ArticleJournal of atherosclerosis and thrombosis2024
Specific Increase in Small Dense Low-Density Lipoprotein-Cholesterol Levels beyond Triglycerides in Patients with Diabetes: Implications for Cardiovascular Risk of MAFLD.
Article in Journal of atherosclerosis and thrombosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 16 citations in OpenAlex.
- A pitfall in the evaluation of Sampson-estimated small dense LDL cholesterol in metabolic disorders: Is it equivalent to directly measured sdLDL-C?Journal of diabetes investigation · 2026Article
- Small Dense Low-density Lipoprotein Cholesterol as a Prognostic Risk Factor in Premature Acute Coronary Syndrome with Multivessel Disease: A Retrospective Cohort Study.Journal of atherosclerosis and thrombosis · 2026Article
- Diversity of Dyslipidemia in MASLD, MetALD, and ALD: Different Profiles of Small Dense LDL Cholesterol.Journal of atherosclerosis and thrombosis · 2026Article
- An Apparent Association of Metabolic Dysfunction-Associated Steatotic Liver Disease with High Levels of Estimated Small Dense LDL Cholesterol in a Japanese Population.Journal of atherosclerosis and thrombosis · 2026Article
- Small dense LDL: An underestimated driver of atherosclerosis (Review).Molecular medicine reports · 2025Review
- Estimated sdLDL-C as a biomarker of hepatic steatosis severity in MASLD: a retrospective study.BMC gastroenterology · 2025Article
- Clinical significance of small dense low-density lipoprotein cholesterol measurement in type 2 diabetes.Journal of diabetes investigation · 2025Review
- Excess Triglycerides in Very Low-Density Lipoprotein (VLDL) Estimated from VLDL-Cholesterol could be a Useful Biomarker of Metabolic Dysfunction Associated Steatotic Liver Disease in Patients with Type 2 Diabetes.Journal of atherosclerosis and thrombosis · 2025Article
- High-density lipoprotein cholesterol trajectory and new-onset metabolic dysfunction-associated fatty liver disease incidence: a longitudinal study.Diabetology & metabolic syndrome · 2024Article
- MAFLD and Small Dense LDL Cholesterol: A Mechanistic Link.Journal of atherosclerosis and thrombosis · 2024Article
- Small dense low density lipoprotein predominance in patients with type 2 diabetes mellitus using Mendelian randomization.PloS one · 2024Article
- New Insights Into the Relation Between Metabolic Dysfunction Associated Fatty Liver Disease and Cardiovascular Disease.JACC. Asia · 2023Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsSmall dense (sd) low-density lipoprotein (LDL)-cholesterol (C) is the most powerful predictor of cardiovascular (CV) disease among lipid biomarkers and is generated by hypertriglyceridemia and insulin resistance. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a newly proposed liver disease with a high CV risk. We investigated the specific association of sdLDL-C with MAFLD beyond triglycerides (TG) and obesityMethods: Participants were 839 non-alcoholic drinkers with type 2 diabetes enrolled in a regional diabetes cohort. Fatty liver (FL) and visceral fat area (VFA) was detected by computed tomography scan. sdLDL-C and LDL-TG were measured by our established homogeneous assay. TG rich lipoprotein (TRL) was calculated by subtracting LDL-C plus HDL-C from total-C. Grade of sdLDL-C (≤ 24, 25-34, 35-44, and ≥ 45 mg/dL) was classified according to the Hisayama study.
resultsCompared to non-FL counterparts, FL subjects were younger, predominantly male and smokers; and had higher body mass index (BMI), VFA, hemoglobin A1c, C-peptide, TG, and sdLDL-C, while had similar levels of LDL-C, LDL-TG, and TRL-C. Multivariate logistic analysis revealed that sdLDL-C was the most powerful lipid parameter for identifying FL, independent of TG, HDL-C, BMI, and VFA. The independent association between TG and FL was lost when sdLDL-C was added to the analysis. These results remained the same when lipid-lowering drug users were excluded. After adjustment for confounders, the odds ratio for FL was 2.4-2.7 at sdLDL ≥ 35 mg/dL based on sdLDL ≤ 24 mg/dL.
conclusionssdLDL-C levels are specifically elevated in patients with diabetes and MAFLD, independent of TG and VFA, suggesting liver-centered metabolic abnormalities.
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