Cardiovascular disease is a dangerous disease that is considered the second leading cause of death in Korea and the leading cause of death worldwide, after cancer. Cardiovascular disease is the leading cause of sudden death, most of which occur suddenly when the original cardiovascular disease is overlooked or overlooked.
Cardiovascular disease is often dismissed as a disease of middle-aged people in their 50s or older, but the number of young patients with dyslipidemia is increasing due to a western lifestyle and lack of exercise. According to a health insurance big data analysis by the Health Insurance Review and Assessment Service, the number of patients in their 20s and 30s treated for hypertension in 2021 exceeded about 250,000, and the time for dyslipidemia to develop is gradually accelerate.
Accordingly, many experts emphasize that even young adults in their 20s and 30s who are considered healthy should actively manage their cholesterol. In particular, sdLDL cholesterol has recently been identified as a major hidden culprit in cardiovascular disease. In response, this paper discussed the definition of sdLDL cholesterol and diagnostic tests to prevent cardiovascular disease with Seonhyun Ahn, a specialist in the Department of Laboratory Medicine at GC Green Cross Medical Institute.
– I wonder what the difference is between LDL cholesterol and sdLDL cholesterol, commonly known as ‘bad cholesterol’.
Low-density lipoprotein (LDL) is a low-density lipoprotein with a specific gravity of 1.019-1.063 kg / L and a size of about 18-25 nm. Small dense LDL (sdLDL) refers to LDL with a small surface area, high density, and low buoyancy.
sdLDL sinks in the blood due to its low buoyancy and easily passes through the inner wall of blood vessels due to its small particle size. In addition, it is known to be the main culprit in causing arteriosclerosis by triggering an inflammatory response by sticking together inside blood vessels and becoming sticky.
– Who recommends the sdLDL cholesterol concentration test? I am also curious about what is recommended for patients after the examination.
People with risk factors for cardiovascular disease, such as ▲family history of cardiovascular disease ▲preexisting cardiovascular disease ▲hyperlipidemia ▲diabetes ▲obesity ▲drinking, smoking, and stress.
High sdLDL levels are often found even when LDL levels are within the normal range. As the incidence of cardiovascular disease is reported to be high when the sdLDL level is high in a study that followed these patients, drug treatment may be necessary after consultation with a specialist even when the LDL level as well as the sdLDL level is high
– According to the notification of the Ministry of Health and Welfare in August last year, the ‘chemical reaction equipment measurement method’ for examining the concentration of sdLDL cholesterol has been certified as a new medical technology (no reimbursement). What are the advantages of the chemical reaction equipment measurement method compared to the existing tests?
A conventional test method for measuring sdLDL cholesterol is a method of classifying LDL cholesterol by size and weight by electrophoresis (gradient gel electrophoresis). When a patient’s specimen is placed in a machine where an electric current flows, light cholesterol moves far and heavy cholesterol moves little, and they were divided according to the size of LDL cholesterol. There was a disadvantage in that it took a long time because the inspector had to carry out all the inspection procedures by hand up to the stage of entering the sample into the electrophoresis.
The chemical reaction equipment measurement method is a method of isolating LDL by chemical reaction and quantifying sdLDL again, and has the advantage of obtaining test results quickly because the test is performed with automated equipment, and the cost of the test is relatively low.
When comparing the conventional electrophoresis method and the chemical reaction equipment measurement method, it is known that the numerical correlation is not high. However, most of the cases showing higher than normal values when tested by all methods are consistent for both sides. In addition, the incidence of cardiovascular disease is known to be significantly high in both methods when patients with high levels are followed.
– This is a somewhat unfamiliar test in Korea. Is the inspection carried out abroad?
In nearby Japan, tests have already been commercialized more than 20 years ago, making it one of the places where most tests are performed. Although there are no global statistics on the number of tests carried out, many studies have been carried out, focusing on Japan and China. Recently, many papers have been published on the effects of drugs that can lower sdLDL levels, mainly in the West.
In Korea, the GC Green Cross Medical Institute introduced a method of measuring chemical reaction equipment. For patients with (suspected) cardiovascular disease, sdLDL cholesterol in the blood is measured by measuring chemical reaction equipment to predict the occurrence of major cardiovascular diseases and evaluate the risk. In addition, it screens the risk level of coronary artery disease and provides information such as tailored treatment according to the test results.