Clinical significance of small dense low-density lipoprotein cholesterol levels determined by the simple precipitation method.

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). CONCLUSIONS 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.