Correlation of small dense low-density lipoprotein cholesterol level and cardiovascular risk score in type 2 diabetic patient

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the world including Thailand. Major risk factors of CVD comprised of hypertension (HT), dyslipidemia and diabetes mellitus (DM). Dyslipidemia is a complication commonly found in T2DM which affecting low-density lipoprotein (LDL) and small dense LDL (sdLDL) levels, thus CVD risk assessment by cardiovascular risk score in T2DM patients is highly recommended. This study aimed to correlate sdLDL cholesterol (sdLDL-C) level and cardiovascular risk score in type 2 diabetic patients and healthy subjects. Plasma sdLDL-C level was estimated  using the formula established by Srisawasdi P, et al., while the cardiovascular risk score were calculated according to the formula of Framingham risk score, RAMA-EGAT risk score, SCORE (Systematic coronary risk evaluation) and QRISK2 (Absolute cardiovascular risk) of T2DM  and healthy subjects (n = 40 for each group). The results showed that estimated sdLDL-C level was significantly related with all of these cardiovascular risk scores and 10-year cardiovascular risk (p-value<0.05) in both groups. For healthy group, sdLDL-C level was significantly correlated with Rama-EGAT risk score, 10-years RAMA-EGAT risk, Framingham risk score in men and 10-year Framingham risk in men with correlation coefficient (r) of 0.5345, 0.3407, 0.5373, and 0.5373, respectively (p-value<0.05), whereas no significant correlation of sdLDL-C and all of these cardiovascular risk scores and 10-year cardiovascular risk (p-value>0.05) for T2DM subjects. However, in well-controlled T2DM patients (HbA1c≤7%), the sdLDL-C level was significantly correlated with Framingham risk score in female and 10-year Framingham risk in female (r= 0.7311 and 0.7311, p-value<0.05). In conclusion, estimation of sdLDL-C level together with cardiovascular risk score is suitable in assessing the risk for CVD in both healthy subjects and patients with T2DM; by using the sdLDL-C level, RAMA-EGAT risk score and 10-year RAMA-EGAT risk in healthy subjects, while sdLDL-C level, Framingham risk score in female and 10-year Framingham risk in female should be used for CVD risk assessment in well-controlled T2DM female patients.

Keywords: Small dense low-density lipoprotein cholesterol, Estimated sdLDL-C, Cardiovascular risk score, Type 2 diabetes