Small Dense Low-Density Lipoprotein as a Predictive Biomarker for Atherosclerosis at the National Heart Centre – Tajura, Libya

Abstract

Atherosclerosis is a chronic inflammatory vascular disease and one of the leading causes of cardiovascular morbidity and mortality worldwide. It represents the pathological basis of acute coronary syndromes (ACS), including ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina. Small dense low-density lipoprotein (sdLDL) has recently gained attention as a highly atherogenic lipid fraction associated with endothelial dysfunction, plaque instability, and increased cardiovascular risk. This study aimed to evaluate the role of sdLDL as a predictive biomarker for atherosclerosis among Libyan patients attending the National Heart Center, Tajura. A cross-sectional study was conducted on 88 participants, including 68 patients diagnosed with atherosclerosis and 20 apparently healthy controls. Serum sdLDL levels were measured using enzyme-linked immunosorbent assay (ELISA), while lipid profile parameters—including LDL, HDL, total cholesterol, and triglycerides—were analyzed using the Roche Cobas Integra 400 plus automated analyzer. The findings demonstrated that sdLDL levels were higher among patients compared to controls, with 20.6% of patients had elevated sdLDL compared to none of the controls (p = 0.033). HDL levels were significantly lower among patients (p = 0.011), whereas triglyceride levels were significantly higher (p = 0.0097). A statistically significant positive correlation was identified between triglycerides and sdLDL in the patient group (r = 1.770, p = 0.034). In conclusion, sdLDL is a valuable biomarker for predicting atherosclerosis and cardiovascular risk in the Libyan population, and its assessment alongside conventional lipid parameters may improve early diagnosis and risk stratification.