title: Increased small low-density lipoprotein particle number: a prominent feature of the metabolic syndrome in the Framingham Heart Study.
abstract: BACKGROUND
  Levels of LDL cholesterol (LDL-C) are frequently not elevated in individuals with the metabolic syndrome (MetSyn). However, the atherogenic potential of LDL may depend on the number and size of LDL particles in addition to the cholesterol content of LDL.
  
  
  RESULTS
  We examined the sex-specific cross-sectional relations of small LDL particle number (determined by nuclear magnetic resonance spectroscopy) to the presence of MetSyn and its components in 2993 Framingham Heart Study participants (mean age, 51 years; 53% women) without cardiovascular disease (CVD) and the relations of small LDL particle number to CVD incidence in people with MetSyn. The MetSyn (> or =3 of 5 traits as defined by the National Cholesterol Education Adult Treatment Panel III) was present in 27% of men and 17% of women. In both sexes, small LDL particle number increased from 0 to 5 MetSyn traits, a pattern partly accounted for by strong correlations between small LDL particle number and serum triglycerides (r=0.61, P<0.0001) and HDL-C (r=-0.55, P<0.0001). Compared with participants without the MetSyn, those with the MetSyn had a higher CVD event rate. However, among participants with the MetSyn, CVD rates were similar for groups with an elevated versus a lower number of small LDL particles (defined by the sex-specific median).
  
  
  CONCLUSIONS
  Small LDL particle number is elevated in the MetSyn, increases with the number of MetSyn components, and most prominently is correlated with triglycerides and HDL-C. Whereas increased small LDL particle number identified the MetSyn with high sensitivity, a higher small LDL particle number was not associated with greater CVD event rates in people with the MetSyn.
authors.affiliation: The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, USA.
authors.forename: Sekar
authors.initials: S
authors.lastname: Kathiresan
authors.forename: James D
authors.initials: JD
authors.lastname: Otvos
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Sullivan
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Keyes
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Schaefer
authors.forename: Peter W F
authors.initials: PW
authors.lastname: Wilson
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Sander J
authors.initials: SJ
authors.lastname: Robins
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D008077:Lipoproteins, LDL / Q000032:analysis* / Q000097:blood; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D010316:Particle Size; D012737:Sex Factors
chemical_list: D008077:Lipoproteins, LDL; D002784:Cholesterol