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Katajamäki TT, Koivula MK, Salminen MJ, Vahlberg T, Heikkilä ETM, Viljanen AM, Löppönen MK, Isoaho RE, Kivelä SL, Viitanen M, Viikari J, Viikari L, Pulkki KJ, Irjala KM. Small dense low-density lipoprotein as biomarker in the elderly. Clin Biochem 2025; 137:110916. [PMID: 40107376 DOI: 10.1016/j.clinbiochem.2025.110916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 03/14/2025] [Accepted: 03/15/2025] [Indexed: 03/22/2025]
Abstract
OBJECTIVES Small dense low-density lipoprotein (sdLDL) is atherogenic and associated with atherosclerotic cardiovascular diseases (ASCVD). The aim of this study was to perform the prospective evaluation of sdLDL-c in new ASCVD over 18 years of follow up, and to compare the association of sdLDL-c and conventional lipids and apolipoproteins with ASCVD in the elderly. METHODS This prospective study included a total of 1770 subjects ≥ 64 years of age with an 18-year follow-up period. The determination of sdLDL-c was measured by a homogenous, selective enzymatic method. Levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c) and triglycerides (TG) were determined by enzymatic methods. Apolipoproteins, ApoA1 and ApoB, were analyzed by immunonephelometric methods. Low-density lipoprotein cholesterol (LDL-c) levels were calculated using the Friedewald formula. RESULTS According to Pearson's correlation coefficients, sdLDL-c concentration was positively correlated with LDL-c, nonHDL-c, TC and ApoB concentrations. During follow up, sdLDL-c was significantly associated with new ASCVD in men aged 64-76 years in both unadjusted and adjusted Cox regression models. The adjusted hazard ratio (95 % CI) for sdLDL-c was 1.61 (1.13-2.28). No significant associations between sdLDL-c and ASCVD were observed in men aged 77-97 years, nor in women aged 64-79 or 80-100 years. CONCLUSIONS Lipid and apolipoprotein concentrations of the elderly were high compared to the recommended target values. In addition, lipid and apolipoprotein baseline concentrations were not higher in the ASCVD group than in the control group. Our results indicated that sdLDL-c is as good a marker as ApoB and better than LDL-c.
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Affiliation(s)
- Taina T Katajamäki
- Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, University of Turku 20521 Turku, Finland; Wellbeing Services County of Southwest Finland, Turku University Hospital, Laboratory Division, 20521 Turku, Finland.
| | - Marja-Kaisa Koivula
- HUS Diagnostic Center, Helsinki University Hospital, HUS Group, 00029 Helsinki, Finland; Clinical Chemistry and Hematology, Faculty of Medicine, University of Helsinki 00014 Helsinki, Finland
| | - Marika J Salminen
- Wellbeing Services County of Southwest Finland, Academic Health and Social Services Center, 20521 Turku, Finland; Faculty of Medicine, Department of Clinical Medicine, Unit of General Practice, University of Turku and Turku University Hospital, 20014 Turku, Finland
| | - Tero Vahlberg
- Department of Biostatistics and Turku University Hospital, University of Turku 20521 Turku, Finland
| | - Elisa T M Heikkilä
- Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, University of Turku 20521 Turku, Finland; Wellbeing Services County of Southwest Finland, Turku University Hospital, Laboratory Division, 20521 Turku, Finland
| | - Anna M Viljanen
- Wellbeing Services County of Southwest Finland, Academic Health and Social Services Center, 20521 Turku, Finland; Faculty of Medicine/Clinical Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Minna K Löppönen
- Wellbeing Services County of Southwest Finland, Turku University Hospital, Domain of General Practice and Rehabilitation, 20521 Turku, Finland
| | - Raimo E Isoaho
- Faculty of Medicine, Department of Clinical Medicine, Unit of General Practice, University of Turku and Turku University Hospital, 20014 Turku, Finland; City of Vaasa, Social and Health Care, 65101 Vaasa, Finland
| | - Sirkka-Liisa Kivelä
- Faculty of Medicine, Department of Clinical Medicine, Unit of General Practice, University of Turku and Turku University Hospital, 20014 Turku, Finland; Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki 00014 Helsinki, Finland
| | - Matti Viitanen
- The Wellbeing Services County of Southwest Finland, Turku University Hospital, Geriatric Medicine, 20700 Turku, Finland; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet and Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Jorma Viikari
- Department of Medicine, University of Turku 20521 Turku, Finland
| | - Laura Viikari
- Faculty of Medicine/Clinical Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, 20521 Turku, Finland; The Wellbeing Services County of Southwest Finland, Turku University Hospital, Geriatric Medicine, 20700 Turku, Finland
| | - Kari J Pulkki
- HUS Diagnostic Center, Helsinki University Hospital, HUS Group, 00029 Helsinki, Finland; Clinical Chemistry and Hematology, Faculty of Medicine, University of Helsinki 00014 Helsinki, Finland
| | - Kerttu M Irjala
- Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, University of Turku 20521 Turku, Finland
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Kounatidis D, Vallianou NG, Poulaki A, Evangelopoulos A, Panagopoulos F, Stratigou T, Geladari E, Karampela I, Dalamaga M. ApoB100 and Atherosclerosis: What's New in the 21st Century? Metabolites 2024; 14:123. [PMID: 38393015 PMCID: PMC10890411 DOI: 10.3390/metabo14020123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
ApoB is the main protein of triglyceride-rich lipoproteins and is further divided into ApoB48 in the intestine and ApoB100 in the liver. Very low-density lipoprotein (VLDL) is produced by the liver, contains ApoB100, and is metabolized into its remnants, intermediate-density lipoprotein (IDL) and low-density lipoprotein (LDL). ApoB100 has been suggested to play a crucial role in the formation of the atherogenic plaque. Apart from being a biomarker of atherosclerosis, ApoB100 seems to be implicated in the inflammatory process of atherosclerosis per se. In this review, we will focus on the structure, the metabolism, and the function of ApoB100, as well as its role as a predictor biomarker of cardiovascular risk. Moreover, we will elaborate upon the molecular mechanisms regarding the pathophysiology of atherosclerosis, and we will discuss the disorders associated with the APOB gene mutations, and the potential role of various drugs as therapeutic targets.
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Affiliation(s)
- Dimitris Kounatidis
- Second Department of Internal Medicine, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Natalia G. Vallianou
- Department of Internal Medicine, Evangelismos General Hospital, 10676 Athens, Greece; (F.P.); (E.G.)
| | - Aikaterini Poulaki
- Hematology Unit, Second Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - Fotis Panagopoulos
- Department of Internal Medicine, Evangelismos General Hospital, 10676 Athens, Greece; (F.P.); (E.G.)
| | - Theodora Stratigou
- Department of Endocrinology and Metabolism, Evangelismos General Hospital, 10676 Athens, Greece;
| | - Eleni Geladari
- Department of Internal Medicine, Evangelismos General Hospital, 10676 Athens, Greece; (F.P.); (E.G.)
| | - Irene Karampela
- Second Department of Critical Care, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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