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Predictive Value of Small Dense Low-density Lipoprotein Cholesterol and Remnant-like Particle Cholesterol for Cardiovascular Events in Chinese Elder Diabetes Mellitus Patients


 BackgroundAs a subcomponent of lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C) have been suggested to be a better predictor of cardiovascular diseases(CVD). This research was to evaluate the predictive of the sdLDL-C in cardiovascular events (CVs) in Chinese elder type 2 diabetes mellitus(DM) patients.MethodsSerum sdLDL-C measured by homogeneous method was compared in 386 consecutive type 2 DM patients between December 2014 and December 2016. Finally, 92 type 2 DM patients had CVs during the 48-month follow-up period. Receiver operating characteristic (ROC) curves were used for assess the predictive value of baseline parameters to major CVs.ResultsNinety-two CVs occurred during the study period.The ROC curve manifested that sdLDL-C in the study population had a matchable discriminatory power (AUC for sdLDL-C was 0.7366, P = 0.003). In addition, kaplan-Meier event-free survival curves displayed a obvious increase of CVs risk for sdLDL-C ≧ 26 mg/dL (log-rank = 9.10,P = 0.003). This phenomenon had analogousresultsin patients who received statins at baseline (log rank = 7.336༌P = 0.007).The study discovered that the increase in HbA1c, glucose, LDL-C, sdLDL-C, non-HDL-C and ApoB and the decrease in ApoA1 were obviously interrelated with heightened CVs risk through Cox regression analysis. Multivariate analysis demonstrated that the increase of sdLDL-C and HbA1c was obviously correlated with CVs. The results of the study indicated that sdLDL-C (per 10 mg/dL) was a increased risk for CVs in the multivariate model (HR 1.281, 95% CI 1.225–16.032; P < 0.01).ConclusionThe consequences demonstrated that sdLDL-C was more effective than RLP-C in predicting the future CVs of Chinese elder type 2 DM patients