Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimation
Abstract Objective This study aimed to (1) evaluate small dense low-density lipoprotein cholesterol (sdLDL-C) dynamics from prediabetes to type 2 diabetes mellitus (T2DM) with complications, (2) validate existing sdLDL-C estimation formulas (Sampson’s, Srisawasdi’s, Han’s) in Chinese populations, an...
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| Format: | Article |
| Language: | English |
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BMC
2025-07-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | https://doi.org/10.1186/s12944-025-02636-0 |
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| author | Bin Feng Yi Wang Jingjie Xu Liang Sang Yanhua Zhao Wei Gan |
| author_facet | Bin Feng Yi Wang Jingjie Xu Liang Sang Yanhua Zhao Wei Gan |
| author_sort | Bin Feng |
| collection | DOAJ |
| description | Abstract Objective This study aimed to (1) evaluate small dense low-density lipoprotein cholesterol (sdLDL-C) dynamics from prediabetes to type 2 diabetes mellitus (T2DM) with complications, (2) validate existing sdLDL-C estimation formulas (Sampson’s, Srisawasdi’s, Han’s) in Chinese populations, and (3) develop a population-specific formula for enhanced accuracy. Methods A multicenter study recruited 1,944 participants (216 controls, 70 with prediabetes, 212 with newly diagnosed T2DM, 164 with treated T2DM, and 1,286 in validation cohorts). Lipid profiles, including sdLDL-C (measured via enzymatic assays), were analyzed. Formula performance was assessed using spearman correlation, intraclass correlation coefficients (ICC), and multivariable linear regression. A novel formula was derived via multivariable regression. Results Atherogenic lipid triad manifestations emerged early: sdLDL-C was significantly elevated in participants with prediabetes (1.07 [0.73, 1.40] vs. 0.57 [0.44, 0.72] mmol/L in controls, P < 0.05) and further increased in those with T2DM, correlating strongly with triglycerides (TG; r = 0.59), non-high-density lipoprotein cholesterol (nonHDL-C; r = 0.69), and apolipoprotein B (ApoB; r = 0.62). Existing formulas overestimated sdLDL-C in controls and treated T2DM (P < 0.05), though both Han’s and Sampson’s formula performed better in newly diagnosed T2DM (P > 0.05). A novel sdLDL-C estimation formula, incorporating low-density lipoprotein cholesterol (LDL-C), TG, nonHDL-C, age, and sex, achieved superior accuracy (R²=0.743; ICC = 0.681) and minimized residuals (Δ = 0.16 vs. 0.28–0.29, P < 0.05). Conclusion sdLDL-C elevation begins in prediabetes, highlighting its value for early atherosclerotic cardiovascular disease (ASCVD) risk assessment. Current formulas show population-specific limitations, whereas the new model provides improved accuracy for Chinese T2DM patients, enabling cost-effective sdLDL-C estimation and personalized lipid management. |
| format | Article |
| id | doaj-art-11ef8ddb486243bbadf85c98c812d18d |
| institution | Kabale University |
| issn | 1476-511X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj-art-11ef8ddb486243bbadf85c98c812d18d2025-08-20T04:01:40ZengBMCLipids in Health and Disease1476-511X2025-07-0124111010.1186/s12944-025-02636-0Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimationBin Feng0Yi Wang1Jingjie Xu2Liang Sang3Yanhua Zhao4Wei Gan5Department of Laboratory Medicine, West China Hospital, Sichuan UniversityDepartment of Laboratory Medicine, The Fourth People’s Hospital of ZigongDepartment of Laboratory Medicine, West China Hospital, Sichuan UniversityMindray Bio-Medical Electronics Co., Ltd.Department of Laboratory Medicine, West China Hospital, Sichuan UniversityDepartment of Laboratory Medicine, West China Hospital, Sichuan UniversityAbstract Objective This study aimed to (1) evaluate small dense low-density lipoprotein cholesterol (sdLDL-C) dynamics from prediabetes to type 2 diabetes mellitus (T2DM) with complications, (2) validate existing sdLDL-C estimation formulas (Sampson’s, Srisawasdi’s, Han’s) in Chinese populations, and (3) develop a population-specific formula for enhanced accuracy. Methods A multicenter study recruited 1,944 participants (216 controls, 70 with prediabetes, 212 with newly diagnosed T2DM, 164 with treated T2DM, and 1,286 in validation cohorts). Lipid profiles, including sdLDL-C (measured via enzymatic assays), were analyzed. Formula performance was assessed using spearman correlation, intraclass correlation coefficients (ICC), and multivariable linear regression. A novel formula was derived via multivariable regression. Results Atherogenic lipid triad manifestations emerged early: sdLDL-C was significantly elevated in participants with prediabetes (1.07 [0.73, 1.40] vs. 0.57 [0.44, 0.72] mmol/L in controls, P < 0.05) and further increased in those with T2DM, correlating strongly with triglycerides (TG; r = 0.59), non-high-density lipoprotein cholesterol (nonHDL-C; r = 0.69), and apolipoprotein B (ApoB; r = 0.62). Existing formulas overestimated sdLDL-C in controls and treated T2DM (P < 0.05), though both Han’s and Sampson’s formula performed better in newly diagnosed T2DM (P > 0.05). A novel sdLDL-C estimation formula, incorporating low-density lipoprotein cholesterol (LDL-C), TG, nonHDL-C, age, and sex, achieved superior accuracy (R²=0.743; ICC = 0.681) and minimized residuals (Δ = 0.16 vs. 0.28–0.29, P < 0.05). Conclusion sdLDL-C elevation begins in prediabetes, highlighting its value for early atherosclerotic cardiovascular disease (ASCVD) risk assessment. Current formulas show population-specific limitations, whereas the new model provides improved accuracy for Chinese T2DM patients, enabling cost-effective sdLDL-C estimation and personalized lipid management.https://doi.org/10.1186/s12944-025-02636-0Small dense LDL cholesterolType 2 diabetes mellitusEstimation formula |
| spellingShingle | Bin Feng Yi Wang Jingjie Xu Liang Sang Yanhua Zhao Wei Gan Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimation Lipids in Health and Disease Small dense LDL cholesterol Type 2 diabetes mellitus Estimation formula |
| title | Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimation |
| title_full | Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimation |
| title_fullStr | Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimation |
| title_full_unstemmed | Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimation |
| title_short | Lipoprotein trajectories from prediabetes to type 2 diabetes with complications: a Chinese population-specific formula for sdLDL-C estimation |
| title_sort | lipoprotein trajectories from prediabetes to type 2 diabetes with complications a chinese population specific formula for sdldl c estimation |
| topic | Small dense LDL cholesterol Type 2 diabetes mellitus Estimation formula |
| url | https://doi.org/10.1186/s12944-025-02636-0 |
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