The ApoB/A-1 ratio is independently associated with subclinical arteriosclerosis and arterial stiffness in type 2 diabetes patients

Abstract

Background The ApoB/ApoA-1 (ApoB/A1) ratio is a predictor of atherosclerotic vascular disease. In this study, we aimed to explore whether ApoB/A1 ratio is related to arteriosclerosis parameters, including subclinical atherosclerosis and arterial stiffness, in type 2 diabetic patients. Methods In this cross-sectional study, 256 type 2 diabetic (T2D) patients, including 152 patients with carotid atherosclerosis, were recruited. Traditional fasting lipid profiles and ApoB and ApoA-1 levels were measured. Arterial stiffness was assessed by brachial ankle pulse wave velocity (baPWV), and subclinical arteriosclerosis was assessed by ankle brachial index (ABI) and carotid atherosclerosis. Results The ApoB/A1 ratio in T2D patients with no carotid atherosclerosis was significantly higher than that in T2D patients with carotid atherosclerosis (p < 0.05). The arterial stiffness parameters baPWV and ABI were significantly lower among T2D patients with no carotid atherosclerosis (all p < 0.05). Moreover, the baPWV and ABI were significantly decreased across the ApoB/A1 ratioquartiles (all p for trend < 0.05). Additionally, baPWV and ABI were both inversely related to ApoB/A1 ratio (r = –0.223 and –0.224, respectively, p < 0.001). Using univariate logistic regression analyses, ApoB/A1 ratio, sex, age, duration, baPWV, HbA1c, and statin use were found to be independent contributors to carotid atherosclerosis, and the corresponding odds ratios (95% confidence intervals) were 0.242 (0.090–0.646), 0.326 (0.178–0.599), 2.730 (1.619–4.603), 6.833 (3.024–15.44), 1.204 (1.103-1.314), 0.842 (0.745-0.953),and 2.704 (1.228, 5.954), respectively. After adjusting for clinical covariates by multiple logistic regression analyses, the corresponding odds ratio (OR) for the ApoB/A1 ratio of carotid atherosclerosis was 0.216 (0.062-0.759). Conclusions The ApoB/A1 ratio was independently and inversely associated with baPWV and ABI and independently contributed to carotid atherosclerosis.