Correlation between Serum Levels of Small, Dense Low-Density Lipoprotein Cholesterol and Carotid Stenosis in Cerebral Infarction Patients >65 Years of Age

Background: We studied the relationship between serum levels of small, dense low-density lipoprotein cholesterol (sdLDL-C) and carotid stenosis in elderly patients with ischemic cerebral infarction. Methods: All patients >65 years of age with newly diagnosed ischemic cerebral infarction were enrolled. None received statins before enrollment. Patients were examined for carotid stenosis by ultrasound color Doppler, and serum sdLDL-C levels were measured using an automated method. Results: The 149 patients were distributed according to their carotid stenosis as without (n = 61) or with mild (n = 30), moderate (n = 34), or severe (n = 24) carotid stenosis. sdLDL-C levels increased significantly with increasing stenosis severity (0.54 +/- 0.19, 0.71 +/- 0.18, 0.98 +/- 0.19, and 1.32 +/- 0.17 mmol/L, respectively). Spearman rank correlation analysis revealed that sdLDL-C levels and degree of carotid stenosis were positively correlated (r = 0.411; P < 0.001). Male sex, body mass index, diabetes, hypertension, hyperlipidemia, drinking, smoking, and sdLDL-C levels were positively correlated with carotid stenosis. Logistic regression analysis revealed that sdLDL-C levels are an independent risk factor of carotid stenosis (P = 0.041). Conclusions: sdLDL-C levels are positively correlated with the severity of carotid stenosis, and are an independent risk factor in elderly patients with ischemic cerebral infarction.