Calculated small-dense and large-buoyant low-density lipoprotein-cholesterol and their ratio in predicting coronary artery disease risk: A cohort study in Thailand
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Issued Date
2025-12-01
Resource Type
ISSN
00099120
eISSN
18732933
Scopus ID
2-s2.0-105017147532
Journal Title
Clinical Biochemistry
Volume
140
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Biochemistry Vol.140 (2025)
Suggested Citation
Chantivas T., Vathesatogkit P., Chittamma A., Thongmung N., Kroll M.H., Srisawasdi P. Calculated small-dense and large-buoyant low-density lipoprotein-cholesterol and their ratio in predicting coronary artery disease risk: A cohort study in Thailand. Clinical Biochemistry Vol.140 (2025). doi:10.1016/j.clinbiochem.2025.111018 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/112414
Title
Calculated small-dense and large-buoyant low-density lipoprotein-cholesterol and their ratio in predicting coronary artery disease risk: A cohort study in Thailand
Corresponding Author(s)
Other Contributor(s)
Abstract
Objectives: Calculated, small dense low-density lipoprotein cholesterol (CsdLDL-C), derived using the Sampson equation, has been proposed as a screening tool for atherosclerotic cardiovascular disease risk. The current study investigated the utility of CsdLDL-C and calculated large buoyant low-density lipoprotein cholesterol (ClbLDL-C) for coronary artery disease (CAD) risk assessment in a Thai population. Methods: This study included 6448 participants without prior CAD from the Electricity Generating Authority of Thailand (EGAT) prospective cohort (2007–2009). CsdLDL-C and ClbLDL-C were estimated from standard lipid panel measurements. Associations with CAD risk were evaluated using Kaplan–Meier survival analysis and Cox proportional hazards models. Results: Over a mean follow-up period of 10.24 ± 1.01 years, 262 (4.06 %) participants experienced CAD events. At the optimal cutoffs, high CsdLDL-C [>1.08 mmol/L (41.85 mg/dL)] was significantly associated with incident CAD events (HR = 1.57; 95 % CI = 1.22–2.02), whereas high ClbLDL-C [>2.52 mmol/L (97.59 mg/dL)] was inversely associated with incident CAD events (HR = 0.72; 95 % CI = 0.56-0.92). The CsdLDL-C/ClbLDL-C ratio exhibited the strongest association (HR = 2.02; 95 % CI = 1.58–2.60) among all lipid parameters. When individually added to the pooled cohort risk equation, CsdLDL-C and the CsdLDL-C/ClbLDL-C ratio remained significant predictors of new-onset CAD. They also demonstrated good discriminatory power (P < 0.004). Conclusion: CsdLDL-C and ClbLDL-C, derived using the Sampson equation, were significantly associated with CAD risk in the opposite direction. Their ratio had greater predictive effectiveness. Incorporating CsdLDL-C and the CsdLDL-C/ClbLDL-C ratio into cardiovascular risk assessment models may improve early identification of at-risk individuals.