Korean J Intern Med.
2018 Jan;33(1):138-147. 10.3904/kjim.2017.396.
ApoB/ApoA-I ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels
- Affiliations
-
- 1Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ky.hur@samsung.com
- 2Huh's Diabetes Center and 21st Century Diabetes and Vascular Research Institute, Seoul, Korea.
- 3Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 4Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
- 5Department of Internal Medicine, CHA University, Seongnam, Korea.
- 6Department of Epidemiology and Health Promotion, Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Korea.
- 7Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- KMID: 2411518
- DOI: http://doi.org/10.3904/kjim.2017.396
Abstract
- BACKGROUND/AIMS
This study aimed to investigate whether the apolipoprotein (Apo) B/ApoA-I ratio is associated with carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM) subjects with low density lipoprotein cholesterol (LDL-C) levels less than 100 mg/dL.
METHODS
This cross-sectional study included 845 subjects aged with T2DM 40 to 75 years who had visited Huh's Diabetes Center in Seoul, Republic of Korea for CIMT measurement. Traditional fasting lipid profiles, ApoB and ApoA-I levels were examined. CIMT was measured at three points on the far wall of 1 cm long section of the common carotid artery in the proximity of the carotid bulb. The mean value of six measurements from right and left carotid arteries were used as the mean CIMT. In this study, carotid atherosclerosis was defined as having a focal plaque or diffuse thickening of the carotid wall (mean CIMT ≥ 1.0 mm).
RESULTS
The prevalence of carotid atherosclerosis increased with ApoB/ApoA-I ratio. The ApoB/ApoA-I ratio, expressed as both quartiles (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.21 to 3.79; p for trend = 0.014) and continuous values (OR, 10.05; 95% CI, 3.26 to 30.97; p < 0.001), was significantly associated with a higher risk for carotid atherosclerosis, regardless of conventional cardiovascular disease risk factors. The optimal ApoB/ApoA-I ratio cutoff value for detecting carotid atherosclerosis was 0.57, based on receiver operating characteristic curve analysis with a sensitivity of 58.0% and a specificity of 55.1%.
CONCLUSIONS
A high ApoB/ApoA-I ratio was significantly associated with carotid atherosclerosis in T2DM patients with LDL-C levels less than 100 mg/dL.
Keyword
MeSH Terms
-
Apolipoprotein A-I
Apolipoproteins
Apolipoproteins B
Cardiovascular Diseases
Carotid Arteries
Carotid Artery Diseases*
Carotid Artery, Common
Carotid Intima-Media Thickness
Cholesterol, LDL*
Cross-Sectional Studies
Diabetes Mellitus, Type 2*
Fasting
Humans
Prevalence
Republic of Korea
Risk Factors
ROC Curve
Sensitivity and Specificity
Seoul
Apolipoprotein A-I
Apolipoproteins
Apolipoproteins B
Cholesterol, LDL
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