SMALL DENSE LDL CHOLESTEROL (SDLDL-C) SIZE MATTERS: THE TRUE WEIGHT OF RISK IN LIPID PROFILING

Background Cardiovascular disease (CVD) is recognised as a leading cause of death, with approximately 17.7million deaths per year, an estimated 31% of all deaths worldwide. Furthermore, 80% of all CVD deaths are due to heart attacks and strokes10. There is a global commitment to reduce the probability of premature CVD deaths by 25% by 2025; a target set by the United Nations member states9. Globally, the mortality rate for CVD has dramatically declined over the past 20 years, however, in low and middle-income regions, the number of lives lost to CVD is increasing9. The global distribution of...

Table 1: Size and density comparison between lbLDL-C and sdLDL-C Risk Assessment As sdLDL-C is particularly atherogenic, a person with elevated sdLDL-C levels has a 3-fold increased risk of myocardial infarction (MI).2 sdLDL-C measurement therefore provides a more comprehensive understanding of cardiovascular disease (CVD) risk compared to traditional LDL-C tests. These factors provide evidence for sdLDL as a valuable screening tool for predicting future cardiovascular events and in the secondary prevention of subtle coronary artery disease (CAD). Figure 2: Atherogenic mechanism of sdLDL-C5 sdLDL-C...

sdLDL-C Measurement vs Calculation A recent paper investigated if sdLDL-C provided an independent atherosclerotic cardiovascular disease (ASCVD) risk factor in various subgroups and set out to determine if there were significant differences in sdLDL-C concentration when measured directly or determined through a calculation method7. Findings showed that men were at an increased risk of ASCVD, CHD and stroke when compared to women. Unsurprisingly, they also reported that risk of ASCVD, CHD and stroke increased with age7. A significant difference between direct and calculated sdLDL-C concentrations...

Methods of Detection sdLDL-C can be easily implemented in the routine biochemistry lab using the Randox IT assay. The only direct automated sdLDL-C kit on the market, the Randox sdLDL-C test is a direct method for the quantitative determinationof sdLDL-C using automated chemistry analysers capable of accommodating tworeagent assays. The assay consists of two steps and is based on the use of well-characterised surfactants and enzymes that selectively react with certain groups of lipoproteins. Figure 3: The Gensini score (Non-diabetic Stable CHD)2 The Gensini score (Non-diabetic stable CHD) dense...

Figure 4: Correlation of Ultracentrifugation & Clearance methods6 Clearance (mg/dL) Figure three – Correlation between the Ultracentrifugation and Denka Seiken Methods (7) Ultracentrifugation (mg/dl) The Randox automated sdLDL-C assay correlates well with the gold standard ultracentrifugation method. Ordering Details Description Controls and Calibrators for Direct sdLDL-C Kit Description sdLDL-C Calibrator sdLDL-C Control Level 1 sdLDL-C Control Level 2 sdLDL-C Control Level 3

Conclusions CVD is a leading cause of death around the world. Although mortality rates associated with CVD have been in decline for the past 20 years, this is not evident in low to middle income countries and many are living with severe side effects related to these diseases. Therefore, it is essential to review the traditional methods of lipid quantification to enable clinician’s to gain a more comprehensive view of CVD risk, allowing more appropriate preventative measures to be taken. The current lipid panel consists of testing: • Total Cholesterol • HDL Cholesterol • LDL Cholesterol • Triglycerides...

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