ApoB/ApoA-i ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels

Ji Eun Jun, Young Ju Choi, Yong Ho Lee, Dae Jung Kim, Seok Won Park, Byung Wook Huh, Eunjig Lee, Sun Ha Jee, Kyu Yeon Hur, Sung Hee Choi, Kap Bum Huh

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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.

Original languageEnglish
Pages (from-to)138-147
Number of pages10
JournalKorean Journal of Internal Medicine
Volume33
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Apolipoproteins A
Carotid Artery Diseases
Apolipoprotein A-I
Apolipoproteins B
Carotid Intima-Media Thickness
LDL Cholesterol
Type 2 Diabetes Mellitus
Odds Ratio
Confidence Intervals
Republic of Korea
Common Carotid Artery
Carotid Arteries
ROC Curve
Fasting
Cardiovascular Diseases
Cross-Sectional Studies
Lipids

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Jun, Ji Eun ; Choi, Young Ju ; Lee, Yong Ho ; Kim, Dae Jung ; Park, Seok Won ; Huh, Byung Wook ; Lee, Eunjig ; Jee, Sun Ha ; Hur, Kyu Yeon ; Choi, Sung Hee ; Huh, Kap Bum. / ApoB/ApoA-i ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels. In: Korean Journal of Internal Medicine. 2018 ; Vol. 33, No. 1. pp. 138-147.
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title = "ApoB/ApoA-i ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels",
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.",
author = "Jun, {Ji Eun} and Choi, {Young Ju} and Lee, {Yong Ho} and Kim, {Dae Jung} and Park, {Seok Won} and Huh, {Byung Wook} and Eunjig Lee and Jee, {Sun Ha} and Hur, {Kyu Yeon} and Choi, {Sung Hee} and Huh, {Kap Bum}",
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ApoB/ApoA-i ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels. / Jun, Ji Eun; Choi, Young Ju; Lee, Yong Ho; Kim, Dae Jung; Park, Seok Won; Huh, Byung Wook; Lee, Eunjig; Jee, Sun Ha; Hur, Kyu Yeon; Choi, Sung Hee; Huh, Kap Bum.

In: Korean Journal of Internal Medicine, Vol. 33, No. 1, 01.01.2018, p. 138-147.

Research output: Contribution to journalArticle

TY - JOUR

T1 - ApoB/ApoA-i ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels

AU - Jun, Ji Eun

AU - Choi, Young Ju

AU - Lee, Yong Ho

AU - Kim, Dae Jung

AU - Park, Seok Won

AU - Huh, Byung Wook

AU - Lee, Eunjig

AU - Jee, Sun Ha

AU - Hur, Kyu Yeon

AU - Choi, Sung Hee

AU - Huh, Kap Bum

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

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