Small dense low-density lipoprotein as biomarker in the elderly

Area of Science:

• Cardiology
• Lipidology
• Geriatrics

Background:

• Small dense low-density lipoprotein (sdLDL) is a known atherogenic particle associated with atherosclerotic cardiovascular diseases (ASCVD).
• Understanding the predictive value of sdLDL cholesterol (sdLDL-c) in the elderly is crucial for cardiovascular risk assessment.

Purpose of the Study:

• To prospectively evaluate sdLDL-c as a predictor of new ASCVD over 18 years in individuals aged 64 and older.
• To compare the association of sdLDL-c with conventional lipids and apolipoproteins in predicting ASCVD in the elderly.

Main Methods:

• A prospective study of 1770 subjects aged ≥64 years with an 18-year follow-up.
• sdLDL-c measured by a homogenous, selective enzymatic method.
• Conventional lipids (TC, HDL-c, TG) and apolipoproteins (ApoA1, ApoB) analyzed using enzymatic and immunonephelometric methods, respectively. LDL-c calculated via Friedewald formula.

Main Results:

• sdLDL-c positively correlated with LDL-c, nonHDL-c, TC, and ApoB.
• During follow-up, sdLDL-c was significantly associated with new ASCVD in men aged 64-76 years (adjusted HR: 1.61).
• No significant associations were found in older men (77-97 years) or in women of any age group studied.

Conclusions:

• Elderly lipid and apolipoprotein levels were generally high compared to targets.
• Baseline lipid/apolipoprotein levels did not differ between ASCVD and control groups.
• sdLDL-c demonstrated comparable or superior predictive value for ASCVD compared to ApoB and LDL-c, particularly in younger elderly men.