Combined Effect of Small Dense Low-Density Lipoprotein Cholesterol (sdLDL-C) and Remnant-Like Particle Cholesterol (RLP-C) on Low-Grade Inflammation

Aims: Small dense low-density lipoprotein cholesterol (sdLDL-C) and remnant-like particle cholesterol (RLP-C) are the novel atherosclerotic risk factors and might be strongly associated with inflammation. The basic evidence supports that sdLDL and RLP have some different mechanisms inducing an inflammatory response. Many studies have focused on the mechanism of inflammation of sdLDL-C or RLP-C per se, with limited data on the association between sdLDL-C and RLP-C in the real-world, population-based setting. Thus, the aim of this study was to investigate the association between sdLDL-C and RLP-C with inflammation. Methods: We examined the baseline cross-sectional data of participants from the Jichi Medical School-II Cohort Study. In total, 5,305 participants (2,439 men and 2,866 women) were included in this study. Results: Of all quartiles of sdLDL-C, the fourth had the highest high-sensitivity C-reactive protein (hs-CRP) level. Once adjusted for age, sex, smoking status, homeostasis model assessment of insulin resistance, antidyslipidemic and antihyperglycemic medication use, and RLP-C, sdLDL-C was significantly and positively associated with hs-CRP (geometric mean, 95% confidence interval (CI), 0.36 mg/L (0.34-0.38 mg/L), 0.37 mg/L (0.35-0.39 mg/L), 0.40 mg/L (0.37-0.42 mg/L) versus 0.44 mg/L (0.42-0.47 mg/L), P< 0.001 for trend). After stratifying the participants into four sdLDL-C x four RLP-C categories, the group in the fourth sdLDL-C quartile and the forth RLP-C quartile had the highest hs-CRP level (geometric mean, 95% CI, 0.52 mg/L, 0.48-0.57 mg/L, interaction P-0.75). Conclusions: SdLDL-C and RLP-C had different associations with inflammation. Our results support sdLDLC as the potential novel factor of cardiovascular disease, independently of RLP-C.