Background

Research proved the importance of dosing apolipoprotein B (ApoB) over LDL cholesterol as a predictor of cardiovascular events. In this study, we aimed to observe the input apolipoprotein A1 (ApoA1) and ApoB, primarily if its ratio could provide in patients with type 2 diabetes mellitus (T2DM) without known atherosclerotic events regarding the coronary heart disease (CHD) risk.

Methods

We enrolled 83 patients with T2DM who attended the National Institute of Diabetes (Bucharest) between March 2022 and December 2022. A blood sample was taken from all patients to measure the different lipid parameters, including ApoA1 and ApoB. Spearman's correlation test for correlation between variables was used, and a multivariate regression analysis was performed to determine whether there are associations between CHD and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Values of p < 0.05 were considered significant.

Results

Correlation analyses revealed that LDL-C was moderately associated with CHD (r = 0.199, p = 0.067). The non-HDL-C/HDL-C ratio exhibited a stronger, significant correlation with CHD (r = 0.366, p = 0.001). Evaluating apolipoproteins, ApoA1 levels negatively correlated with CHD (r = −0.233, p = 0.035), whereas ApoB levels showed a positive association (r = 0.292, p = 0.008). Notably, the severity of CHD risk increased with the ApoB/ApoA1 ratio (r = 0.530, p < 0.001). Similar trends in correlation coefficients were observed for fatal CHD and ASCVD, albeit with varied significance levels.

Conclusions

Among patients with T2DM, the ApoB/ApoA1 ratio exhibited the strongest correlation with CHD risk, surpassing traditional LDL-C and even the non-HDL-C/HDL-C ratio, suggesting its potential utility as a more reliable marker for cardiovascular risk assessment in this population.

中文翻译：

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LDL-CT、非HDL/HDL比值和ApoB/ApoA1评估2型糖尿病患者冠心病风险的比较评估

背景

研究证明，相比 LDL 胆固醇，载脂蛋白 B (ApoB) 的剂量对于心血管事件的预测具有重要意义。在这项研究中，我们的目的是观察输入载脂蛋白 A1 (ApoA1) 和 ApoB，主要是其比率是否可以为没有已知动脉粥样硬化事件的 2 型糖尿病 (T2DM) 患者提供与冠心病 (CHD) 风险相关的信息。

方法

我们招募了 2022 年 3 月至 2022 年 12 月期间在国家糖尿病研究所（布加勒斯特）就诊的 83 名 T2DM 患者。从所有患者身上采集血样以测量不同的血脂参数，包括 ApoA1 和 ApoB。使用 Spearman 相关性检验来检验变量之间的相关性，并进行多变量回归分析以确定 CHD 与 ApoB/ApoA1 和非 HDL 胆固醇/HDL 胆固醇比率之间是否存在关联。p < 0.05 的值被认为是显着的。

结果

相关分析显示，LDL-C 与 CHD 中度相关（r = 0.199，p = 0.067）。非 HDL-C/HDL-C 比率与 CHD 表现出更强的显着相关性（r = 0.366，p = 0.001）。评估载脂蛋白时，ApoA1 水平与 CHD 呈负相关（r = -0.233，p = 0.035），而 ApoB 水平则呈正相关（r = 0.292，p = 0.008）。值得注意的是，冠心病风险的严重程度随着 ApoB/ApoA1 比率的增加而增加 (r = 0.530，p < 0.001)。尽管显着性水平不同，但致死性 CHD 和 ASCVD 的相关系数也有类似的趋势。

结论

在 T2DM 患者中，ApoB/ApoA1 比值与 CHD 风险的相关性最强，超过传统的 LDL-C，甚至超过非 HDL-C/HDL-C 比值，表明其作为更可靠的心血管风险评估指标的潜在用途在这个人群中。