Cited by 847Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCholesterol and Lipid Metabolism

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Association of Small Low-Density Lipoprotein Particles With the Incidence of Coronary Artery Disease in Men and Women

Gardner, Christopher D.·1996·JAMA: The Journal of the American Medical Association

DOI 10.1001/jama.1996.03540110029028

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Abstract

OBJECTIVE: To investigate the prospective association of low-density lipoprotein (LDL) particle diameter with the incidence of fatal and nonfatal coronary artery disease (CAD). DESIGN: A nested case-control study. SETTING: Cases and controls were identified from a population-based sample of men and women combining all of the 5 cross-sectional surveys conducted from 1979 to 1990 of the Stanford Five-City Project (FCP). PARTICIPANTS: Incident CAD cases were identified through FCP surveillance between 1979 and 1992. Controls were matched by sex, 5-year age groups, survey time point, ethnicity, and FCP treatment condition. The sample included 124 matched pairs: 90 pairs of men and 34 pairs of women. MAIN OUTCOME MEASURES: LDL peak particle diameter (LDL size) was determined by gradient gel electrophoresis on plasma samples collected during the cross-sectional surveys (stored at 70 degrees C for 5-15 years). Established CAD risk-factor data were available from FCP baseline measurements. RESULTS: LDL size was smaller among CAD cases than controls (mean +/- SD) (26.17 +/- 1.00 nm vs 26.68 +/- 0.90 nm; P<.001). The association was graded across control quintiles of LDL size. The significant case-control difference in LDL size was independent of levels of high-density lipoprotein cholesterol (HDL-C), non-HDL cholesterol (non-HDL-C), triglyceride, smoking, systolic blood pressure, and body mass index, but was not significant after adjusting for the ratio of total cholesterol (TC) to HDL-C (TC:HDL-C). Among all the physiological risk factors, LDL size was the best differentiator of CAD status in conditional logistic regression. However, when added to the physiological parameters above, the TC:HDL-C ratio was found to be a stronger independent predictor of CAD status. CONCLUSION: LDL size was significantly smaller in CAD cases than in controls in a prospective, population-based study. These findings support other evidence of a role for small, dense LDL particles in the etiology of atherosclerosis.

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Early alterations in the postprandial VLDL1 apoB‐100 and apoB‐48 metabolism in men with strong heredity for type 2 diabetes
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“Abbreviations AA: Amino acids; AAT : Abdominal adipose tissue; ADA: American Diabetes Association; ALP: Alkaline phosphatase; ALT: Alanine transaminase; AST: Aspar‑ tate transaminase; BCAA : Branched chain amino acids; BMI: Body mass index; Cer: Ceramide; CHO: Carbohydrate; DBP: Diastolic blood pressure; DG: Diglyc‑ e…”
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“[6] Atherosclerotic factors such as Lp (a) (or) triglyceride (TG) (or) decreased high‑density lipoprotein (HDL) are involved in the atherosclerotic process.”
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“51 nm) in adults with coronary artery disease compared with those without (14).”
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Fatty liver in men is associated with high serum levels of small, dense low-density lipoprotein cholesterol
Hosoyamada, K., Uto, H., Imamura, Y., Hiramine, Y., Toyokura, E., Hidaka, Y., Kuwahara, T., Kusano, K., Saito, K., Oketani, M., et al. (2012) · Diabetology & Metabolic Syndrome · doi:10.1186/1758-5996-4-34 · Cited by 21
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“Indeed, an increased TG/HDL ratio has been shown to closely correlate with insulin resistance in SCZ (37) as well as with the presence of small dense LDL particles which are particularly atherogenic (37, 38).”
Background
Lipoprotein subclass profiles of hyperlipidemic diabetic mice measured by nuclear magnetic resonance spectroscopy
Hammad, S. M., Powell-Braxton, L., Otvos, J. D., Eldridge, L., Won, W. B., & Lyons, T. J. (2003) · Metabolism · doi:10.1016/s0026-0495(03)00058-1 · Cited by 21
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Metabolism of Triglyceride-Rich Lipoproteins
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Background
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Distribution and correlates of lipoproteins and their subclasses in black and white young adults. The Bogalusa Heart Study
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Increased Apolipoprotein Deposits in Early Atherosclerotic Lesions Distinguish Symptomatic From Asymptomatic Patients
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Genetic determination of HDL variation and response to diet in baboons
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Background

Authors: Gardner, C. D.
Affiliations: Stanford Medicine (US)
Corresponding author: Gardner, Christopher D.
ORCID: Gardner, Christopher D.
Venue: JAMA: The Journal of the American Medical Association
Publisher: American Medical Association (AMA)
Published: 1996-09-18
Volume: 276
Issue: 11
Pages: 875
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1996.03540110029028
OpenAlex: W2050758709
Cited by: 843
References: 53
Citations by year: 2026: 3 · 2025: 4 · 2024: 5 · 2023: 10 · 2022: 10 · 2021: 16 · 2020: 23 · 2019: 14 · 2018: 7 · 2017: 16 · 2016: 10 · 2015: 23 · 2014: 14 · 2013: 33 · 2012: 22
FWCI: 37.88
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5p01hl018574-26, 5r01hl021906-19)
National Heart, Lung, and Blood Institute (T32HL007034, HL21906, HL-18574, 5 T32 HL07034)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
Keywords: small dense LDL, LDL particle size, coronary artery disease, atherosclerosis, cardiovascular risk factors, TC/HDL-C ratio, HDL cholesterol, non-HDL cholesterol, triglycerides, sex differences
MeSH terms: Adult, Aged, Coronary Disease, Cross-Sectional Studies, Electrophoresis, Polyacrylamide Gel, Female, Humans, Lipids, Lipoproteins, LDL, Male, Middle Aged, Prospective Studies, Risk Factors, Body Mass Index, Incidence, Linear Models, Logistic Models, Case-Control Studies

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Association of Small Low-Density Lipoprotein Particles With the Incidence of Coronary Artery Disease in Men and Women

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