{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:39:09Z","timestamp":1792564749910,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Small dense low-density lipoprotein cholesterol (sdLDL-C) particles are more atherogenic than large and intermediate low-density lipoprotein cholesterol (LDL-C) subfractions. We sought to investigate the association of sdLDL-C and the sdLDL-C\/LDL-C ratio with incident carotid plaques with stable and vulnerable morphology in rural China.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This community-based cohort study used data from the RICAS study (Rose Asymptomatic Intracranial Artery Stenosis), which enrolled 887 participants (aged \u226540 years) who were living in Kongcun Town, Pingyin County, Shandong, and free of carotid plaques and had no history of clinical stroke or transient ischemic attack at baseline (2017). Incident carotid plaques and their vulnerability were detected by carotid ultrasound at follow-up (2021). Multivariable logistic regression models were used to explore the association of sdLDL-C or sdLDL-C\/LDL-C ratio with incident carotid plaques while adjusting for demographic factors, vascular risk factors, and follow-up time.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Of the 887 participants (mean age [SD], 53.89 [8.67%] years; 54.34% women), 179 (20.18%) were detected with incident carotid plaques during an average follow-up of 3.94 years (SD=0.14). Higher sdLDL-C or sdLDL-C\/LDL-C ratio, but not LDL-C, was significantly associated with an increased risk of incident carotid plaques. The upper tertile of sdLDL-C (versus lower tertile) was associated with the multivariate-adjusted odds ratio of 2.48 (95% CI, 1.00\u20136.15;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.049;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              for linear trend=0.046) for carotid plaques with vulnerable morphology (n=41), and the association remained significant in participants with normal LDL-C (&lt;130 mg\/dL; n=693; upper versus lower tertile: odds ratio, 3.38 [95% CI, 1.15\u20139.90];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.027;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              for linear trend=0.025). Moreover, the sdLDL-C\/LDL-C ratio was associated with a higher odds ratio of incident carotid plaques in participants without diabetes (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              for interaction=0.014).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Higher sdLDL-C was associated with an increased risk of incident carotid plaques, especially carotid plaques with vulnerable morphology, even in participants with normal LDL-C. This suggests the potential of sdLDL-C as a therapeutic target for stroke prevention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\">https:\/\/www.chictr.org.cn<\/jats:ext-link>\n              ; Unique identifier: ChiCTR1800017197.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.123.045601","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T14:09:52Z","timestamp":1749046192000},"page":"576-585","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Association of sdLDL-C With Incident Carotid Plaques With Stable and Vulnerable Morphology: A Prospective Cohort Study"],"prefix":"10.1161","volume":"55","clinical-trial-number":[{"clinical-trial-number":"chictr1800017197","registry":"10.18810\/chictr"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3104-3129","authenticated-orcid":true,"given":"Xiaotong","family":"Ma","sequence":"first","affiliation":[{"name":"Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People\u2019s Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1334-2527","authenticated-orcid":true,"given":"Qiuting","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People\u2019s Republic of China (Q.W., Y.D., C.Q., Q.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4763-9361","authenticated-orcid":true,"given":"Xinyan","family":"Hu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People\u2019s Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People\u2019s Republic of 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