Both Serum Apolipoprotein B and the Apolipoprotein B/Apolipoprotein A-I Ratio Are Associated with Carotid Intima-Media Thickness

Abstract

BackgroundPrevious studies indicated that apolipoprotein measurements predicted cardiovascular disease (CVD) risk; however, associations between apolipoproteins and carotid intima-media thickness (CIMT) were less explored.Methodology and Principal FindingsThe cross-sectional study included 6069 participants aged 40 years or older with NGT from Shanghai, China. Serum fasting traditional lipids (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C] and triglycerides [TG]), apoA-I and apoB were assessed. A high-resolution B-mode ultrasonography was performed to measure CIMT. We found CIMT increased progressively across the quartiles of serum apoB (p for trend <0.0001). In logistic regression, concentrations of apoB (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.18–1.36), TC (OR 1.23, 95% CI 1.14–1.32), LDL-C (OR 1.25, 95% CI 1.16–1.34) and TG (OR 1.11, 95% CI 1.04–1.20) were significantly related to elevated CIMT after adjusted for age and sex. Meanwhile, the apoB/apoA-I ratio (OR 1.25, 95% CI 1.17–1.34) related to elevated CIMT. ApoB (OR 1.23, 95% CI 1.00–1.51) and the apoB/apoA-I ratio (OR 1.19, 95% CI 1.04–1.36) remained significantly associated with elevated CIMT, after adjusted for the traditional CVD risk factors including traditional lipids.Conclusions and SignificanceThere were significant associations between serum apoB, the apoB/apoA-I ratio and elevated CIMT. Serum apoB and the apoB/apoA-I ratio might be independent predictors of early atherosclerosis in NGT.

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“…Our finding was concordant to those of Huang et al who found that both apoB levels and apoB/apoA-I ratio were associated to increased CIMT (34). As reported by Dahlen et al we also observed that high apoB/apoA-I ratio, and not serum lipid profile, were associated with increased CIMT (35).…”

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“…For example, levels of ApoB have been associated with the increased carotid intima-media thickness, (Huang et al 2013) and LDL/HDL is an independent predictor of vulnerable coronary plaque (Fujihara et al 2013). PAI-1, a principal inhibitor of fibrinolysis, is induced in thrombotic, fibrotic, and cardiovascular diseases, which in turn primarily afflict the older population.…”

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“…It should be emphasized that only the apo B and the apo B/apo A-I ratio remained significantly associated after the adjustment for traditional risk factors (46). Similarly, the association of the same parameters with the media-intima thickness suggest they may be early predictors of atherosclerosis (48).…”

“…In fact, several investigators confirmed its usefulness in the prediction of cardiovascular events (46). Apo A and B are easy to be measured and showed to be useful in the prediction of cardiovascular events in some studies (45)(46)(47)(48). The meta-analysis carried out with 23 studies showed that the greatest concentrations of apo B determined a relative risk of 1.99 for events, whereas the lowest levels of apo A-I raised the risk in 62% (47).…”