Evaluation of Malondialdehyde Low-Density Lipoprotein Stratified by Low-Density Lipoprotein Cholesterol

Background: Malondialdehyde low-density lipoprotein (MDA-LDL) is a major form of oxidized LDL and considered to be more atherogenic than LDL. Information on major determinants of MDA-LDL and their association in subjects who are not under treatment for diabetes mellitus and dyslipidemia is limited. Methods: This study included 778 Japanese subjects who were not taking medication for diabetes mellitus and dyslipidemia. All subjects underwent an annual health examination that included MDA-LDL analysis. Study subjects were divided into four groups according to mean values of LDL-C and MDA-LDL, and the metabolic profile was compared. Results: LDL cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were mainly associated with MDA-LDL. When subjects were stratified based on LDL-C levels, small dense LDL-C and MDA-LDL levels increased as LDL-C levels increased. Comparison of the characteristics of study subjects in the same LDL-C level group revealed that subjects with high MDA-LDL showed high metabolic risk in all LDL-C groups, particularly notable in the group with LDL-C levels < 120 mg/dL. Conclusions: Our data indicated that high LDL-C and low HDL-C levels were independently associated with high MDA-LDL. To prevent high MDA-LDL, it is important to lower LDL-C level as well as to increase HDL-C even in subjects with low LDL-C level by lifestyle modification.