A STUDY ON THE RELATIONSHIP BETWEEN SMALL DENSE LDL AND AN EXTENDED LIPID PROFILE, INCLUDING NON-HDL, APO-LIPOPROTEINS, AND THEIR RATIO IN THE DIAGNOSIS OF CARDIOVASCULAR RISK

Abstract

Coronary Heart Disease (CHD) is one of the most prevalent metabolic disorders linked with dyslipidemia,
with Asian Indians having a greater incidence. According to reports, migratory Asian Indians have
dyslipidemia, which is characterised by high Triglycerides (TG), low High Density Lipoprotein (HDL), and
near normal Low Density Lipoprotein (LDL) cholesterol levels. Elevated LDL, which is also the primary
goal of lipid lowering treatment, is one of the key risk factors for CHD. LDL is classified into many
subclasses based on its atherogenic propensity, with Small dense (sd) LDL being a highly important risk
biomarker for early CHD. All atherogenic Apo-lipoprotein B-containing lipoproteins, including LDL-C,
VLDL-C, IDL-C, lipoprotein(a), chylomicrons, and chylomicron remnants, are included in non-HDLc.
Apo-lipoproteins, which include Apo-lipoprotein B and Apo-lipoprotein A1, are cholesterol transporters
that play a key role in lipid metabolism. Furthermore, Apo-B and Apo- A1 indicate total atherogenic and
non-atherogenic particles, respectively. As a result, their Apo-B/Apo- A1 ratio has been significantly linked
to a variety of cardiovascular problems. The study was conducted to assess the role of small dense LDL,
Non-HDL and Apo-lipoprotein Ratios as an early clinical marker for cardiovascular risk. This CaseControl study was conducted in SRM Medical College Hospital and Research center on subjects attending
the cardiology and medicine OP. The study was conducted on 546 subjects in the age group of 30 to 55
years. After overnight fasting blood samples were collected for analysis of Apo-lipoprotein- B, Apolipoprotein-A1 were measured by the ELISA method. And sd-LDL, Non-HDL and Apo-B/Apo-A1 ratio
were obtained by Calculation. Statistical analysis was done using the Student ‘t’ test and Pearson
correlation analysis for the comparison between two groups. sd-LDL, Non-HDL, Apo-lipoproteins and
Apo-B/Apo-A1 ratio were significantly increased in the CHD group when compared to controls. Whereas
The mean of Low-Density Lipoprotein level in CHD was elevated and statistically significant (p-value
<0.001) compared to the normal healthy controls. The study concludes that a strong association exist
between sd-LDL, non-HDL-C, apo-lipoproteins and its Apo-B/Apo-A1 ratio. The estimation of all these
parameters appears to be a better marker in predicting the early risk of cardiovascular disease when
compare to conventional lipid parameters in both diabetic and non-diabetic CHD subjects, which could be
effectively used in clinical practice.