Nonalcoholic fatty liver disease (NAFLD) is associated with atherogenic dyslipidemia, in particular with a small LDL particle size. However, there are no data on the association between LDL particle size and cardiovascular events in cardiovascular disease patients with NAFLD. This issue is addressed in the present study. We measured LDL particle size and concentration in 298 statin-naïve cardiovascular disease patients, of whom 141 had NAFLD. In patients with NAFLD, LDL particle size was significantly lower (21.0 vs. 21.2 nm, p<0.001) and particle concentration was significantly higher (1487 vs. 1336 nmol/l, p=0.006) than in those without NAFLD. Prospectively, we recorded 135 cardiovascular events during a follow-up time of 8.2±3.3 years. In multivariate Cox regression analysis LDL particle size (standardized adjusted HR 0.68 [0.54-0.85], p=0.001), but not LDL particle concentration (standardized adjusted HR 0.97 [0.79-1.19], p=0.774) was a significant and independent predictor of cardiovascular events after adjustment for age, sex, BMI, hypertension, smoking, HDL particle size and HDL particle concentration, and for the presence of T2DM and NAFLD. In subgroup analysis regarding the presence of NAFLD, LDL particle size significantly predicted cardiovascular events both in patients with NAFLD (standardized adjusted HR 0.60 [0.42-0.86], p=0.005) and in those without NAFLD (standardized adjusted HR 0.64 [0.46-0.90], p=0.010). We conclude that LDL particle size is a predictor of cardiovascular events in cardiovascular disease patients with NAFLD as well as in those without NAFLD.
A. Leiherer: None. A. Muendlein: None. C.H. Saely: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. J.F. Dopheide: None. I. Baumgartner: None. P. Fraunberger: None. H. Drexel: None.