Journal of diabetes and its complications · 2025
Elevated small dense low-density lipoprotein-cholesterol as a risk factor for lower extremity arterial disease in patients with type 2 diabetes mellitus.
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Zheng Delu, Cui Chenli
Аннотация
AIMS: Small dense low-density lipoprotein-cholesterol (sdLDL-C) is an emerging atherogenic lipid marker, but its association with lower extremity arterial disease (LEAD) in type 2 diabetes mellitus (T2DM) remains underexplored. This study aimed to evaluate whether sdLDL-C independently predicts LEAD risk in T2DM patients.
METHODS: A cross-sectional study was conducted with 47 healthy controls, 66 T2DM patients, and 120 patients with both T2DM and LEAD. Biochemical markers were compared, and predictive value was assessed using a receiver operating characteristic (ROC) curve. Multivariable logistic regression analyzed the association between sdLDL-C and LEAD after adjusting for conventional risk factors.
RESULTS: sdLDL-C levels were significantly higher in T2DM patients compared to healthy controls (1.06 [0.88-1.25] vs. 0.77 [0.43-1.04] mmol/L, P < 0.001), and even higher in those with both T2DM and LEAD (1.33 [1.17-1.56] mmol/L). sdLDL-C levels were associated with the severity of LEAD and positively correlated with fasting blood glucose, fasting C-peptide, hemoglobin A1c, total cholesterol, triglycerides, LDL-C, apolipoprotein B, and body mass index. ROC analysis yielded an area under the curve of 0.765 (95 % CI: 0.692-0.838, P < 0.0001), indicating good predictive value of sdLDL-C for LEAD in T2DM. Multivariable logistic regression identified sdLDL-C (OR = 7.881, 95%CI: 1.368-45.394, P = 0.021), fasting C-peptide, hemoglobin A1c, apolipoprotein B, diabetes duration, and sedentary lifestyle as significant risk factors for LEAD in T2DM patients.
CONCLUSIONS: Elevated sdLDL-C is independently associated with LEAD in T2DM patients and outperforms conventional LDL-C in risk stratification. sdLDL-C may serve as a valuable biomarker for early detection of LEAD in this high-risk population.
METHODS: A cross-sectional study was conducted with 47 healthy controls, 66 T2DM patients, and 120 patients with both T2DM and LEAD. Biochemical markers were compared, and predictive value was assessed using a receiver operating characteristic (ROC) curve. Multivariable logistic regression analyzed the association between sdLDL-C and LEAD after adjusting for conventional risk factors.
RESULTS: sdLDL-C levels were significantly higher in T2DM patients compared to healthy controls (1.06 [0.88-1.25] vs. 0.77 [0.43-1.04] mmol/L, P < 0.001), and even higher in those with both T2DM and LEAD (1.33 [1.17-1.56] mmol/L). sdLDL-C levels were associated with the severity of LEAD and positively correlated with fasting blood glucose, fasting C-peptide, hemoglobin A1c, total cholesterol, triglycerides, LDL-C, apolipoprotein B, and body mass index. ROC analysis yielded an area under the curve of 0.765 (95 % CI: 0.692-0.838, P < 0.0001), indicating good predictive value of sdLDL-C for LEAD in T2DM. Multivariable logistic regression identified sdLDL-C (OR = 7.881, 95%CI: 1.368-45.394, P = 0.021), fasting C-peptide, hemoglobin A1c, apolipoprotein B, diabetes duration, and sedentary lifestyle as significant risk factors for LEAD in T2DM patients.
CONCLUSIONS: Elevated sdLDL-C is independently associated with LEAD in T2DM patients and outperforms conventional LDL-C in risk stratification. sdLDL-C may serve as a valuable biomarker for early detection of LEAD in this high-risk population.