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A Potential Role of Apo B in the Risk Stratification of Type 2 Diabetic Patients with Dyslipidemia
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Background: Dyslipidemia matters in type 2 diabetes and appreciation of the lipid abnormalities in diabetes has changed with time. There are few data on Apo B levels in these patients and consequently there is little information on the frequencies of the various dyslipidemic phenotypes.
Methods: Plasma lipids and Apo B were measured by standardized methods. The patients were categorized by two different methods. The first was based on triglyceride (<150mg/dl) and LDL cholesterol (<100mg/dl), and the second was based on triglyceride (<150mg/dl) and Apo B (<137mg/dl).
Results: As overall, plasma triglycerides were elevated, total and LDL cholesterol were normal and HDL was decreased. Results of the phenotyping analysis were, using the conventional approach; only 20% has elevated LDL cholesterol. Using the new approach, 63% has an elevated Apo B and therefore an elevated LDL particle number. The mean LDLc for hypertriglceridemic-hyperapo B group was 120.4mg/dl, whereas the mean Apo B for the same was 239mg/dl, indicating its significance over LDL cholesterol.
Conclusion: Diagnosis based on triglycerides and Apo B revealed more number of patients with atherogenic, dyslipidemic status rather than by diagnosing on triglycerides and LDL cholesterol levels. Apo B is a better cardiovascular risk marker and can replace LDL cholesterol in maintaining statin therapy in type 2 diabetic patients.
Keywords
- Shekar HU, Shahjalal HM, Ahmed R, Uddin M, E-Jannat KK. Prevalence of dyslipidemic phenotypes including hyper-apo b & evaluation of cardiovascular disease risk in normocholesterolemic Type 2 diabetic patients. Pak J Biol Sci 2006;9(8):1536-1541.
- Allan D, Sniderman AD. Diabetic atherogenic dyslipidmias. In: Falk E, Shah PK, de Feyter PJ (eds.): Ischemic heart disease. Manson publication, London, 2007: 243-245.
- Sniderman AD, Seccombe D, Lamarche B, Tilley J :Hypertriglyceridemic Hyperapo B in Type 2 Diabetes. Diabetic Care 2002; 25: 579-582.
- Kastelein JJP, van der Steeg WA, Holme I, Gaffney M, Cater NB, Barter P et al. Lipids, Apolipoproteins, and their ratios in relation to cardiovascular events with statin treatment. Circulation 2008;117:3002-3009.
- Sniderman AD, Bergeron J, Frohlich J. Apolipoprotein B versus lipoprotein lipids : Vital lessons from the AFCAPS/TexCAPS trial. CMAJ 2001;164(1):44-47.
- Jiang R, Stampfer MJ, Schulze MB, Rimm EB, Li T, Hu FB et al. Non-HDL Choleterol and Apolipoprotein B Predict Cardiovascular Disease Events Among Men With Type 2 Diabetes. Diabetic Care 2004;27:1991-1997.
- Sniderman AD, Scantlebury T, Cianflone K. Hypertriglyceridemic Hyperapo B: The Unappreciated Atherogenic Dyslipoproteinemia in Type 2 Diabetes Mellitus. Ann Int Med 2001;135:447-459.
- Lamarche B, Moorjani S, Lupien PJ, Cantin B, Bernard PM, Dagenais GR et al : Apolipoprotein A-1 and B Levels and the Risk of Ischemic Heart Disease During a Five-Year Follow-up of Men in the Quebec Cardivascular Study. Circulation 1996;94:273-278.
- Wagner AM, Bonet R, Perez A, Cartellvi A, Calvo F, Ordonez J. Apolipoprotein(B) identifies dyslipidemic phenotypes associated with cardiovascular risk in Normocholesterolemic type 2 diabetic patients. Diabetic Care 1999;22:812-817.
- Alberts JJ, Marcovina SM, Imperatore G, Snively BM, Stafford J, Fujimoto WY et al. Prevalence and Determinants of Elevated Apolipoprotein B and Dense Low-Density Lipoprotein in Youths with Type 1 and Type 2 Diabetes. J Clin Endocrinol Metab 2008;93(3):735-742.
- Tseng CH. Apolipoprotein B Is an Independent Risk Factor for Microalbuminuria in Taiwanese Patients With Type 2 Diabetes. Diabetes Care 2003;26:2965-2966
- Barter PJ, Ballantyne CM, Carmena R, Cabezas MC, Chapman MJ, Couture P et al . Apo B versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirty-person/ ten-country panel. J Int Med 2006; 259: 247-258.
- Sniderman AD. Non-HDL Cholesterol Versus Apolipoprotein B in Diabetic Dyslipoproteinemia alternatives and surrogates versus the real thing. Diabetic Care 2003;26(7):2207-2208.
- Ballantyne CM, Raichlen JS, Cain VA. Statin Therapy Alters the Relationship Between Apolipoprotein B and Low-Density Lipoprotein Cholesterol and Non-High-Density Lipoprotein Cholesterol Targets in High-Risk Patients. J Am Coll Cardiol 2008; 52(8):626-6232.
- Carr MC, Brunzell JD. Abdominal Obesity and Dyslipidemia in the Metabolic Syndrome: Importance of Type 2 Diabetes and Familial Coronary Artery Disease Risk. J Clin Endocrinol Metab 2004;89(6):2601-2607.
- Brunzell JD, Howard BV, Davidson M, Stein JH, Furberg CD, Witztum JL et al. Lipoprotein Management in Patients With Cardiometabolic Risk. J Am Coll Cardiol 2008;51(15):1512-1524.
- Chan DC,Watts GF. Apolipoproteins as markers and managers of coronary risk. QJM 2006;99(5):277-287.
- Contois JH, McConnell JP, Sethi AA, Csako G, Devaraj S, Hoefner DM et al. Apolipoprotein B and Cardiovascular Disease Risk: Position Statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices. Clin Chem 2009;55:407-419.
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