Low-density Lipoprotein Cholesterol/Apolipoprotein B Ratio May Be a Useful Index That Differs in Statin-Treated Patients With and Without Coronary Artery Disease

Abstract

SummaryLow density lipoproteins (LDLs) are heterogeneous aggregations of molecules of different particle sizes, and smallsize LDLs are more potent risk factors for atherosclerosis. We examined the qualitative characteristics of LDLs in patients with stable coronary artery disease (CAD) receiving statin therapy. LDL-particle size was estimated based on the LDL-cholesterol/apolipoprotein B ratio (LDL-C/apoB) in 214 age-adjusted men receiving statin therapy. The LDL-C/ apoB ratio was significantly lower in the CAD (+) group (n = 107) than in the CAD (-) group (n = 107) (median, 1.17 versus 1.19, P = 0.0095). LDL-C/apoB was significantly lower in patients with serum TG ≥ 150 mg/dL than in those with serum TG < 150 mg/dL, and in patients with serum HDL-C < 40 mg/dL than in those with serum HDL-C ≥ 40 mg/ dL (1.06 versus 1.18, P = 0.012; 1.08 versus 1.22, P = 0.0023). Stepwise logistic regression analysis revealed that elevated serum TG was an independent predictor for smaller sizes of LDLs, both in the overall subjects (β : -0.165, P = 0.02) as well as in the subset with serum LDL-C < 100 mg/dL (β : -0.252, P = 0.011). This study demonstrated that not only the absolute serum LDL-C level, but also the qualitative characteristics of LDL may be monitored for secondary prevention of CAD. Such monitoring is particularly important in patients with elevated serum TG levels, which is associated with smaller sizes of LDL-particles. (Int Heart J 2011; 52: 343-347) Key words: Coronary artery disease, Low-density lipoprotein particle size, Statins M any large clinical studies have demonstrated the efficacy of statins for coronary artery disease (CAD) prevention. However, it has been demonstrated that strict control of the serum low-density lipoprotein cholesterol (LDL-C) level by statin therapy is not sufficient by itself to completely prevent ischemic cardiac events, even when secondary prevention measures are undertaken to control coronary risk factors other than the serum LDL-C. 1,2)Atherosclerosis-inducing lipoproteins are produced in the liver, which is the major site of production of very low-density lipoprotein (VLDL). VLDLs are then metabolized to intermediated-density lipoprotein (IDLs) and LDLs, with a progressive decrease in particle size and an increase in particle specific gravity. LDLs, among other lipoproteins, are aggregations of molecules of different particle sizes. Those with small particle sizes are called small-dense (sd-) LDLs (pattern B phenotype), which have a potent atherosclerosis-inducing effect.3) For a given level of the serum LDL-C levels, the presence of molecules of smaller particle sizes has been demonstrated to be associated with higher ischemic cardiac events. 4,5) In current clinical practice, however, only the absolute serum level of LDL-C is measured, and no qualitative tests (eg, measurement of the particle size) of LDL are performed. Hence, we hypothesized that some patients with chronic stable CAD might have qualitatively abnormal LDL (LDL with a small particle size) despite statin therap...

Antioxidant Complexes and Lipoprotein Metabolism – Experience of Grape Extracts Application Under Metabolic Syndrome and Neurogenic Stress

“…It is well-known that in MS the key factor for TAG and ApoB-LP accumulation in the blood is the VLDL hyperproduction by the liver [34]. According to our data, accumulation of ApoB-LP in the blood occurs parallelly with increase in the content of this lipoprotein fraction in the liver (Table 2).…”

Beneficial Effects of the RESMENA Dietary Pattern on Oxidative Stress in Patients Suffering from Metabolic Syndrome with Hyperglycemia Are Associated to Dietary TAC and Fruit Consumption

“…However, this significant increase was not observed on apolipoprotein B (Apo B) concentrations, which has been considered a better predictor of cardiovascular disease than any other lipid measurement [25]. Moreover, according to the LDL/Apo B ratio that predicts the LDL-particle size, the values being significantly raised in both groups, it indicates an increase in LDL-particle size and a lower risk of ischemic cardiac events [26,27]. With regards to high density lipoprotein-cholesterol (HDL-c) concentrations, they rose in both groups, but this increase was statistically significant only in the control group, although apolipoprotein A-I (Apo A-I), a major protein component of HDL-c [28], did not show any changes in any of the dietary groups.…”

Postprandial phase time influences the uptake of TAG from postprandial TAG-rich lipoproteins by THP-1 macrophages

“…3(a)). The use of the TAG:apoB ratio as an estimate of particle size is a limitation of the present study, but this ratio, as well as the cholesterol:apoB ratio, has been used for this purpose previously and proved to be reliable and convenient ( 16 , 20 , 27 ) . The fatty acid composition of dietary fat has been shown to modify the particle size of postprandial TRL in earlier studies.…”