Is sdLDL a valuable screening tool for cardiovascular disease in patients with metabolic syndrome?

Many patients with cardiovascular disease have their low density lipoprotein cholesterol within normal range. This raises the question about the most important lipoprotein to use as a marker of atherogenecity. In fact, small dense low density lipoprotein has recently been suggested as a strong predictor of cardiovascular disease. Among high risk patients, those with metabolic syndrome represent an important target population. Different methods of small dense low density lipoprotein measurement were developed. Accordingly, two phenotypes of low density lipoprotein are recognized: Phenotype A (predominance of large buoyant low density lipoprotein) & phenotype B (predominance of small dense low density lipoprotein). However, none of the methods has been yet considered as a gold standard one. A lot of studies confirmed the role of small dense low density lipoprotein in the development of cardiovascular disease through atherogenic properties & clinical trials. However, others failed to do so. These discrepancies may be due to different sample sizes, different populations, different age groups, different methods of measurement & other possible confounding factors. The aim of this review is to discuss the role of small dense low density lipoprotein as a valuable screening/preventive tool of cardiovascular disease in patients with metabolic syndrome