The value of the apoB/apoAΙ ratio and the non-HDL-C/HDL-C ratio in predicting carotid atherosclerosis among Chinese individuals with metabolic syndrome: a cross-sectional study

Lipids in Health and Disease

Wensheng Pan²  Undurti N Das⁴  Shengrong Shen¹  Lisha Tao³  Wen Lu³  Lingang Liu³  Jiaqi Wu³  Laisheng Luo³  Xiaoxiao Tang³  Chenjing Zhang³  Jiangfeng Tu³  Guangming Qin⁵ 

[1] School of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310029, China;Department of Gastroenterology, The Second Affiliated Hospital Binjiang Campus, School of Medicine, Zhejiang University, Hangzhou 310009, China;Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou 310009, China;UND Life Sciences, 2020 S 360th St., Federal Way 98003, WA, USA;Department of Laboratory, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

关键词: Non-HDL-C/HDL-C;    ApoB/apoAΙ;    Metabolic syndrome;    Carotid intima-media thickness;    Carotid atherosclerosis;   

Others  :  1175101
DOI  :  10.1186/s12944-015-0023-4

 received in 2014-08-28, accepted in 2015-03-20,  发布年份 2015

【 摘 要 】

Background

Metabolic syndrome (MetS) is associated with carotid intima-media thickness (CIMT), which is a good predictor of cardiovascular disease (CVD). However, among individuals with MetS, direct comparative data regarding the utility of the apoB/apoAΙ ratio and the non-HDL-C/HDL-C ratio to diagnose carotid atherosclerosis are scarce, particularly in Chinese populations. We aimed to determine the relationship between the apoB/apoAΙ ratio and the non-HDL-C/HDL-C ratio and carotid atherosclerosis among Chinese individuals with MetS.

Methods

We performed a retrospective study of 5822 Chinese participants who underwent a routine health screening examination. Lipid profiles, fasting glucose, fasting insulin, CRP, apoB, apoAΙ and CIMT were measured.

Results

We observed that among Chinese individuals with MetS, men (53.95 ± 0.58 ys) developed carotid atherosclerosis at a younger age than women (58.47 ± 1.17 ys) (P < 0.001). Both the apoB/apoAΙ ratio and the non-HDL-C/HDL-C ratio positively correlated with carotid atherosclerosis among Chinese individuals with MetS, particularly among women. Meanwhile, CIMT increased progressively across the quartiles of the non-HDL-C/HDL-C ratio (P for trend, < 0.05). Receiver Operating Characteristic (ROC) analysis indicated that the AUC of the apoB/apoAΙ ratio (0.561) was higher than that of the non-HDL-C/HDL-C ratio (0.522) in men (P < 0.05) and the AUC of the apoB/apoAΙ ratio (0.640) was lower than that of the non-HDL-C/HDL-C ratio (0.695) in women (P < 0.05). Among Chinese individuals with MetS, the AUC of the non-HDL-C/HDL-C ratio was more prominent among women compared with men (P < 0.05).

Conclusion

Our findings indicate that among individuals with MetS, Chinese men develop carotid atherosclerosis at a much younger age than women. There were no significant differences between the apoB/apoAΙ ratio and the non-HDL-C/HDL-C ratio for the prediction of carotid atherosclerosis among Chinese individuals with MetS. Among Chinese individuals with MetS, the utility of the non-HDL-C/HDL-C ratio was found to be greater among women than among men.

【 授权许可】

   
2015 Qin et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Syvanne M, Taskinen MR: Lipids and lipoproteins as coronary risk factors in non-insulin-dependent diabetes mellitus. Lancet 1997, 350:Si20-Si23.
• [2]Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al.: Diagnosis and management of the metabolic syndrome - an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005, 112:2735-2752.
• [3]Sengul C, Cevik C, Ozveren O, Oduncu V, Sunbul A, Akgun T, et al.: Echocardiographic epicardial fat thickness is associated with carotid intima-media thickness in patients with metabolic syndrome. Echocardiography 2011, 28:853-858.
• [4]Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al.: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001, 24:683-689.
• [5]Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults - findings from the Third National Health and Nutrition Examination Survey. JAMA 2002, 287:356-359.
• [6]Rong D, Jianfei M, Changqing Y, Changyan W, Hongyuan L: morbidity of metaboiism syndrome in middle and aged crowd. Med J west China 2010, 1:130-132.
• [7]Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M: Prediction of clinical cardiovascular events with carotid intima-media thickness - a systematic review and meta-analysis. Circulation 2007, 115:459-467.
• [8]Chambless LE, Heiss G, Folsom AR, Rosamond W, Szklo M, Sharrett AR, et al.: Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: The Atherosclerosis Risk in Communities (ARIC) study, 1987–1993. Am J Epidemiol 1997, 146:483-494.
• [9]O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL: carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med 1999, 340:14-22.
• [10]Polak JF, Pencina MJ, Pencina KM, O’Donnell CJ, Wolf PA, D’Agostino RB: Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med 2011, 365:213-221.
• [11]Bots ML, Baldassarre D, Simon A, de Groot E, O’Leary DH, Riley W, et al.: Carotid intima-media thickness and coronary atherosclerosis: weak or strong relations? Eur Heart J 2007, 28:398-406.
• [12]Dahlen EM, Lanne T, Engvall J, Lindstrom T, Grodzinsky E, Nystrom FH, et al.: Carotid intima-media thickness and apolipoprotein b/apolipoprotein a-i ratio in middle-aged patients with type 2 diabetes. Diabet Med 2009, 26:384-390.
• [13]Huang F, Yang Z, Xu BH, Bi YF, Xu M, Xu Y, et al.: Both serum apolipoprotein B and the Apolipoprotein B/Apolipoprotein A-I ratio are associated with carotid intima-media thickness. Plos One 2013, 8:e54628.
• [14]Zhao WW, Gong W, Wu N, Li YT, Ye KP, Lu B, et al.: Association of lipid profiles and the ratios with arterial stiffness in middle-aged and elderly Chinese. Lipids Health Dis 2014, 13:37. BioMed Central Full Text
• [15]Scuteri A, Najjar SS, Muller DC, Andres R, Hougaku H, Metter EJ, et al.: metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness. J Am Coll Cardiol 2004, 43:1388-1395.
• [16]McNeill AM, Rosamond WD, Girman CJ, Heiss G, Golden SH, Duncan BB, et al.: Prevalence of coronary heart disease and carotid arterial thickening in. patients with the metabolic syndrome (The ARIC Study). Am J Cardiol 2004, 94:1249-1254.
• [17]Sipila K, Moilanen L, Nieminen T, Reunanen A, Jula A, Salomaa V, et al.: Metabolic syndrome and carotid intima media thickness in the health 2000 survey. Atherosclerosis 2009, 204:276-281.
• [18]Tabatabaei-Malazy O, Fakhrzadeh H, Sharifi F, Mirarefin M, Badamchizadeh Z, Larijani B: Gender differences in association between metabolic syndrome and carotid intima media thickness. J Diabetes Metab Disord 2012, 11:13. BioMed Central Full Text
• [19]Kweon SS, Shin MH, Lee YH, Choi JS, Nam HS, Park KS, et al.: Higher normal ranges of urine albumin-to-creatinine ratio are independently associated with carotid intima-media thickness. Cardiovasc Diabetol 2012, 11:112. BioMed Central Full Text
• [20]Alcohol-attributable deaths and years of potential life lost–United States, 2001. MMWR Morb Mortal Wkly Rep 53: 866–870
• [21]Cleeman JI, Grundy SM, Becker D, Clark LT, Cooper RS, Denke MA, et al.: Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001, 285:2486-2497.
• [22]Johnsen SH, Mathiesen EB, Joakimsen O, Stensland E, Wilsgaard T, Lochen ML, et al.: Carotid atherosclerosis is a stronger predictor of myocardial infarction in women than in men: A 6-year follow-up study of 6226 persons: The Tromso study. Stroke 2007, 38:2873-2880.
• [23]Writing Group of 2010 Chinese Guidelines for the Management of Hypertension: 2010 Chinese guidelines for the management of hypertension Chin J Cardiol 2011, 39:579-614.
• [24]Ying Y, Qiang Y, Lirong L, Miao W, Wuxiang X, Jiangyi X, et al.: Ultrasonic Testing of the Intima Media Thickness (IMT) in the carotid artery-repetitive comments. Ultrasonic Imag Mag 2010, 19:120-123.
• [25]Kaess BM, Jozwiak J, Mastej M, Lukas W, Grzeszczak W, Windak A, et al.: Association between anthropometric obesity measures and coronary artery disease: a cross-sectional survey of 16 657 subjects from 444 polish cities. Heart 2010, 96:131-135.
• [26]Wassink AMJ, Van Der Graaf Y, Soedamah-Muthu SS, Spiering W, Visseren FLJ, Grp SS: Metabolic syndrome and incidence of type 2 diabetes in patients with manifest vascular disease. Diab Vasc Dis Res 2008, 5:114-122.
• [27]Walldius G, Jungner I: The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy - a review of the evidence. J Intern Med 2006, 259:493-519.
• [28]Olofsson SO, Wiklund O, Boren J: Apolipoproteins A-I and B: Biosynthesis, role in the development of atherosclerosis and targets for intervention against cardiovascular disease. Vasc Health Risk Manag 2007, 3:491-502.
• [29]Meisinger C, Loewel H, Mraz W, Koenig W: Prognostic value of Apolipoprotein B and A-I in the prediction of myocardial infarction in middle-aged men and women: results from the MONICA/KORA Augsburg cohort study. Eur Heart J 2005, 26:271-278.
• [30]Barton M: Postmenopausal oestrogen replacement therapy and atherosclerosis: can current compounds provide cardiovascular protection? Expert Opin Investig Drugs 2001, 10:789-809.
• [31]Ndumele CE, Matsushita K, Astor B, Virani SS, Mora S, Williams EK, et al.: Apolipoproteins do not add prognostic information beyond lipoprotein cholesterol measures among individuals with obesity and insulin resistance syndromes: The ARIC study. Eur J Prev Cardiol 2014, 21:866-875.
• [32]Paul TK, Chen W, Srinivasan SR, Toprak A, He J, Berenson GS: Gender divergence on the impact of multiple cardiovascular risk factors on the femoral artery intima-media thickness in asymptomatic young adults: The Bogalusa heart study. Am J Med Sci 2012, 343:40-45.
• [33]Shaw LJ, Merz CNB, Pepine CJ, Reis SE, Bittner V, Kelsey SF, et al.: Insights from the NHLBI-sponsored women’s ischemia syndrome evaluation (WISE) Study part I: gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies. J Am Coll Cardiol 2006, 47:4S-20S.