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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:558.)
© 2004 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Clinical Significance of Small Dense Low-Density Lipoprotein Cholesterol Levels Determined by the Simple Precipitation Method

Tsutomu Hirano; Yasuki Ito; Shinji Koba; Miwako Toyoda; Ayako Ikejiri; Haruhisa Saegusa; Jun-ichi Yamazaki; Gen Yoshino

From the First Department of Internal Medicine (T.H., A.I.) and the Third Department of Internal Medicine (S.K.), Showa University School of Medicine, Tokyo, Japan; the Research and Development Department (Y.I., H.S.), Denka Seiken Co. Ltd., Tokyo, Japan; and the Division of Cardiovascular Disease (M.T., J.Y.) and the Division of Diabetes, Metabolism, and Endocrinology (G.Y.), Department of Medicine, Toho University School of Medicine, Tokyo, Japan.

Correspondence to Dr Tsutomu Hirano, First Department of Internal Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. E-mail hirano{at}med.showa-u.ac.jp

Objective— Recently, we established a simple method for the quantification of small dense LDL cholesterol (C) using heparin-magnesium precipitation. The small dense LDL-C level was identical to cholesterol in the denser LDL fraction with a density of 1.044 to 1.063 g/mL. The aim of this study was to examine clinical significance of this precipitation method for small dense LDL-C.

Methods and Results— Small dense LDL-C was measured by a direct homogenous LDL-C assay in the supernatant that remained after heparin-magnesium precipitation with density <1.044 lipoproteins. In 313 normolipidemic subjects, the mean value of small dense LDL-C was 31±13 mg/dL. In 462 healthy subjects, small dense LDL-C levels were positively correlated with serum triglyceride and LDL-C and were inversely correlated with high-density lipoprotein cholesterol (HDL-C). Combined hyperlipidemia showed the highest small dense LDL-C level among the various types of hyperlipidemia. Patients with type 2 diabetes had an increased small dense LDL-C level (55±17). Patients with coronary heart disease also had increased small dense LDL-C levels (53±30) irrespective of the presence of diabetes, whereas their LDL-C levels were comparable to those of normolipidemic controls (111±31 versus 104±22).

Conclusion— These results suggest that measurement of small dense LDL-C by the present precipitation method is useful to evaluate atherogenic risk and may be applicable to routine clinical examination.

Key Words: small dense LDL cholesterol • precipitation • hyperlipidemia • coronary heart disease • diabetes