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SMALL DENSE LDL CHOLESTEROL (sdLDL-C)
SIZE MATTERS: THE TRUE WEIGHT
OF RISK IN LIPID PROFILING
By Emma Callaghan, Randox Laboratories Ltd
Cardiovascular disease is a leading cause of death worldwide,
accounting for approximately 17.7million deaths per year,
representing 31% of all deaths worldwide. Globally, the mortality
rate for cardiovascular disease (CVD) has dramatically declined
over the past 20 years, however, in low and middle-income regions,
the number of lives lost to CVD is increasing. This highlights the
growing need for the assessment of CVD risk to include methods
that account for uncertainty and heterogeneity (1) (2) .
The current NICE guidelines for assessing
cardiovascular risk
The current UK National Institute for Health Care Excellent
(NICE) (2014) guidelines states those at risk of developing
CVD should be screened. Risk factors include: age, diet,
smoking, alcohol consumption, kidney disease and diabetes.
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NICE recommend testing the full lipid profile when testing for
CVD and before starting a patient on lipid modification
therapy which is the primary prevention method for CVD.
The full lipid profile according to NICE encompasses: total
Cholesterol, HDL Cholesterol, non-HDL Cholesterol and
Triglycerides (3) .
Clinical Significance of sdLDL-C
LDL Cholesterol (LDL-C) is a low-density lipoprotein involved
in cholesterol and triglycerides transfer from the liver to
peripheral tissues. LDL-C consists of two parts: the bigger part
with phenotypic pattern A is light and almost rich in
cholesterol (Large Buoyant LDL Cholesterol (LBLDL-C)) and
the smaller part with more special weight and phenotypic
pattern B (sdLDL-C) composed of less cholesterol. The two
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