Oxidized LDL, CRP and cholesterol may help in early detection of Coronary Heart Disease

A new study published in the Journal of the Association of Physicians of India of India shows that, high oxidized LDL (ox-LDL), high-sensitivity C-reactive protein (hs-CRP) and remnant lipoprotein cholesterol (RLP-C) levels associate with atherogenesis in coronary heart disease patients (CHD).

Coronary heart disease is a prominent disease entity in the Indian population, accounting for considerable death and morbidity. In India, the prevalence of CHD is growing. The oxidative changes in low-density lipoproteins have been associated with artery hardening. The conversion of LDL to oxidized LDL is a critical stage in the oxidation theory of atherogenesis. Oxidized LDL and residual lipoprotein cholesterol induced atherosclerosis by stimulating immunological and inflammatory responses. Because of their smaller size, high cholesterol content, and longer residence time in the circulation, residual lipoproteins are extremely atherogenic. When compared to LDL particles, remnant lipoproteins transfer more cholesterol to macrophages. Remnant lipoproteins easily infiltrate the artery wall and are promptly picked up by macrophages. This causes foam cells to develop, kicking off the lipid-laden plaque. C-reactive protein is a nonspecific inflammatory measure with a high sensitivity. Oxidized LDL, RLP-C, and high-sensitivity C-reactive protein all play important roles in the pathogenesis of CHD.

As a result, Thirnavukkarasu Jaishankar and colleagues undertook this study to evaluate ox-LDL and RLP-C as prospective biomarkers in the progression of CHD.

This cross-sectional study was done on participants appearing for master health check-up and medicine at Sri Ramaswamy Memorial Medical College Hospital and Research Center. This cross-sectional study included 273 individuals who were 45 years old and of the same gender. As controls, 91 non-diabetic people with CHD, 91 diabetic subjects with CHD, and 91 normal healthy participants were chosen. After an overnight fast, bodily fluid samples were obtained for lipid profile, ox-LDL, and hs-CRP analyses. The enzyme-linked immunosorbent assay (ELISA) technique was used to evaluate oxidized LDL and hs-CRP, and the Auto Analyzer AU480 was used to measure the lipid profile. For the comparison of two groups, statistical analysis was performed using the Student's t-test and Pearson's correlation analysis.

The key findings of this study were as follow:

1. The CHD group had substantially higher mean levels of ox-LDL, RLP-C, and hs-CRP.

2. There was a substantial positive connection between plasma ox-LDL, RLP-C, and hs-CRP.

The current study concludes that measuring RLP-C, ox-LDL, and hs-CRP may help to detect CHD earlier and lower morbidity and mortality risk. The revelation of its relationship with RLP-C, ox-LDL, hs-CRP, hypertension, dyslipidemia, and diabetes is currently causing worry.

Reference:

Jaishankar T, Shivasekar M, Vinodhini VM. Assessment of Remnant Lipoprotein Cholesterol and Oxidized Low-density Lipoprotein Associated with Low-grade Inflammation in Coronary Heart Disease Subjects of Young South Indian Population. J Assoc Physicians India 2022;70(6):15–19.