Associations of apolipoprotein B/apolipoprotein A-I ratio with pre-diabetes and diabetes risks: a cross-sectional study in Chinese adults

BMJ Open. 2017 Jan 20;7(1):e014038. doi: 10.1136/bmjopen-2016-014038.

Abstract

Background: 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.

Aims: 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.

Methods: 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.

Results: 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.

Conclusions: The ApoB/ApoA-I ratio showed positive associations with the risk of diabetes and pre-diabetes in Chinese women.

Keywords: apolipoprotein A-I; apolipoprotein B; dyslipidemia; prediabetes; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Apolipoprotein A-I / blood*
  • Apolipoproteins B / blood*
  • Blood Glucose / metabolism
  • China
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prediabetic State / blood
  • Prediabetic State / etiology*
  • Reference Values
  • Risk Factors
  • Sex Factors
  • Triglycerides / blood

Substances

  • APOA1 protein, human
  • Apolipoprotein A-I
  • Apolipoproteins B
  • Blood Glucose
  • Triglycerides
  • Cholesterol