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Small, dense low‐density lipoproteins (LDL) are predictors of cardio‐ and cerebro‐vascular events in subjects with the metabolic syndrome
Author(s) -
Rizzo Manfredi,
Pernice Vincenzo,
Frasheri Arian,
Di Lorenzo Gabriele,
Rini Giovam Battista,
Spinas Giatgen A.,
Berneis Kaspar
Publication year - 2009
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2008.03407.x
Subject(s) - medicine , univariate analysis , endocrinology , metabolic syndrome , cholesterol , apolipoprotein b , blood pressure , risk factor , multivariate analysis , cardiology , gastroenterology , obesity
Summary Objective Small, dense low‐density lipoproteins (LDL) are a feature of the metabolic syndrome (MS) but their predictive role still remains to be established. We performed a 2‐year follow‐up study in 124 subjects with MS (63 ± 6 years), as defined by the American Heart Association/National Heart, Lung and Blood Institute guidelines, to assess clinical and biochemical predictors of cerebro‐ and cardio‐vascular events. Methods and results Beyond traditional cardiovascular risk factors, we measured LDL size and subclasses by gradient gel electrophoresis. Clinical events were registered in the 25% of subjects. At univariate analysis subjects with events had increased prevalence of elevated fasting glucose ( P = 0·0117), smoking ( P = 0·0015), family history of coronary artery disease ( P = 0·0033) and higher levels of total‐ and LDL‐cholesterol ( P = 0·0027 and P = 0·0023, respectively); LDL size was lower ( P < 0·0001), due to reduced larger subclasses and increased small, dense LDL (all P < 0·0001). At multivariate analysis the following were independent predictors of events (univariate odd ratios were calculated): low HDL‐cholesterol (OR 15·4, P = 0·0238), elevated fasting glucose (OR 12·1, P = 0·0102), elevated small, dense LDL (OR 11·7, P = 0·0004), elevated blood pressure (OR 9·2, P = 0·0392), smoking (OR 4·8, P = 0·0054). Conclusions This is the first study that assessed the predictive role of small, dense LDL beyond traditional cardiovascular risk factors in subjects with MS.