Method for estimating high sdLDL-C by measuring triglyceride and apolipoprotein B levels

Lipids in Health and Disease

Research

Shinji Koba¹  Tsutomu Hirano²  Toshiyuki Hayashi²  Yasuki Ito³ 

[1] Department of Medicine, Division of Cardiology, Showa University School of Medicine, Shinagawa, Tokyo, Japan;Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, 142-8666, Tokyo, Japan;Reagent R&D Department, Denka Seiken Co., Ltd., Tokyo, Japan;

关键词: Apolipoprotein B;    Coronary artery disease;    Cholesterol;    Small dense low-density lipoproteins;    Triglycerides;   

DOI  :  10.1186/s12944-017-0417-6

 received in 2016-10-20, accepted in 2017-01-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundWe previously developed an assay to directly measure small dense (sd) low-density lipoprotein cholesterol (LDL-C) levels, which is not widely used in general clinical practice. Therefore, we propose a simpler method, “LDL window,” that uses conventional methods for estimating high sdLDL-C levels.MethodsWe analyzed our previous studies (2006–2008) on healthy subjects and patients with type 2 diabetes and coronary artery disease (CAD). The sdLDL-C level was measured using the precipitation method, and LDL size was determined using gradient gel electrophoresis. The “LDL window” comprises the estimation of LDL particle number and size. We adopted apolipoprotein B (apoB) for the estimation of the LDL particle number and used 110 mg/dL as the cutoff value for hyper-apoB. Triglycerides (TGs) are a powerful inverse determinant of LDL particle size. Therefore, we adopted TG for the estimation of the LDL particle size and used 150 mg/dL as the cutoff value for hyper-TG. Subjects were stratified into the following four subgroups: normal, hyper-TG, hyper-apoB, and hyper-TG/-apoB. Non-high-density lipoprotein cholesterol (non-HDL-C) is a surrogate marker for apoB; therefore, the “alternative LDL window” comprised non-HDL-C (cutoff, 170 mg/dL) and TG.ResultsThe top quartile (Q4) of sdLDL-C (>31 mg/dL) doubled in patients with diabetes and CAD. The hyper-TG/-apoB group in the “LDL window” represented >90% Q4 and <4% Q1 and Q2, irrespective of the subjects. The sdLDL-C levels in the hyper-TG/-apoB group were 50% higher in patients with diabetes and CAD than those in controls. Similar results were obtained using the “alternative LDL window.”ConclusionsOur proposed “LDL window” may help identify patients at high risk of CAD independent of LDL-C.

【 授权许可】

CC BY   
© The Author(s). 2017