Small LDL confounded the association of large LDL with IMT because of its strong inverse
correlation with large LDL, which may underlie the widespread belief that large LDL confers
less cardiovascular risk than small LDL. Contrary to current opinion, both small and large LDL
were significantly associated with subclinical atherosclerosis independent of each other,
traditional lipids, and established risk factors, with no association between LDL size and
atherosclerosis after accounting for the concentrations of the two subclasses. This knowledge
may contribute to our understanding of atherogenesis, and future studies examining LDL size
and atherosclerosis should account for the significant inverse correlation between small and large
LDL.
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