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Association of sdLDL-C/LDL-C ratio with atherosclerotic cardiovascular disease: a case-control study

Yuxin Yang1, Tao Yan1, Ya Wang1

  • 1School of Public Health, Inner Mongolia Medical University, Hohhot, China.

BMC Cardiovascular Disorders
|June 2, 2025
PubMed

Insights

The small dense low-density lipoprotein cholesterol to low-density lipoprotein cholesterol (sdLDL-C/LDL-C) ratio is linked to higher atherosclerotic cardiovascular disease (ASCVD) risk. This ratio may improve ASCVD prediction beyond sdLDL-C alone.

Area of Science:

  • Cardiology
  • Biochemistry
  • Epidemiology

Background:

  • Low-density lipoprotein cholesterol (LDL-C) and small dense LDL-C (sdLDL-C) are established risk factors for atherosclerotic cardiovascular disease (ASCVD).
  • The sdLDL-C/LDL-C ratio's role in ASCVD risk stratification requires further investigation.

Purpose of the Study:

  • To analyze the correlation between the sdLDL-C/LDL-C ratio and ASCVD.
  • To explore the ratio's potential for identifying high-risk individuals and improving ASCVD prediction.

Main Methods:

  • Utilized data from 8924 patients at the Affiliated Hospital of Inner Mongolia Medical University (January 2019 - July 2023).
  • Employed univariate and multivariate logistic regression, including subgroup analyses by age, sex, and hypertension.

Main Results:

  • A higher sdLDL-C/LDL-C ratio significantly correlated with increased ASCVD odds (Quartile 2: 1.39x, Quartile 3: 3.48x, Quartile 4: 9.34x).
  • This association remained consistent across subgroups stratified by age, hypertension, and sex (P < 0.001).

Conclusions:

  • An elevated sdLDL-C/LDL-C ratio is independently associated with a higher likelihood of ASCVD.
  • The sdLDL-C/LDL-C ratio demonstrates superior predictive value for ASCVD occurrence compared to sdLDL-C alone.
Abstract

Keywords:
Atherosclerotic cardiovascular diseasesdLDL-C/LDL-C

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