Lack of association between small dense low-density lipoprotein levels and coronary artery disease in chronic hemodialysis patients

Background/Aims: Small, dense low-density lipoprotein (sd-LDL) is a newly recognized risk factor for coronary artery disease (CAD) in the general population. This study was performed to evaluate the relationship between sd-LDL, and CAD and cardiovascular risk factors such as other lipid profiles and hemostatic factors, in patients with chronic hemodialysis (CHD). Methods: Thallium single-photon emission computed tomography (SPECT) was performed to evaluate for CAD in 126 CHD patients. Coronary angiography was performed in patients with positive thallium SPECT. CHD patients were classified into CAD and non-CAD group. LDL subfractions, other lipid profiles, and hemostatic factors were measured. Results: The proportion of sd-LDL, and mean LDL size did not differ between CHD patients and healthy controls. Twenty-eight CHD patients had CAD by thallium SPECT and coronary angiography. The proportion of sd-LDL and mean LDL size did not differ between CAD and non-CAD patients. Age, diabetes mellitus presentation and high-sensitivity C-reactive protein (hs-CRP) levels were significantly higher, and prealbumin and apolipoprotein A1 levels were significantly lower, in the CAD group (p < 0.05). The proportion of sd-LDL was positively correlated with triglyceride levels (p < 0.001), apolipoprotein B (p < 0.05) and fibrinogen (p < 0.05). Conclusion: This study showed that sd-LDL is not increased in CHD patients and is not associated with CAD in such patients.