Measurement of small, dense lipoproteins. Usefulness of the Tg/HDL index compared to direct LDL measurement

Abstract Funding Acknowledgements Type of funding sources: None. Main funding source(s): Ninguna Introduction The Triglyceride/HDL (Tg/HDL) ratio when > 2 is translated into the presence of small, dense lipoproteins (sdLDL), which are more atherogenic and help us measure global lipid risk regardless of LDL levels. There is the possibility of measuring sdLDL directly, but it is not performed in routine clinical practice. The objective of our study was to analyze the correlation of the TG/HDL index with the direct measurement of sdLDL and cardiovascular risk (CVR). Materials and methods Patients who were treated in cardiology from July 1 – July to September 30, 2022 were analyzed consecutively and the determination of the lipid profile with direct measurement of sdLDL was requested. This measurement is considered risk when sdLDL> 50 mg/dl. Results n 75. Mean age 60 ± 15 years. 37.3% were women. 49.3% were hypertensive, 48% dyslipidemic, 22.7% diabetic, 32% smokers, 58.7% very high CVR and 54.7% with lipid-lowering treatment. Mean LDL levels were 84.3±37 mg/dl, non-HDL 110±39 mg/dl, triglycerides 139±75 mg/dl, remnant cholesterol 27.8 ±15 mg/dl, LDL-sd 34±20 mg/dl and Tg/HDL 3.5±±2. Patients with Tg/HDL>2 had mean sdLDL levels 36± 23 mg/dl vs 29.7 ± 14 mg/dl (p0.06) and those with Tg/HDL>3 39.8± 26 mg/dl vs 28.9± 12 mg/dl ±(p<0.02). All patients with LDL> 50 mg/dL levels had Tg/HDL>2, however 60% of patients with Tg/HDL>2 had LDL<50 mg/dL levels (p0.01), but only 37% Tg/HDL>3 (p<0.001). (Table 1. Relationship between lipid profile, Tg/HDl and LDL-SD) 20% of very high/high RCV patients had LDL>50 mg/dl, 9.1% moderate RCV and 12.5% low RCV. Conclusions The Tg/HDL index may be more useful in identifying patients with LDL> 50 mg/dl primarily when it is > 3.