Associations of apolipoprotein B/apolipoprotein A-I ratio with pre-diabetes and diabetes risks: a cross-sectional study in Chinese adults

Abstract

BackgroundApolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) ratio is a useful predictor of cardiovascular risk. However, the association between the ApoB/ApoA-I ratio and the risk of type 2 diabetes mellitus (T2DM) is still obscure.AimsTo investigate the associations between the ApoB/ApoA-I ratio and the risk of T2DM and pre-diabetes in a Chinese population, and to assess the role of gender in these associations.MethodsA stratified random sampling design was used in this cross-sectional study which included 264 men and 465 women with normal glucose tolerance (NGT), pre-diabetes or T2DM. Serum ApoB, ApoA-I and other lipid and glycaemic traits were measured. Pearson's partial correlation and multivariable logistic analysis were used to evaluate the associations between ApoB/ApoA-I ratio and the risk of T2DM and pre-diabetes.ResultsThe ApoB/ApoA-I ratios were significantly increased across the spectrum of NGT, pre-diabetes and T2DM. Women showed higher levels of ApoB/ApoA-I ratio and ApoB than men in the pre-diabetic and T2DM groups, but not in the NGT group. The ApoB/ApoA-I ratio was closely related with triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and other glycaemic traits. Moreover, in women, the risk of diabetes and pre-diabetes in the top and middle tertiles of the ApoB/ApoA-I ratio were 3.65-fold (95% CI 1.69 to 6.10) and 2.19-fold (95% CI 1.38 to 2.84) higher than in the bottom tertile, respectively, after adjusting for potential confounding factors. However, the associations disappeared in men after adjusting for other factors.ConclusionsThe ApoB/ApoA-I ratio showed positive associations with the risk of diabetes and pre-diabetes in Chinese women.

Do Postpartum Levels of Apolipoproteins Prospectively Predict the Development of Type 2 Diabetes in Women with Previous Gestational Diabetes Mellitus?

“…While this is the first study in GDM postpartum in relation to type 2 diabetes development, a number of studies in the general population have prospectively explored the relationship between Apo levels with incident diabetes. Apo AI levels [9,10], Apo B levels [11][12][13], Apo CIII levels [16,18], Apo E levels [16], Apo B/Apo AI ratio [12,14,15], Apo E/Apo AI ratio [16] and Apo CIII/Apo AI ratio [16] have all been found to independently predict the development of type 2 diabetes. Most of these earlier studies focussed on Apo AI and Apo B levels only and did not study other Apo species; mainly due to the unavailability of standardised clinical immunoassays [19].…”

“…High Apo B levels have also been associated with incident type 2 diabetes in Aboriginal Canadians [11], Koreans [12] and Turkish women [13]. Moreover, multiple studies have shown that an increased Apo B/Apo AI ratio is associated with incident type 2 diabetes [12,14,15]. Recently, high serum Apo CIII and Apo E levels and Apo E/Apo AI and Apo CIII/Apo AI ratios were associated with incident type 2 diabetes in 971 individuals from the Rotterdam Study [16].…”

Association of sleep duration with apolipoproteins and the apolipoprotein B/A1 ratio: the China health and nutrition survey

“…Findings from previous research showed that apoB and apoA1 levels were superior to total cholesterol and low-density lipoprotein cholesterol (LDL-C) in predicting the future risk of fatal myocardial infarction [ 2 ]. Epidemiological studies have also demonstrated that apolipoproteins and the apoB/apoA1 ratio represent potential risk factors for the development of type 2 diabetes mellitus (T2DM) [ 3 ], insulin resistance [ 4 ], non-alcoholic fatty liver disease [ 5 ], metabolic syndrome [ 6 ], and cancer [ 7 ]. Multiple adverse health outcomes have been linked to low apoA1 levels, high apoB levels and high apoB/apoA1 ratios, leading to interest in developing strategies to manage abnormal apo variables for the prevention or treatment of associated metabolic and cardiovascular diseases.…”

Evaluation of atherogenic laboratory markers in Behçet’s disease patients with vascular involvement

“…An increase in apoB/apoA1 ratio has been shown to be associated with cardiovascular disease progression. An increased ratio of apoB/ apoA1 has been found in previous studies in chronic illnesses such as diabetes, coronary artery disease and some chronic inflammatory diseases including RA [10,11,30]. There are no previous studies in the literature evaluating apoB/apoA1 ratio in Behçet's patients.…”

“…Apolipoproteins are one of the major components of lipoproteins, apolipoprotein B (apoB) is found atherogenic lipoproteins like low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL), while apolipoprotein A1 (apoA1) is found in the structure of the anti-atherogenic cholesterol high-density lipoprotein (HDL). That is why an increase in apoB/apoA1 ratio is considered to be related to progression of cardiovascular disease and a tendency for atherosclerosis [10,11].…”