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Abstract
Background
The Apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I) is a powerful clinical indicator of metabolic syndrome. However, few studies have searched for an association between ApoB/ApoA-I and metabolic syndrome in Korean patients with type 2 diabetes. We investigated the relation between ApoB/ApoA-I and the risk of metabolic syndrome and its components.
Methods
Subjects were 812 (424 males and 388 females) Korean patients who were being treated for type 2 diabetes at Huh's Diabetes Center in Seoul. The patients were classified into quartiles (lowest:Q1-highest:Q4) of ApoB/ApoA-I by gender. Anthropometric and hematological characteristics and dietary intake using a food frequency questionnaire were assessed.
Results
The prevalence of metabolic syndrome in our sample was 47.9% in males and 66.5% in females. The odds ratios (OR) for metabolic syndrome and for having its components were significantly increased from Q2 to Q4 quartiles of ApoB/ApoA-I in males (OR = 5.37; 95% CI = 2.98-9.65 and OR = 7.41; 95% CI = 4.04-13.6) and females (OR = 2.57; 95% CI = 1.28-5.15 and OR = 8.49; 95% CI = 4.28-16.8). These trends withstood adjustment for age, duration of type 2 diabetes, fasting blood glucose levels, and macronutrient intake both in males (OR = 5.24; 95% CI = 2.80-9.24 and OR = 7.98; 95% CI = 4.09-15.6) and in females (OR=4.41; 95% CI = 2.26-8.61 and OR = 8.29; 95% CI = 3.85-17.8).
Conclusion
ApoB/ApoA-I appeared to be independently associated with risk of having metabolic syndrome and its components in Korean patients with type 2 diabetes after adjustment for putative risk factors including macronutrient intake, a particularly important lifestyle factor for patients with type 2 diabetes. A follow-up study of this population should evaluate the mechanisms underlying the relation between ApoB/ApoA-I and metabolic syndrome and its components.
Figures and Tables
Fig. 1
Daily average macronutrient intakes of male (A) and female (B) subjects. Upper figures for energy intake and lower figures for carbohydrate, protein, and fat intakes. P-values indicate statistical differences among four quartile groups from one-way ANOVA test abValues with different alphabets are significantly different among the four quartile groups in same gender by Duncan's multiple range test: P < 0.05.
Table 2
Anthropometric and hematological characteristics of subjects (N = 812)
Values are means ± SE. Calculated using one-way ANOVA test. *abcdValues with different alphabets are significantly different among the four quartile groups by Duncan's multiple range test: P < 0.05. AI, atherogenic index; BMI, body mass index; HDL-C, high density lipoprotein-cholesterol; hsCRP, highly sensitive C-reactive protein; IL-6, interleukin-6; LDL-C, low density lipoprotein-cholesterol; TNF-α, tumor necrosis factor-α; Total-C, total-cholesterol; WHR, waist-hip ratio.
Table 3
OR and 95% CI for the metabolic syndrome and its components according to quartiles of ApoB/ApoA-I
Calculated using a logistic regression analysis. Adjusted for age, duration of diabetes mellitus, fasting blood glucose levels, and macronutrient intake (energy for males and fat for females). ApoB/ApoA-1, Apolipoprotein B/apolipoprotein A-I ratio; BP, blood pressure; HDL, high density lipoprotein; MetS, metabolic syndrome; TG, triglyceride; WC, waist circumference.
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