Clinical Utility of Small, Dense LDL as an Atherogenic Risk Marker

Abstract

Low-density lipoprotein (LDL) has a major role in the origination and development of atherosclerosis and Cardio Vascular Diseases (CVD). Over the past few years, many studies have been concerned with different subclasses of LDLs and their atherogenicity. Low-density lipoproteins (LDLs) include many subclasses. The most common are large buoyant (LB), intermediate and small dense (sd) low-density lipoprotein particles. Small dense low-density lipoproteins attracted a lot of attention. Small dense LDL (sdLDL) has recently been proven to be more atherogenic than other lipoproteins containing apolipoprotein B, which have the potential to trigger atherosclerotic reactions. Many researchers have reported that small dense low-density lipoproteins are the superior biomarker for the prediction of atherosclerosis and CVDs regarding all other markers, including total low-density lipoprotein cholesterol(LDL-C), and total serum cholesterol, non-high-density lipoprotein (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride content. Circulating small dense, low-density lipoproteins go through several modifications in the blood, rendering them more atherogenic. These modifications may include glycation, oxidation, and desialylation. Modified particles are strong inducers of inflammation resulting in many cardiovascular diseases, making them the primary target during the treatment of coronary artery disease. This article will elaborate on the clinical utility of sdLDL as an early marker to predict atherosclerosis and CVDs, and why it is considered superior to other atherosclerotic markers.