A Potential Role of Apo B in the Risk Stratification of Type 2 Diabetic Patients with Dyslipidemia

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.