Clinical Utility of Small Dense LDL Cholesterol in Metabolic Syndrome

The metabolic syndrome (syndrome X, Insulin resistance syndrome) consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM). The rising prevalence of overweight and obesity in India has a direct correlation with the increasing prevalence of obesityrelated co-morbidities, hypertension, the metabolic syndrome, dyslipidemia, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Small dense low density lipoprotein (sdLDL) also represents a marker for diagnosis and severity of the metabolic syndrome. Additionally, it has been suggested that the sdLDL/LDL ratio correlates with various parameters associated with MS rather than the LDL-C or sdLDL-C levels, thus possibly representing a more useful clinical indicator. Total 72 symptomatic cases of either sex, age between 20-80 yrs were recruited, of which, 38 were with MS and 34 were with metabolic syndrome with type 2 DM (MSwT2DM). The lipids and lipoproteins, including sdLDL by homogeneous assay, were determined in controls, MS and T2DM patients. In this study, the mean value of total cholesterol was higher in MS (142.88 ± 7.15) and MSwT2DM (171.16 ± 11.36) compared to normal subjects (109.41 ± 4.97) which was found statistically significant (p<0.001). The mean sdLDL level and sdLDL/HDL ratio of three groups, there was significant difference in sdLDL level and sdLDL/HDL ratio among the groups, there was different and higher mean sdLDL level in both case groups as compared to normal control group. Furthermore, mean sdLDL level was also found significantly (p<0.001) different and higher in MSwT2DM as compared to MS. It is concluded that LDL particle size such as sdLDL concentration has a positive correlation in increase in MS and diabetes mellitus in comparison to normal subjects.