Assessment of sdLDL-C by Three Different Formula and Its Correlation with Clinical Variables Among Diabetes Individuals with and without Nephropathy
Abstract
BACKGROUND: Diabetes mellitus is a common disease worldwide which affects renal function. Cardiovascular morbidity and mortality in diabetes patients can be accelerated by dyslipidemia. Small dense lowdensity lipoprotein-cholesterol (sdLDL-C) is atherogenic and its predominance has been known as a cardiovascular risk factor. The study aimed to assess the validity of calculated sdLDL-C using three different formulae and its association with other clinical variables in diabetic patients with and without nephropathy, and also to determine the best suited formula to measure sdLDL-C.
METHODS: The study subjects were divided into two groups based on the amount of albumin excreted in the urine. Group I or the control group consisted of diabetic subjects without microalbuminuria, while group II consisted of diabetic subjects with microalbuminuria. Blood glucose, glycated haemoglobin (HbA1c), creatinine, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), LDL-C and apoB were estimated. Three formulae used for the validation of calculated sdLDL-C were TG/HDL, sdLDL (mg/dL) = 0.580 (nonHDL) + 0.407 (direct-LDL-C) – 0.719 (calculated-LDL-C) – 12.05, and LDL-C/LDL apoB.
RESULTS: There was no significant difference in sdLDL-C levels of diabetic subjects with and without nephropathy. The sdLDL-C had strong correlation with TC, TG, LDL-C, very-low-density lipoprotein (VLDL), non-HDL and apoB in both study groups. ROC curve showed that LDL-C/LDL apoB derived sdLDL-C had better sensitivity (85%) and specificity (69%) compared to other two measures.
CONCLUSION: Though the calculated sdLDL-C do not predict the occurrence of nephropathy in diabetes subjects, it may still be used in conjunction with the traditional markers since it is cost effective. The LDL-C/LDL apoB formula is the best predictor of sdLDL-C among the three equations.
KEYWORDS: HDL-C, LDL-C, Microalbuminuria, sdLDL-C, T2DM
Full Text:
PDFReferences
Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?. World J Diabetes. 2014; 5: 444-70, CrossRef.
Viazzi F, Leoncini G, Conti N, Tomolillo C, Giachero G, Vercelli M, et al. Microalbuminuria is a predictor of chronic renal insufficiency in patients without diabetes and with hypertension: the MAGIC study. Clin J Am SocNephrol. 2010; 5: 1099-106, CrossRef.
Gerber PA, Thalhammer C,Schmied C, Spring S, Amann-Vesti B, Spinas GA, et al. Small, dense LDL particles predict changes in intima media thickness and insulin resistance in men with type2 diabetes and prediabetes – A prospective cohort study. PloS ONE. 2013; 8: e72763, CrossRef.
Fan J, Liu Y, Yin S,hen N, Bai X, Ke Q, Shen J, et al. Small dense LDL cholesterol is associated with metabolic syndrome traits independently of obesity and inflammation. NutrMetab (Lond). 2019; 16: 7, CrossRef.
Goel PK, Ashfaq F, Khanna R, Ramesh V, Pandey CM. The association between small dense low density lipoprotein and coronary artery disease in North Indian patients. Indian J Clin Biochem. 2017; 32: 186-92, CrossRef.
Xia F, Liu G, Shi Y, Zhang Y. Impact of microalbuminuria on incident coronary heart disease, cardiovascular and all-cause mortality: a meta-analysis of prospective studies. Int J Clin Exp Med. 2015; 8: 1-9, PMID.
Ivanova EA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN. Small dense low-density lipoprotein as biomarker for atherosclerotic diseases. Oxid Med Cell Longev. 2017; 2017: 1273042, CrossRef.
Srisawasdi P, Chaloeysup S, Teerajetgul Y, Pocathikorn A, Sukasem C, Vanavanan S, et al. Estimation of plasma small dense LDL cholesterol from classic lipid measures. Am J Clin Pathol. 2011; 136: 20-9, CrossRef.
Ito Y, Fujimura M, Ohta M, Hirano T. Development of a homogeneous assay for measurement of small dense LDL cholesterol.Clin Chem. 2011; 57: 57-65, CrossRef.
Koga M, Okuda M, Inada S, Shin-Ichiro U, Yuko N, Toshika O, et al. HbA1c levels measured by enzymatic assay during off-site health checkups are lower than those measured by on-site HPLC assay. Diabetol Int. 2019; 11: 67-71, CrossRef.
Stefani S, Ngatidjan S, Paotiana M, Sitompul KA, Abdullah M, Sulistianingsih DP, et al. Dietary quality of predominantly traditional diets is associated with blood glucose profiles, but not with total fecal Bifidobacterium in Indonesian women. PLoS One. 2018; 13: e0208815, CrossRef.
Corso G, Papagni F, Gelzo M, Gallo M, Barone R, Graf M, et al. Development and validation of an enzymatic method for total cholesterol analysis using whole blood spot. J Clin Lab Anal. 2016; 30: 517-23, CrossRef.
Rohatgi R, Gupta R, Ray R, Kalra V. Is obstructive sleep apnea the missing link between metabolic syndrome and second-generation antipsychotics: Preliminary study. Indian J Psychiatry. 2018; 60: 478-84, CrossRef.
Fawwad A, Sabir R, Riaz M, Moin H, Basit A. Measured versus calculated LDL-cholesterol in subjects with type 2 diabetes. Pak J Med Sci. 2016; 32: 955-60, CrossRef.
Penumarthy S, Penmetsa GS, Mannem S. Assessment of serum levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in periodontitis patients. J Indian Soc Periodontol. 2013; 17: 30-5, CrossRef.
Hoste L, Deiteren K, Pottel H, Callewaert N, Martens F. Routine serum creatinine measurements: how well do we perform? BMC Nephrol. 2015; 16: 21, CrossRef.
Marcovina SM, Albers JJ. Lipoprotein (a) measurements for clinical application. J Lipid Res. 2016; 57: 526-37, CrossRef.
Swetha NK, Virupaksha HS, Vishwanath P, Suma MN, Bhimappa M. Hypomagnesemia, poor glycemic control and microalbuminuria as risk factors of diabetic retinopathy. Natl J Lab Med. 2014; 3: 10-4, article.
Palazhy S, Kamath P, Vasudevan DM. Estimation of small, dense LDL particles using equations derived from routine lipid parameters as surrogate markers. Biochem Anal Biochem. 2014; 3: 1000146, CrossRef.
Maruyama C, Imamura K, Teramoto T. Assessment of LDL particle size by triglyceride/HDL-cholesterol ratio in non-diabetic, healthy subjects without prominent hyperlipidemia. J Atheroscler Thromb. 2003; 10: 186-91, CrossRef.
Hirayama S, Miida T. Small dense LDL: An emerging risk factor for cardiovascular disease. Clin Chim Acta. 2012; 414: 215-24, CrossRef.
Krittayaphong R, Phrommintikul A, Boonyaratvej S, Na Ayudhya RK, Tatsanavivat P, Komoltri C, et al. The rate of patients at high risk for cardiovascular disease with an optimal low-density cholesterol level: a multicenter study from Thailand. J Geriatr Cardiol. 2019; 16: 344-53, CrossRef.
Essam A, Badr HB, Mohamad A, Ahmad OM, Hamdy S. Small dense low-density lipoprotein as a potential risk factor of nephropathy in type 2 diabetes mellitus. Indian J Endocrinol Metab. 2014; 18: 94-8, CrossRef.
Palazhy S, Viswanathan V. Lipid abnormalities in type 2 diabetes mellitus patients with overt nephropathy. Diabetes Metab J. 2017; 41: 128-34, CrossRef.
Hirano T. Pathophysiology of diabetic dyslipidemia. J Atheroscler Thromb. 2018; 25: 771-82, CrossRef.
Klop B, Elte JWF, Cabezas MC. Dyslipidemia in obesity: Mechanisms and potential targets. Nutrients. 2013; 5: 1218-40, CrossRef.
Pasko N, Toti F, Strakosha A, Thengjilli E, Shehu A, Dedej T, et al. Prevalence of microalbuminuria and risk factor analysis in type 2 diabetes patients in Albania: the need for accurate and early diagnosis of diabetic nephropathy. Hippokratia. 2013; 17: 337-41, PMID.
Manjunath CN, Rawal JR, Irani PM, Madhu K. Atherogenic dyslipidemia. Indian J Endocrinol Metab. 2013; 17: 969-76, CrossRef.
Karupaiah T, Chuah KA, Chinna K, Pressman P, Clemens RA, Hayes AW, et al. A cross-sectional study on the dietary pattern impact on cardiovascular disease biomarkers in Malaysia. Sci Rep. 2019; 9: 13666, CrossRef.
He J, He S, Liu K, Wang Y, Shi D, Chen X. The TG/HDL-C ratio might be a surrogate for insulin resistance in Chinese nonobese women. Int J Endocrinol. 2014; 2014: 105168, CrossRef.
Ren X, Chen Z, Zheng S, Han T, Li Y, Liu W, et al. Association between triglyceride to HDL-C Ratio (TG/HDL-C) and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus. PLoS ONE. 2016; 11: e0154345, CrossRef.
Abd-Allha E, Hassan BB, Abduo M, Omar SA, Sliem H. Small dense low-density lipoprotein as a potential risk factor of nephropathy in type 2 diabetes mellitus. Indian J Endocrinol Metab. 2014; 18: 94-8, CrossRef.
Tani S, Yagi T, Atsumi W, Kawauchi K, Matsuo R, Hirayama A. Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study. CardiovascDiabetol. 2017; 16: 123, CrossRef.
Wakabayashi I, Daimon T. Comparison of discrimination for cardio-metabolic risk by different cut-off values of the ratio of triglycerides to HDL cholesterol. Lipids Health Dis. 2019; 18: 156, CrossRef.
DOI: https://doi.org/10.18585/inabj.v13i2.1312
Copyright (c) 2021 The Prodia Education and Research Institute
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Indexed by:
The Prodia Education and Research Institute
