Factors influencing the formation of small dense LDL particles

Aims:

We wanted to study factors influencing the size of LDL particles.

Material and methods:

752 persons (330 males, 422 females) have been studied. We performed an OGTT (plasma glucose, insulin, proinsulin). Triglycerides (TG), total cholesterol (TC) and protein (in whole plasma, in VLDL, in LDL) and HDL cholesterol have been measured. The size of the LDL particles has been estimated using a gel electrophoresis
(in LDL subclasses 1 – 3, mean LDL particle diameter, affiliation to phenotypes A or B). Probands have been subdivided into those with normal glucose tolerance (n 540), with an impaired glucose tolerance (n 137), with a newly discovered or known diabetes (n 51), or with a diabetes mellitus which was treated by insulin (n 24). The
Metabolic Syndrome (MS) has been defined according to the NCEP criteria.

Results:

In 29 % of all probands a MS was observed. These probands had a significantly smaller mean LDL particle diameter (25.5 nm) than those persons without a MS (26.2 nm). In univariate analysis (partially adjusted for fasting plasma glucose, proinsulin, insulin, gender, age, body mass index) the mean LDL diameter showed significant
correlations with the VLDL TG, plasma TG, VLDL cholesterol, VLDL proteins and HDL cholesterol. In a linear stepwise regression analysis in the different groups of glucose tolerance different independent factors of influence were seen. Conclusions: The data obtained show the significance of TG levels, of glucose intolerance and the presence of the MS for the formation of atherogenic small dense LDL particles.