Small Dense Low-Density Lipoprotein Cholesterol is a Potential Marker for Predicting Laser Treatment for Retinopathy in Diabetic Patients
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- Nakayama Atsuko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Morita Hiroyuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Sato Tatsuyuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Kawahara Takuya
- Clinical Research Promotion Center, The University of Tokyo
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- Takeda Norifumi
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Kato Satoshi
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo
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- Itoh Hiroshi
- Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine
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- Komuro Issei
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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<p> Aim: We explored the superiority of small dense low-density lipoprotein cholesterol (sdLDL-C) as a marker for predicting not only the occurrence of cardiovascular (CV) events but also the need for laser treatment in patients with hypercholesterolemia and diabetic retinopathy.</p><p>Methods: We performed a sub-analysis of the intEnsive statin therapy for hyper-cholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY) study (n=5042), in which patients were assigned randomly to intensive or standard statin therapy targeting low-density lipoprotein cholesterol ＜70 mg/dl or 100-120 mg/dl. Using the survival analysis, the risks for CV events and the need for laser treatment were evaluated according to the lipids one year after registration.</p><p> Results: The patients were 63±11 years old. LDL-C and sdLDL-C levels were 98±25 and 32±14 mg/dl, respectively, one year after registration. The sdLDL-C level had a strong positive correlation with apolipoprotein B level (r=0.83 at registration). SdLDL-C was a sensitive marker for predicting CV events when comparing among the quartiles according to sdLDL-C levels (hazard ratios: HR for quartiles 1-4 were 1.0, 1.4, 1.6, and 2.5, respectively; p for trend ＜0.01). Also, sdLDL-C was a sensitive marker for predicting the need for laser treatment among lipids (log rank, p=0.009), especially in patients with elderly (≧65 yrs) and obesity (BMI ≧25 kg/m2).</p><p> Conclusions: SdLDL-C is a sensitive target marker to predict cardiovascular events as well as the need for laser treatment in patients with hypercholesterolemia and diabetic retinopathy.</p>
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- Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ
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Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ 29 (5), 678-691, 2022-05-01
一般社団法人 日本動脈硬化学会