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Innovative Lipid Biomarkers (Denka Seiken Co.)
Small Dense LDL-Cholesterol and Risk for Coronary Heart Disease: Recent
Findings from the Atherosclerosis Risk in Communities (ARIC) Study
Ron C. Hoogeveen, Ph.D., Assistant Professor
Section of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine
and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center,
Houston, TX
Background- Evidence from in vitro studies indicates that small dense LDL (sd-LDL) is more
atherogenic than large buoyant LDL (lb-LDL). Furthermore, circulating levels of sd-LDL are highly
correlated with triglycerides and are increased in individuals with an atherogenic lipoprotein profile
such as patients with diabetes and metabolic syndrome. Previously, sd-LDL has been associated with
risk for vascular disease. However, the lack of a standardized sd-LDL assay which can be performed in
routine clinical laboratories has hampered its clinical application.
Objectives- We recently examined the relationship between plasma sd-LDL-cholesterol (sd-LDL-C)
level and risk for incident coronary heart disease (CHD) and stroke in the ARIC cohort.
Methods- Plasma sd-LDL-C was measured in 11,419 men and women of the biracial ARIC study using
a newly developed automated homogeneous assay. A proportional hazards model was used to examine
the relationship between sd-LDL-C, vascular risk factors, and risk for CHD events and stroke over a
period of ≈10 years.
Results- Mean plasma sd-LDL-C was higher in Caucasians than in African Americans (45.2 vs. 37.4
mg/dL, p