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@# Dyslipidaemia is a recognised conventional risk factor for cardiovascular disease (CVD). However, even when traditional lipid parameters are normal, CVD risk can exist. Small dense lowdensity lipoprotein cholesterol (sdLDL) has appeared as a significant risk marker for CVD. This study aimed to determine the prevalence and associated factors of atherogenic lipoprotein Pattern B in the Malaysian population. Materials and Methods: This cross-sectional study included 150 subjects aged 30 years and above who attended a health screening in a Malaysian tertiary institution. Sociodemographics, clinical characteristics and laboratory parameters (lipids, glucose, and sdLDL) were obtained. Lipoprotein subfraction was analysed using the polyacrylamide gel electrophoresis method. Results: Malays and females made up the majority of subjects and the median age was 37 years. Normolipidaemic Pattern B was significantly higher in women (p=0.008). Significant independent predictors of Pattern B were gender (p=0.02), race (p=0.01), body mass index (BMI) [p=0.02] and lipid status (p=0.01). Triglyceride was the only independent predictor of sdLDL (p=0.001). Conclusion: The prevalence of Pattern B of 33% in this study was comparatively high, of which 6.7% were normolipidaemic. Chinese males with dyslipidaemia and increased BMI independently predicted Pattern B. Differences in triglyceride levels alone among these ethnic groups do not fully explain the differences in the prevalence of Pattern B although it was the only lipid parameter to independently predict sdLDL. Individuals with atherogenic normolipidaemia are at greater risk for a CVD event as they are not included in the protective measures of primary CVD prevention.
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Objective To investigate the significance of combined detection of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and small dense low-density lipoprotein cholesterol (sdLDL-C) in the clinical diagnosis of coronary heart disease.Methods 100 patients with coronary heart disease were selected as the ex-periment group ,and 50 healthy subjects who underwent the health assessment were selected as the control group.The levels of serum Lp-PLA2 ,sdLDL-C ,homocysteine (Hcy) ,triglyceride (TG) ,total cholesterol (TC) ,high density lipoprotein cholesterol (HDL-C) ,low density lipoprotein cholesterol (LDL-C) ,and the de-gree of coronary heart disease (CHD) were measured and the correlation was analyzed.Results Compared with the control group ,the level of Lp-PLA2 ,sdLDL-C and Hcy increased significantly ,and the level of HDL-C was lower ,and the difference was statistically significant (P＜0.05) ;there was a positive correlation between Lp-PLA2 and sdLDL-C ,Hcy ,TG ,TC and LDL-C (r=0.430 ,0.633 ,0.259 ,0.450 ,0.269 ,P=0.026 , 0.013 ,0.028 ,0.032 ,0.023).There was a negative correlation between Lp-PLA2 and HDL-C (r= -0.632 , P=0.01).In 0- ＜20 points ,20- ＜40 points and ≥40 points experiment groups ,the levels of Lp-PLA2 and sdLDL-C were significantly higher than those in the control group ,and the differences were significant (P＜0.05) ;there was also a significant difference in the level of Lp-PLA2 and sdLDL-C between 0- ＜20 points ,20- ＜40 points and ≥40 points experiment groups (P＜0.05).The positive rates of the combined detection of Lp-PLA2 and sdLDL-C in the acute coronary syndrome (ACS) group and the stable angina (SAP) group were significantly higher than those of the single test ,and the differences were statistically significant (χ2=4.246 , 4.974 ,P=0.039 ,0.026).Conclusion Lp-PLA2 and sdLDL-C levels are both higher in patients with coronary heart disease than those in healthy people.The combined detection of Lp-PLA2 and sdLDL-C has a certain clinical significance for assessing the development and prognosis of patients with coronary heart disease.
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Objective To investigate the predictive effects of small dense low density lipoprotein cholesterol (sdLDL-C) level and sdLDL-C/high density lipoprotein cholesterol (HDL-C) ratio on the occurrence in patients with acute coronary syndrome (ACS). Methods Two hundred and sixty-eight patients with acute chest pain and diagnosed as ACS according to the clinical symptoms, changes in electrocardiogram and myocardial enzymes, and coronary angiography from November 2017 to April 2018 were enrolled. One hundred and thirty-four cases of unstable angina (UA) and 134 cases of acute myocardial infarction (AMI) were included. Meanwhile, 66 patients with non-ACS were selected as the control group. They baseline data were matched with those of ACS in the same period. Results The sdLDL-C levels and sdLDL-C/HDL-C of ACS patients were significantly increased [0.88(0.70, 1.09) mmol/L vs. 0.61(0.41, 0.84) mmol/L, 0.98(0.72, 1.30) vs. 0.58(0.40, 0.86)]. The sdLDL-C levels and sdLDL-C/HDL-C of AMI group were higher than those of UA group [0.94(0.82, 1.21) mmol/L vs. 0.78 (0.61, 0.98) mmol/L, 1.10(0.79, 1.40) vs. 0.86 (0.62, 1.19)], while those of UA group were also higher than those of the control group [0.78(0.61, 0.98) mmol/L vs. 0.61(0.41, 0.84) mmol/L, 0.86(0.62, 1.19) vs. 0.58(0.40, 0.86)]. There were significant differences (P＜0.01). Logistic regression analysis showed that sdLDL-C level was an independent risk factor for ACS prediction. Compared with those of the control group, the OR values of ACS group, UA group and AMI group were respectively 26.85, 15.19 and 74.40. Correlation analysis showed that sdLDL-C was significantly positively correlated with TC and LDL-C levels (r＝0.697, 0.684, P＜0.01), while it controlled TC and LDL-C levels, and sdLDL-C levels were still significantly positively correlated with ACS (r＝0.185, P＝0.001). ROC analysis revealed that sdLDL-C≥0.613 mmol/L had a sensitivity of 86.6% and specificity of 51.5%, and a sdLDL-C/HDL-C≥0.938 mmol/L had a sensitivity of 53.7% and specificity of 87.9%. ROC curve was used to analyze AMI in ACS group, and the best threshold sdLDL-C＝0.732 mmol/L divided the cases into low-risk groups and high-risk groups. Logistic regression analysis showed that, compared with the low-risk groups, the relative risk estimates of the AMI in the high-risk group was 4.84, after other indicators were adjusted. Conclusions sdLDL-C levels and sdLDL-C/HDL-C are closely related to the occurrence of ACS. As independent risk factors, they are risk assessment predictors for ACS.
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Objective To evaluate the association between small,dense low-density lipoprotein cholesterol (sdLDL-C)and severity of coronary atherosclerosis disease (CAD).Methods A total of 436 outpatients with suspected coronary atherosclerotic heart disease (CAD) and underwent coronary computed tomography (CT) were consecutively enrolled from July 2015 to March 2016 in Fuwai Hospital.Correlations between serum sdLDL-C and the severity of CAD including characteristics of plaque,the number of stenosed coronary vessels,the degree of stenosis were analyzed.Results sdLDL-C was positively correlated with apolipoprotein B (apoB),triglyceride (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),blood glucose (Glu)with the coefficient correlation 0.644,0.631,0.558,0.434 and 0.145 successively(P ＜ 0.01),and negatively correlated with high-density lipoprotein cholesterol (HDL-C) (r =-0.241,P ＜ 0.01).sdLDL-C and apoB were the risk factors for severe CAD (triple-vessel disease and severe stenosis),independent of traditional risk factors (age,gender,hypertension,diabetes,smoking,alcohol consumption)and the use of lipidlowering agents.For the patients with triple-vessel disease,odds ratio of LDL-C,sdLDL-C and apoB were 1.936,2.673 and 31.707 respectively.For the patients with severe stenosis,LDL-C was not an independent factor,while sdLDL-C and apoB still had predictive value (odds ratio were 2.000 and 9.457 respectively).Conclusion sdLDL-C should be a predictor of severe CAD independent of traditional risk factors that may be useful for further risk stratification in the patients with CAD.
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Objective To survey small dense low-density lipoprotein cholesterol(sdLDL-C)distribution among different popula-tions,and analyze its relationship with lipid component.Methods 986 cases of people who underwent medical examination in the hospital were recruited in the study.There were 654 people with normal concentrations of serum blood lipids(normal blood lipids group),according to sex and age they were divided into groups.The people whose serum lipids concentrations increased above the normal range were divided into TG increasing group,LDL-C increasing group and joint increasing group according to the type of lip-ids componet increased.Serum sdLDL-C,LDL-C,TG,TC,HDL-C,ApoAⅠ and ApoB were determind in the people mentioned a-bove,and the correlation between sdLDL-C and TG,TC,HDL-C,ApoAⅠ,ApoB concentrations were analyzed.Results SdLDL-C began to decline after the age of 70,the difference was statistically significant(P <0.05 );the ensemble average of the males was higher than that of females,the difference was statistically significant(P <0.05).The serum sdLDL-C cocentrations of all the serum lipis increasing groups were significantly higher than those of normal blood lipids group,the difference was statistically significant (P <0.05 ).SdLDL-C concentrations were positively correlated with TC,TG,ApoB(r =0.254,0.589,0.302),and was negative correlated with HDL-C and ApoA Ⅰ (r = - 0.421,- 0.275,- 0.311 ).Conclusion There was a positive correlation between sdLDL-C and TC,TG,ApoB,and sdLDL-C was negatively correlated with HDL-C,ApoAⅠ,which can accurately reflect the overall status of lipid metabolism.