Original Article

Ann Lab Med 2015; 35(6): 586-594

Published online November 1, 2015

Copyright © Korean Society for Laboratory Medicine.

Hypertriglyceridemia is a Major Factor Associated With Elevated Levels of Small Dense LDL Cholesterol in Patients With Metabolic Syndrome

Yonggeun Cho, M.D.1,4,*, Sang-Guk Lee, M.D.2,*, Sun Ha Jee, Ph.D.3, and Jeong-Ho Kim, M.D.2

Departments of Microbiology and Immunology1, Laboratory Medicine2; Epidemiology and Health Promotion3, Graduate School of Public Health; and Brain Korea 21 PLUS Project for Medical Science4, Yonsei University College of Medicine, Seoul, Korea

Correspondence to: Jeong-Ho Kim
Department of Laboratory Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: +82-2-2228-2448
Fax: +82-2-364-1583
*Yonggeun Cho and Sang-Guk Lee contributed equally to this work.

Received: September 18, 2014; Revised: April 22, 2015; Accepted: August 13, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: We aimed to determine the major contributing component of metabolic syndrome (MetS) that results in an elevated small dense LDL cholesterol (sdLDL-C) concentration and sdLDL-C/LDL-C ratio. Methods: Four hundred and forty-seven subjects (225 men; 222 women) with MetS were randomly selected from the Korean Metabolic Syndrome Research Initiatives-Seoul cohort study. Age- and sex-matched healthy controls (181 men; 179 women) were also randomly selected from the same cohort. Results: A comparison of the median values of the sdLDL-C concentration between subgroups, divided according to whether subjects met or did not meet the criteria for each MetS component in patients with MetS, revealed a significant difference in the sdLDL-C concentration only between subgroups divided according to whether subjects met or did not meet the triglyceride (TG) criteria (P<0.05 for each gender). The TG level showed a good correlation with sdLDL-C concentration (correlation coefficients [r]=0.543 for men; 0.653 for women) and the sdLDL-C/LDL-C ratio (r=0.789 for men; 0.745 for women). Multiple linear regression analyses conducted for the MetS group concordantly identified TG as one of the most significant contributors to sdLDL-C concentration (β=0.1747±0.0105, P<0.0001) and the sdLDL-C/LDL-C ratio (β=6.9518±0.3011, P<0.0001). Conclusions: Among five MetS components, only the abnormal TG level was a differentiating factor for sdLDL-C concentration and sdLDL-C/LDL-C ratio. These results were reproducible in both genders, with or without MetS.

Keywords: Hypertriglyceridemia, Small dense LDL, Metabolic syndrome