Zheng Shuang, Han Tingting, Xu Hua, Zhou Huan, Ren Xingxing, Wu Peihong, Zheng Jun, Wang Lihua, Zhang Ming, Jiang Yihong, Chen Yawen, Qiu Huiying, Liu Wei, Hu Yaomin
Department of Endocrinology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
BMJ Open. 2017 Jan 20;7(1):e014038. doi: 10.1136/bmjopen-2016-014038.
Apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) ratio is a useful predictor of cardiovascular risk. However, the association between the ApoB/ApoA-I ratio and the risk of type 2 diabetes mellitus (T2DM) is still obscure.
To investigate the associations between the ApoB/ApoA-I ratio and the risk of T2DM and pre-diabetes in a Chinese population, and to assess the role of gender in these associations.
A stratified random sampling design was used in this cross-sectional study which included 264 men and 465 women with normal glucose tolerance (NGT), pre-diabetes or T2DM. Serum ApoB, ApoA-I and other lipid and glycaemic traits were measured. Pearson's partial correlation and multivariable logistic analysis were used to evaluate the associations between ApoB/ApoA-I ratio and the risk of T2DM and pre-diabetes.
The ApoB/ApoA-I ratios were significantly increased across the spectrum of NGT, pre-diabetes and T2DM. Women showed higher levels of ApoB/ApoA-I ratio and ApoB than men in the pre-diabetic and T2DM groups, but not in the NGT group. The ApoB/ApoA-I ratio was closely related with triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and other glycaemic traits. Moreover, in women, the risk of diabetes and pre-diabetes in the top and middle tertiles of the ApoB/ApoA-I ratio were 3.65-fold (95% CI 1.69 to 6.10) and 2.19-fold (95% CI 1.38 to 2.84) higher than in the bottom tertile, respectively, after adjusting for potential confounding factors. However, the associations disappeared in men after adjusting for other factors.
The ApoB/ApoA-I ratio showed positive associations with the risk of diabetes and pre-diabetes in Chinese women.
载脂蛋白B/载脂蛋白A-I(ApoB/ApoA-I)比值是心血管风险的有效预测指标。然而,ApoB/ApoA-I比值与2型糖尿病(T2DM)风险之间的关联仍不明确。
研究中国人群中ApoB/ApoA-I比值与T2DM及糖尿病前期风险的关联,并评估性别在这些关联中的作用。
本横断面研究采用分层随机抽样设计,纳入264名男性和465名具有正常糖耐量(NGT)、糖尿病前期或T2DM的女性。检测血清ApoB、ApoA-I及其他血脂和血糖指标。采用Pearson偏相关分析和多变量逻辑回归分析评估ApoB/ApoA-I比值与T2DM及糖尿病前期风险的关联。
在NGT、糖尿病前期和T2DM范围内,ApoB/ApoA-I比值显著升高。在糖尿病前期和T2DM组中,女性的ApoB/ApoA-I比值和ApoB水平高于男性,但在NGT组中并非如此。ApoB/ApoA-I比值与甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及其他血糖指标密切相关。此外,在女性中,调整潜在混杂因素后,ApoB/ApoA-I比值最高和中间三分位数的糖尿病和糖尿病前期风险分别比最低三分位数高3.65倍(95%CI 1.69至6.10)和2.19倍(95%CI 1.38至2.84)。然而,在调整其他因素后,男性中的这些关联消失。
在中国女性中,ApoB/ApoA-I比值与糖尿病和糖尿病前期风险呈正相关。