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Non-HDL as a Valid Surrogate Marker of Small Dense LDL in a Young Indian Population

Anjali Manocha1, Seema Bhargava1, Rajneesh Jain2

  • 11Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India.

Indian Journal of Clinical Biochemistry : IJCB
|August 9, 2019
PubMed

Insights

Non-high-density lipoprotein (non-HDL) cholesterol is a better indicator of small dense low-density lipoprotein (sdLDL) particle size than LDL or apoB/A1 ratio. This finding is crucial for assessing dyslipidemia and coronary artery disease risk in young Indian adults.

Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Preventive Cardiology

Background:

  • Small dense low-density lipoprotein (sdLDL) is a significant risk factor for premature coronary artery disease (CAD).
  • Estimating sdLDL is challenging due to specialized equipment needs, high costs, and time-consuming methods.
  • Non-high-density lipoprotein (non-HDL) cholesterol offers a calculated, accessible measure of atherogenic lipoproteins.

Purpose of the Study:

  • To evaluate non-HDL cholesterol as a superior surrogate marker for sdLDL cholesterol in a young Indian population.
  • To compare the efficacy of non-HDL, LDL, and apoB/A1 ratio in reflecting sdLDL particle size.
  • To determine the optimal marker for assessing dyslipidemia and CAD risk in this demographic.

Main Methods:

  • Lipid profiles, apolipoproteins A1 and B, and sdLDL particle size were measured in 161 healthy Indian subjects under 45 years.
  • Correlation analyses were performed between sdLDL particle size and non-HDL, LDL, and apoB/A1 ratio.
  • Receiver Operating Characteristic (ROC) curve analysis was used to assess diagnostic accuracy.

Main Results:

  • sdLDL particles showed a significant negative correlation with non-HDL (r = -0.283, p < 0.001), LDL (r = -0.195, p = 0.013), and apoB/A1 (r = -0.175, p = 0.026), with the strongest association with non-HDL.
  • ROC analysis indicated a higher Area Under the Curve (AUC) for non-HDL (0.704) compared to LDL (0.686) and apoB/A1 (0.596).
  • Non-HDL demonstrated stronger correlations with sdLDL particle size across various LDL and triglyceride levels compared to LDL and apoB/A1.

Conclusions:

  • Non-HDL cholesterol is a superior surrogate marker for sdLDL particle size in young, healthy Indian adults.
  • Non-HDL cholesterol should be utilized for optimal assessment of dyslipidemias and CAD risk in this population.
  • This finding supports the broader clinical application of non-HDL cholesterol measurement for cardiovascular risk stratification.

Keywords:
ApolipoproteinsNon-HDLPremature coronary artery diseaseRisk factorsSmall dense LDL

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