Key result
High levels of small LDL particles were associated with increased unadjusted odds of incident CHD (OR 1.68 in men), but this association was no longer significant after adjusting for confounders.
Why the study?
The association of LDL cholesterol levels in small and large LDL particles with incident coronary heart disease risk was evaluated in a European cohort.
Do high levels of cholesterol in small LDL particles predict the risk of incident coronary heart disease in apparently healthy adults?
Case-Control (n=2,955)
Do high levels of cholesterol in small LDL particles predict the risk of incident coronary heart disease in apparently healthy adults?
Cholesterol levels in small LDL particles are associated with increased CHD risk, but this relationship is not independent of other confounding variables.
Answers are grounded in this paper and cite their sources.
Small LDL-C predicts CHD unadjusted but not after triglyceride/HDL adjustment; leaves open whether LDL subclasses add value beyond standard lipids.
AIMS: To evaluate the association of low-density lipoprotein cholesterol (LDL-C) levels in small and large LDL particles with risk of incident coronary heart disease (CHD). METHODS AND RESULTS: We performed a prospective case-control study nested in the EPIC-Norfolk cohort. Cases were apparently healthy men and women aged 45-79 years who developed fatal or non-fatal CHD (n = 1035), and who were matched by age, gender, and enrollment time to 1920 controls who remained free of CHD. Electrophoretic characteristics of LDL particles were measured using 2-16% polyacrylamide gradient gel electrophoresis. Concentrations of LDL-C(<255 A) were higher in cases than controls in men (1.34 +/- 0.88 vs. 1.15 +/- 0.80 mmol/L, P < 0.001) as well as in women (1.12 +/- 0.84 vs. 0.94 +/- 0.74 mmol/L, P < 0.001). The unadjusted odds ratio (OR) for future CHD in men of the top tertile of LDL-C(<255 A) was 1.68 (95% CI, 1.33-2.13; P < 0.001) whereas in women the unadjusted OR was 1.53 (95% CI, 1.13-2.07; P < 0.001). However, after further adjustments for confounding variables, the association between LDL-C(<255 A) and CHD was no longer significant in men and in women. CONCLUSION: Cholesterol concentrations in different LDL subclasses show different relationships with CHD risk in this European cohort.
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Arsenault et al. (2007) conducted a case-control in incident coronary heart disease (CHD) (n=2,955). Small LDL particle cholesterol levels (LDL-C <255 A) vs. Lower levels of small LDL particles was evaluated on incident coronary heart disease (CHD) (OR 1.68, 95% CI 1.33-2.13, p=<0.001). High levels of small LDL particles were associated with increased unadjusted odds of incident CHD (OR 1.68 in men), but this association was no longer significant after adjusting for confounders.
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