Small Dense Low-Density Lipoprotein-Cholesterol Concentrations Predict Risk for Coronary Heart Disease: The Atherosclerosis Risk in Communities (ARIC) Study
Open accessAbstract
OBJECTIVE: To investigate the relationship between plasma levels of small dense low-density lipoprotein-cholesterol (sdLDL-C) and risk for incident coronary heart disease (CHD) in a prospective study among Atherosclerosis Risk in Communities (ARIC) study participants. APPROACH AND RESULTS: Plasma sdLDL-C was measured in 11 419 men and women of the biracial ARIC study using a newly developed homogeneous assay. A proportional hazards model was used to examine the relationship among sdLDL-C, vascular risk factors, and risk for CHD events (n=1158) for a period of ≈11 years. Plasma sdLDL-C levels were strongly correlated with an atherogenic lipid profile and were higher in patients with diabetes mellitus than non-diabetes mellitus (49.6 versus 42.3 mg/dL; P<0.0001). In a model that included established risk factors, sdLDL-C was associated with incident CHD with a hazard ratio of 1.51 (95% confidence interval, 1.21-1.88) for the highest versus the lowest quartile, respectively. Even in individuals considered to be at low cardiovascular risk based on their LDL-C levels, sdLDL-C predicted risk for incident CHD (hazard ratio, 1.61; 95% confidence interval, 1.04-2.49). Genome-wide association analyses identified genetic variants in 8 loci associated with sdLDL-C levels. These loci were in or close to genes previously associated with risk for CHD. We discovered 1 novel locus, PCSK7, for which genetic variation was significantly associated with sdLDL-C and other lipid factors. CONCLUSIONS: sdLDL-C was associated with incident CHD in ARIC study participants. The novel association of genetic variants in PCSK7 with sdLDL-C and other lipid traits may provide new insights into the role of this gene in lipid metabolism.
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Individuals with a high amount of small dense LDL are at greater risk of atherosclerotic cardiovascular disease and myocardial infarction.
“individuals with a high amount of small density LDL (sdLDL) are at greater risk of atherosclerotic CVD and myocardial infarction.3”
From <i>Lactiplantibacillus plantarum</i> strains KABP011, KABP012, and KABP013 modulate bile acids and cholesterol metabolism in humans (2024) · cites this paper as [3]
The Results section reports that ARIC participants in the highest sdLDL-C quartile had greater risk of incident coronary heart disease than those in the lowest quartile. This supports the general cardiovascular-risk claim, but the paper does not report a separate association between sdLDL-C levels and myocardial infarction; its references to myocardial infarction concern other studies. (LLM, conf=0.85)
Experimental — accuracy not yet measuredHigh concentrations of small LDL lipoproteins are associated with a greater incidence of atherosclerosis and CVD events.
“Considering that high concentrations of small LDL lipoproteins are associated with a greater incidence of atherosclerosis and CVD events [207]”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [207]
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“3 Dietary and lifestyle recommendations are often used as a first line of action in the treatment of hypercholesterolaemia.”
Background
- Authors
- Hoogeveen, R. C., Gaubatz, J. W., Sun, W., Dodge, R. C., Crosby, J. R., Jiang, J., Couper, D., Virani, S. S., Kathiresan, S., Boerwinkle, E., & Ballantyne, C. M.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- ORCID
- Venue
- Arteriosclerosis Thrombosis and Vascular Biology
- Published
- 2014-05
- Volume
- 34
- Issue
- 5
- Pages
- 1069-1077
- ISSN
- 1079-5642 (ISSN-L)
- 1524-4636
- PMC
- PMC3999643
- OpenAlex
- W2530844910
- Cited by
- 507
- References
- 53
- Citations by year
- 2026: 32 · 2025: 39 · 2024: 31 · 2023: 67 · 2022: 56 · 2021: 56 · 2020: 58 · 2019: 35 · 2018: 33 · 2017: 29 · 2016: 29 · 2015: 34 · 2014: 8
- FWCI
- 33.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000371, n01hc65226-6-0-0, UL1TR001079)
- National Heart, Lung, and Blood Institute (HHSN268201 100012C, HHSN268201100007I, HHSN268201100007C, HHSN2682 01100008C, HH-SN-268201100006C, HHSN268201100011C, HHSN2682011-00005I, HHSN2682011-00009I, HHSN268201100005C, HHSN268201100005G, HHSN268201100010C, HHSN268201100011I, R01HL087641, R01HL059367, HHSN26820 1100009C, N01 HC065226, HHSN2682011-00008I, RC2HL102419, R01HL086694)
- National Human Genome Research Institute (U01HG004402)
- National Center for Research Resources (UL1RR025005)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- coronary heart disease risk, PCSK7, genetic variants, lipid metabolism, diabetes mellitus, atherogenic lipid profile, cardiovascular risk prediction, genome-wide association study, Atherosclerosis Risk in Communities Study
- MeSH terms
- Aged, Coronary Disease, Female, Humans, Cholesterol, LDL, Male, Middle Aged, Particle Size, Phenotype, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Factors, Subtilisins, Time Factors, United States, Genetic Variation, Biomarkers, Incidence, Prevalence, Linear Models, Logistic Models, Proportional Hazards Models, Risk Assessment, Genetic Predisposition to Disease, Atherosclerosis, Genome-Wide Association Study
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