Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
PLoS One. 2012;7(7):e40878. doi: 10.1371/journal.pone.0040878. Epub 2012 Jul 25.
The ratio between apolipoprotein B and apolipoprotein A-I (apoB/apoA-I) has been suggested to be a powerful and more accurate predictor of future cardiovascular disease risk than total cholesterol and HDL cholesterol. Since diet and lifestyle can directly influence dyslipidemia, it is of interest to identify modifiable factors that are associated with high levels of the apolipoprotein ratio and if they can have a different association with a more traditional indicator of cardiovascular risk such as total cholesterol/HDL. The relationship between obesity and dyslipidemia is established and it is of interest to determine which factors can modify this association. This study investigated the cross-sectional association of obesity, diet and lifestyle factors with apoB/apoA-I and total cholesterol/HDL respectively, in a Swedish population of 2,907 subjects (1,537 women) as part of the INTERGENE study. The apolipoprotein and lipoprotein ratios were highly correlated, particularly in women, and obesity was strongly associated with both. Additionally, age, cigarette smoking and alcohol intake were important determinants of these ratios. Alcohol was the only dietary factor that appreciably attenuated the association between obesity and each of the ratios, with a stronger attenuation in women. Other dietary intake and lifestyle-related factors such as smoking status and physical activity had a lower effect on this association. Because the apolipoprotein and lipoprotein ratios share similar diet and lifestyle determinants as well as being highly correlated, we conclude that either of these ratios may be a sufficient indicator of dyslipidemia.
载脂蛋白 B 与载脂蛋白 A-I 的比值（apoB/apoA-I）被认为是预测未来心血管疾病风险的有力且更准确的指标，优于总胆固醇和高密度脂蛋白胆固醇。由于饮食和生活方式可以直接影响血脂异常，因此确定与载脂蛋白比值升高相关的可改变因素以及它们与总胆固醇/高密度脂蛋白等更传统的心血管风险指标的关联是否不同是很有意义的。肥胖与血脂异常之间的关系已经确立，确定哪些因素可以改变这种关联是很有意义的。本研究在 INTERGENE 研究中，对瑞典 2907 名受试者（1537 名女性）的横断面数据进行了分析，研究了肥胖、饮食和生活方式因素与 apoB/apoA-I 和总胆固醇/高密度脂蛋白胆固醇的关系。载脂蛋白和脂蛋白比值高度相关，尤其是在女性中，肥胖与两者均有强烈关联。此外，年龄、吸烟和饮酒也是这些比值的重要决定因素。酒精是唯一能明显减弱肥胖与各比值之间关联的饮食因素，对女性的影响更强。其他饮食摄入和生活方式相关因素，如吸烟状况和体力活动，对这种关联的影响较小。由于载脂蛋白和脂蛋白比值具有相似的饮食和生活方式决定因素，并且高度相关，我们得出结论，这两种比值中的任何一种都可能是血脂异常的充分指标。
