaneous adipose tissue area ratio were at increased risk for elevation of sdLDL over 35 mg/dL (log-rank test: p<0.001; p=0.008, p=0.002 and p=0.042, respectively). A multivariate analysis performed on the factors contributing to elevation of sdLDL 2 years after DAA treatment (≥35.0 mg/dL) revealed pretreatment LDL (≥91.0 mg/dL) and muscle attenuation (≥33.7 HU) as significant factors (p=0.007 and p=0.032, respectively). Conclusion SdLDL increased continuously after DAA treatment, and high LDL levels and low intramuscular fat deposition before treatment contributed to elevated sdLDL levels after treatment.

Can calculated SdLDL serve as a substitute for estimated SdLDL?

Background: SdLDL is the atherogenic component of LDL. Though it is a predictive biomarker for coronary artery disease, lack of standardisation, complexity and cost of analytical techniques has prevented SdLDL from being routinely estimated in clinical practice. Methods available for estimation include Ultracentrifugation, NMR, HPLC and the enzymatic method. Srisawasdi et al. 2011 developed a formula for estimation of SdLDLusing commonly estimated lipid parameters. The formula was: SdLDL (mg/dl) = 0.580(non HDL- Cholesterol) + 0.407(direct LDL- Cholesterol) – 0.719(calculated LDL- Cholesterol) – 12.05. Mohan et al. 2005 proposed that Triglyceride/ HDL ratio of 3.0 had optimum sensitivity for predicting elevated SdLDL, hence TG/HDL ratio could be used to predict SdLDL levels instead of directly estimating SdLDL.&#x0D; Aims and Objectives: The study was to determine the correlation between SdLDL estimated using the enzymatic method and between that calculated using Srisawasdi’s formula, and Mohan et al.’s proposed TG/HDL ratio.&#x0D; Materials and Methods: This a retrospective study done on 374 samples for which total cholesterol, HDL, LDL and triglycerides were estimated using routine methods and SdLDL by the enzymatic method. SdLDL was calculated using Srisawasdi’s formula and correlation was determined between estimated and calculated SdLDL. We also determined the correlation between the estimated SdLDL and TG/HDL ratio, and with Non HDL.&#x0D; Results: A highly significant and positive correlation was found between estimated and calculated SdLDL (r=0.74, p&lt;0.001), and between estimated SdLDL and non HDL (r=0.721, p=&lt;0.001). The correlation between SdLDL and TG/HDL ratio was positive but poor (r=0.353). &#x0D; Conclusions: Calculated SdLDL may be used as a substitute for estimated SdLDL. Further studies on a larger population are required before use of calculated SdLDL can be implemented in routine clinical practice.

Predictive Value of Small Dense Low-Density Lipoprotein in Coronary Heart Disease in the Chinese Population.

Coronary heart disease (CHD) is a global public health concern, and CHD risk assessment remains a major challenge. Therefore, in this study, the ability of small dense low-density lipoprotein (sdLDL) alone to sufficiently predict CHD risk in the Chinese population was evaluated. Patients with CHD (139) and healthy controls (58) were included in this study. Serum sdLDL was measured using the peroxidase method. Other lipid parameters were also determined. The sdLDL level in the CHD group was significantly higher than that in the control group (p < 0.001). Logistic regression analysis revealed that sdLDL was an independent risk factor for CHD. Based on the receiver operating characteristic curves, the area under the curve (AUC) of sdLDL alone for CHD was 0.722. The AUC of triglycerides (TG), high-density lipoprotein (HDL), and sdLDL combined was 0.763, which was larger than that of the independent ones or combinations of any two; however, the value was not significant. sdLDL alone can predict CHD risk efficiently similar to the combination of TG, HDL, and sdLDL. This finding suggests that sdLDL can be considered as an ideal parameter for the preliminary diagnosis of CHD in Chinese people.

Proatherogenic Changes in the Blood Lipid Profile in Patients with Cerebrovascular Disease and Type 2 Diabetes

The link between type 2 diabetes mellitus and atherosclerotic lesions in the cerebral arteries is one of the leading risk factors for acute and chronic cerebrovascular disease (CVD). Materials and methods: 126 patients with cerebrovascular disease (CVD) were examined to assess the proatherogenic blood changes: Group 1 consisted of 75 patients with CVD and type 2 diabetes mellitus (T2DM), aged 65 [55; 71] years, including 36 men; Group 2 consisted of 51 patients without T2DM, aged 66 [59; 72] years, including 23 men. The control group consisted of 32 people without CVD and T2DM, aged 63 [50; 67] years, including 17 men. All patients underwent a clinical examination, a range of biochemical blood tests, neuroimaging and vascular imaging studies. The results of the lipid panel (in particular, small dense LDL (sdLDL) and carbohydrate metabolism (glycated haemoglobin (HbA1c)) were the primary focus when the laboratory blood results were examined. Results: patients in the comorbidities group (CVD + T2DM) were more likely to have a history of CVD (52% versus 33.3% of all cases, p = 0.035) and haemodynamically significant carotid artery stenosis (38.6% versus 21.6%, p = 0.044). The concentration of hyperatherogenic sdLDL particles was also significantly higher in this group—49.1 [46.3; 53.7] mg/dL versus 33.4 [26.7; 45.6] mg/dL in patients with CVD but without T2DM, and 25.0 [19.9; 29.4] in the control group. At the same time, sdLDL values in Group 1 patients correlated with LDL, triglycerides, fasting glycaemia and HbA1c levels. Conclusion. Atherosclerotic plaques in the brachiocephalic arteries in CVD are accompanied by proatherogenic changes of the blood lipid spectrum. The sdLDL level is highest and correlates with the severity of carbohydrate metabolism disorders in patients with chronic CVD and T2DM.

Association of small, dense LDL-cholesterol concentration and lipoprotein particle characteristics with coronary heart disease: A systematic review and meta-analysis.

The aim of this study was to systematically collate and appraise the available evidence regarding the associations between small, dense low-density lipoprotein (sdLDL) and incident coronary heart disease (CHD), focusing on cholesterol concentration (sdLDL-C) and sdLDL particle characteristics (presence, density, and size). Coronary heart disease (CHD) is the leading cause of death worldwide. Small, dense low-density lipoprotein (sdLDL) has been hypothesized to induce atherosclerosis and subsequent coronary heart disease (CHD). However, the etiological relevance of lipoprotein particle size (sdLDL) versus cholesterol content (sdLDL-C) remains unclear. PubMed, MEDLINE, Web of Science, and EMBASE were systematically searched for studies published before February 2020. CHD associations were based on quartile comparisons in eight studies of sdLDL-C and were based on binary categorization in fourteen studies of sdLDL particle size. Reported hazards ratios (HR) and odds ratios (OR) with 95% confidence interval (CI) were standardized and pooled using a random-effects meta-analysis model. Data were collated from 21 studies with a total of 30,628 subjects and 5,693 incident CHD events. The average age was 67 years, and 53% were men. Higher sdLDL and sdLDL-C levels were both significantly associated with higher risk of CHD. The pooled estimate for the high vs. low categorization of sdLDL was 1.36 (95% CI: 1.21, 1.52) and 1.07 (95% CI: 1.01, 1.12) for comparing the top quartiles versus the bottom of sdLDL-C. Several studies suggested a dose response relationship. The findings show a positive association between sdLDL or sdLDL-C levels and CHD, which is supported by an increasing body of genetic evidence in favor of its causality as an etiological risk factor. Thus, the results support sdLDL and sdLDL-C as a risk marker, but further research is required to establish sdLDL or sdLDL-C as a potential therapeutic marker for incident CHD risk reduction.

Association between the FABP2 Ala54Thr and CRP+1059C/G polymorphisms and small dense LDL level in patients with atherosclerosis: a case–control study

Background The polymorphisms of fatty acid-binding protein 2 (FABP2) and C-reactive protein (CRP) might act as genetic risk factors for atherosclerosis. The study aimed to investigate the relationship between FABP2 Ala54Thr and CRP+1059C/G polymorphisms and atherosclerosis as well as the association of Small dense-LDL (sd-LDL). Methods A total of 255 subjects (125 controls and 130 patients) were included. The FABP2 and CRP polymorphisms were determined by PCR-RFLP and AS-PCR methods, respectively. Sd-LDL was measured based on Hirano et al method. Results There were no significant distinctions between the patient and control groups concerning FABP2 and CRP polymorphisms (p > .05). No significant relationship was observed between studied polymorphisms and sd-LDL level in the patient group (p > .05). However, patients group had higher level of sd-LDL compared to controls (p < .05). Conclusion FABP2 Ala54Thr and CRP+1059G/C polymorphisms were not associated with atherosclerosis and sd-LDL level. However, the increased sd-LDL level was known as a risk factor for atherosclerosis.

Small dense low-density lipoprotein-lowering agents.

Metabolic disorders, including obesity, diabetes, and hyperlipidemia, as well as cardiovascular diseases (CVD), particularly atherosclerosis, are still leading causes of death worldwide. Plasma levels of low-density lipoprotein (LDL) are currently being considered as a critical risk factor for the diseases mentioned above, especially atherosclerosis. Because of the heterogeneous nature of LDL, many studies have already been conducted on its subclasses, especially small dense LDL (sdLDL). According to available evidence, sdLDL levels can be considered as an ideal alternative to LDL levels for monitoring CVD and early diagnosis of atherosclerosis. Recently, several researchers have focused on factors that are able to decrease sdLDL levels and improve health quality. Therefore, the purpose of this study is to describe the production process of sdLDL particles and review the effects of pharmaceutical and dietary agents as well as lifestyle on sdLDL plasma levels. In brief, their mechanisms of action are discussed. Apparently, cholesterol and LDL-lowering compounds are also effective in the reduction of sdLDL levels. In addition, improving lipid profile, especially the reduction of triglyceride levels, appropriate regimen, and lifestyle can decrease sdLDL levels. Therefore, all the aforementioned parameters should be taken into consideration simultaneously in sdLDL levels reducing strategies.

135-OR: The Effect of Fixed-Dose Combination of Insulin Degludec and Liraglutide on Serum Lipoprotein Metabolism in Patients with Type 2 Diabetes Mellitus

Aim: Administration of fixed-dose combination of Insulin Degludec and Liraglutide (IDegLira) has been associated with changes in the lipid-profile of diabetic patients. We assessed the effect of IDegLira on serum apolipoproteins, apoB-containing lipoprotein subclasses and HDL lipidome in patients with type 2 diabetes mellitus (T2DM). Methods: Sixty uncontrolled patients with T2DM on oral antidiabetic drugs were included. Of them, thirty received IDegLira and the remaining Insulin Degludec(IDeg). Lipid and carbohydrate metabolism parameters were assessed before and following 3-month-treatment. ApoB-containing lipoprotein subclasses levels were measured by LDL-Lipoprint method, whereas HDL lipidomic analysis via 1H-NMR spectroscopy. Results: Administration of IDegLira resulted in a significant reduction of total (TC) and LDL cholesterol (LDLC) by 14.68mg/dl and 10.45mg/dl, respectively. ApoA1 and apoB decreased in patients treated with IDegLira. A non-significant change in small-dense LDLC (sdLDL-C) levels was observed that was significantly correlated with changes in TG levels (r=0.468, p=0.007). Furthermore, IDegLira administration resulted in significant enrichment of HDL particles’ core in esterified cholesterol and depletion of TGs content. IDegLira induced an atheroprotective shift in fatty acid pattern of HDLs characterized by a statistically significant lower content in saturated and higher in unsaturated fatty acids (linoleic acid, eicosapentaenoic and arachidonic acids and docosahexaenoic acid). No significant changes were observed in the IDeg group. Conclusions: Administration of IDegLira is accompanied by changes in HDL lipdome, a decrease in TC, LDLC, apoA1 and B, while the levels of sdLDL were only reduced in patients experiencing a decrease in TGs. The contribution of these changes to cardiovascular risk reduction after treatment with liraglutide in clinical trials cannot be excluded. Disclosure E. Pappa: None. C. Kostara: None. C. Tellis: None. A.D. Tselepis: None. E. Bairaktari: None. V. Tsimihodimos: None.

Association of small dense low-density lipoprotein with cardiovascular outcome in patients with coronary artery disease and diabetes: a prospective, observational cohort study

BackgroundElevation in small dense low-density lipoprotein (sdLDL) is common in patients with diabetes mellitus (DM), which has already been reported to be associated with incidence of coronary artery disease (CAD). The aim of the present study was to investigate the prognostic value of plasma sdLDL level in patients with stable CAD and DM.MethodsA total of 4148 consecutive patients with stable CAD were prospectively enrolled into the study and followed up for major cardiovascular events (MACEs) up to 8.5 years. Plasma sdLDL level was measured in each patient by a direct method using automated chemistry analyzer. The patients were subsequently divided into four groups by the quartiles of sdLDL and the association of sdLDL level with MACEs in different status of glucose metabolism [DM, Pre-DM, normal glycaemia regulation (NGR)] was evaluated.ResultsA total of 464 MACEs were documented. Both Kaplan–Meier analysis and Cox regression analysis indicated that the patients in quartile 4 but not quartile 2 or 3 of sdLDL level had significantly higher rate of MACEs than that in lowest quartile. When the prognostic value of high sdLDL was assessed in different glucose metabolism status, the results showed that the high sdLDL plus DM was associated with worse outcome after adjustment of confounding risk factors (hazard ratio: 1.83, 95% confident interval: 1.24–2.70, p < 0.05). However, no significant association was observed for high sdLDL plus Pre-DM or NGR.ConclusionsThe present study firstly indicated that elevated levels of plasma sdLDL were associated with increased risk of MACEs among DM patients with proven CAD, suggesting that sdLDL may be useful for CAD risk stratification in DM.

Integrated Small Dense Low-density Lipoprotein Profile in Cardiovascular Disease and Cancer: A Longitudinal Study.

Low-density lipoproteins (LDL) are a heterogeneous class of particles that differ in size and density from each other. Small dense LDL (sdLDL) particles are considered more atherogenic than larger particles. The aim of the study was to evaluate serum levels of sdLDL in patients who died from cardiovascular diseases (CVD) or cancer in a cohort of patients followed up in the De Bellis Research Hospital for 20 years. A total of 75 participants who died of cancer and 87 who died of CVD were enrolled and they were matched for age and sex with 135 healthy controls, i.e. without CVD or cancer and are still alive. Patients who died from cancer had the highest value of LDL IV subfraction (0.25±1.16), followed by those who died from CVD (0.17±0.96). The integrated profile of sdLDL between CVD and cancer suggests that therapeutic modulation of sdLDL may be associated with a risk reduction for these diseases.

PCSK9 positively correlates with plasma sdLDL in community-dwelling population but not in diabetic participants after confounder adjustment.

This study aimed to investigate the relationship between plasma proprotein convertase subtilisin kexin 9 (PCSK9) and small dense low-density lipoprptein (sdLDL) in diabetic and non-diabetic participants in a community-dwelling cohort.The plasma levels of PCSK9 and sdLDL were detected in 1766 participants (median age: 61.40 years; 733 males vs 1033 females; 383 diabetic vs 1383 non-diabetic patients) from the Pingguoyuan community of Beijing, China.Results showed that Pearson correlation analysis revealed a positive correlation between PCSK9 and sdLDL (r = 0.263, P < .001). Multiple linear regression analysis showed a significant positive correlation between plasma PCSK9 and sdLDL in the whole population study. sdLDL was used as the dependent variable, and the potential cofounders were adjusted. However, any independent relationship was not observed between circulating PCSK9 and sdLDL in the diabetic subpopulation (r = 0.269, P < .05, β = 9.591, P > .05).Thus, there is a positive correlation between plasma PCSK9 and sdLDL in a community-dwelling cohort, but not in type 2 diabetic subpopulation, after confounder adjustment.

Small Dense Low-Density Lipoprotein: Biomarker or Potential Drug Target?

AbstractIschemic heart disease is currently an epidemic affecting individuals worldwide. Increased incidence along with earlier onset of disease has led to the constant search for biomarkers that will help in earlier identification and treatment of at risk individuals. Small dense low-density lipoprotein (sdLDL) is the atherogenic subtype of low-density lipoprotein (LDL). It is smaller in size and higher in density in comparison to other LDL subtypes. Higher levels of sdLDL have beenfound to be associated with increased incidence of ischemic heart disease and adverse outcomes. Properties including decreased resistance to oxidative stress and prolonged residence time in the circulation account for its increased atherogenic potential. Hence intervention approaches targeting sdLDL directly in at risk individuals may be beneficial.Genetic, lifestyle, and environmental factors affect sdLDL levels.But the main determining factor is the level of triglycerides (TGs). Higher TG levels are associated with higher levels of very low density lipoprotein (VLDL) 1 and sdLDL. Various drugs have been used for targeting sdLDL with varying outcomes; drugs tried out include statins, fibrates, niacin, cholesterol ester transfer protein inhibitors and sodium-glucose co-transporter-2 inhibitors. Future prospects include modification of enzymes involved in fatty acid and TG synthesis, for example, lipoprotein lipase and acyl CoA carboxylase. However, further research is still necessary to draw clear guidelines for sdLDL reduction therapy in coronary artery disease treatment and prevention.

Abstract 033: Directly Measured Triglyceride-Rich Lipoprotein Cholesterol and Small Dense LDL-Cholesterol Concentrations Associate With Incident Cardiovascular Disease: Prospective Data From the Women’s Health Study

Background: Elevated triglyceride rich lipoproteins (TRLs) and small dense LDL (sdLDL) levels are hallmarks of atherogenic dyslipidemia and the cholesterol content of these particles is hypothesized to drive atherosclerotic risk. However, laboratory quantitation has thus far been impractical with limited prospective clinical data utilizing directly measured levels of this cholesterol burden. Methods: We conducted a prospective case-cohort study within the Women’s Health Study. Randomly selected CVD case subjects (n=500) were compared to a reference subcohort (n=496). TRL-C and sdLDL-C (mg/dl) were directly measured in baseline blood specimens. Cox proportional hazards models were used to compute quartile-specific multivariable-adjusted HRs for total CVD and individual outcomes of coronary and cerebrovascular disease (CCVD) and peripheral artery disease (PAD). Clinical models also adjusted for LDL-C and hsCRP. Results: TRL-C and sdLDL-C were strongly correlated ( ρ =0.716, p&lt;0.001) and levels were higher in case subjects than in the reference risk set. The risk of each outcome increased across quartiles of TRL-C (HR adj Q4 vs Q1: total events 1.87, 95% CI 1.14 - 3.06, p=0.012; CCVD 1.81, 95% CI 1.05 - 3.09, p = 0.030; PAD 2.43, 95% CI 1.11 - 5.31, p=0.039). In contrast, elevated sdLDL-C associated with incident CCVD but not PAD (HR adj Q4 vs Q1: total events 1.85, 95% CI 1.04 - 3.31, p=0.014; CCVD 2.17, 95% CI 1.14 - 4.13, p = 0.006; PAD 1.34, 95% CI 0.54 - 3.33, p=0.389). Conclusion: Directly measured TRL-C and sdLDL-C concentrations are strongly linked to incident CVD with potentially differential effects for PAD. These findings may indicate a greater potential benefit of therapeutics targeting TRL-C rather than LDL in the prevention of PAD.

The value of combined detection of LP-PLA2 and sd-LDL in the auxiliary diagnosis of atherosclerosis

Objective To investigate the auxiliary diagnostic value of combined detection serum lipoprotein-associated phospholipase A2 (LP-PLA2) and small and dense low-density lipoprotein (sd-LDL) in atherosclerosis. Methods The subjects were divided into experimental group and control group by random block design from May 2017 to January 2018, in the First Affiliated Yijishan Hospital of Anhui Wannan Medical College. The experimental group selected 125 AS patients with clinical diagnosis and confirmed by angiography, and 55 healthy subjects were chosen as the normal control group at the same time. Serum samples were collected within 24 hours after admission, and the level of LP-PLA2, sdLDL-C, low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) and high-sensitive C reactive protein(hs-CRP) were unified detection. The t test, single factor variance analysis and Mann-Whitney U and multivariate logistic regression analysis were used to analyze the data. Results LP-PLA2, sd-LDL, LDL, TC, TG and hs-CRP of the AS group were all higher than those of the healthy control group (Z=5.279,6.663,6.012,5.863,5.508 and 2.845, respectively, P 0.05). Conclusions sd-LDL combined with LP-PLA2 has high sensitivity and specificity in the prediction of AS, which makes up for the deficiency of individual detection; sd-LDL and LP-PLA2 serum level has nothing to do with the lesion and has a positive correlation with the degree of lesions. It is not easily affected by other risk factors and can be used as a risk factor for predicting the occurrence of AS. Key words: Atherosclerosis; 1-Alkyl-2-acetylglycerophosphocholine esterase; Lipoproteins, LDL; Risk factors