| Ability of traditional lipid ratios and apolipoprotein ratios to predict cardiovascular risk in people with type 2 diabetes. | |
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MedLine Citation:
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PMID: 20526762 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS/HYPOTHESIS: The apolipoprotein B (ApoB):apolipoprotein A (ApoA)-I ratio may be a better indicator of cardiovascular disease (CVD) risk in people with type 2 diabetes than traditional lipid risk markers (LDL-cholesterol, HDL-cholesterol and triacylglycerol), but whether the ApoB:ApoA-I ratio should be used to indicate lipid-lowering therapy is still debated. METHODS: The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study randomised 9,795 patients with type 2 diabetes to fenofibrate (200 mg daily) or placebo and followed them up for a median of 5 years. We compared ApoB, ApoA-I, ApoAII and the ApoB:ApoA-I ratio with traditional lipid variables as predictors of CVD risk. We estimated the HR of the effect of 1 SD difference in baseline concentrations of lipids, apolipoproteins and respective ratios on the risk of CVD events and also used receiver operating characteristic curve analysis. RESULTS: In the placebo group, the variables best predicting CVD events were non-HDL-cholesterol:HDL-cholesterol, total cholesterol:HDL-cholesterol (HR 1.21, p < 0.001 for both), ApoB:ApoA-I (HR 1.20, p < 0.001), LDL-cholesterol:HDL-cholesterol (HR 1.17, p < 0.001), HDL-cholesterol (HR 0.84, p < 0.001) and ApoA-I (HR 0.85, p < 0.001). In the fenofibrate group, the first four predictors were very similar (but ApoB:ApoA-I was fourth), followed by non-HDL-cholesterol and ApoB. Lipid ratios and ApoB:ApoA-I performed better than any single lipid or apolipoprotein in predicting CVD risk. CONCLUSIONS/INTERPRETATION: In patients with type 2 diabetes in the FIELD study, traditional lipid ratios were as strong as the ApoB:ApoA-I ratio in predicting CVD risk. The data provide little evidence for replacement of traditional lipids and their ratios with measures of ApoB, ApoA-I and their ratio. |
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Authors:
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M-R Taskinen; P J Barter; C Ehnholm; D R Sullivan; K Mann; J Simes; J D Best; S Hamwood; A C Keech; |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-06-06 |
Journal Detail:
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Title: Diabetologia Volume: 53 ISSN: 1432-0428 ISO Abbreviation: Diabetologia Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-07-28 Completed Date: 2010-11-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0006777 Medline TA: Diabetologia Country: Germany |
Other Details:
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Languages: eng Pagination: 1846-55 Citation Subset: IM |
Affiliation:
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Department of Medicine, Division of Cardiology, Helsinki University Central Hospital, Biomedicum, Haartmaninkatu 8, Helsinki, Finland. Marja-Riitta.Taskinen@helsinki.fi |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antilipemic Agents / therapeutic use Apolipoprotein A-I / metabolism Apolipoprotein A-II / blood Apolipoproteins / metabolism* Apolipoproteins B / metabolism Cardiovascular Diseases / blood, drug therapy, metabolism Cholesterol / blood Cholesterol, HDL / blood Diabetes Mellitus, Type 2 / blood*, drug therapy, metabolism Female Humans Lipids / blood* Male Middle Aged Procetofen / therapeutic use Risk Factors Triglycerides / blood |
| Chemical | |
Reg. No./Substance:
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0/Antilipemic Agents; 0/Apolipoprotein A-I; 0/Apolipoprotein A-II; 0/Apolipoproteins; 0/Apolipoproteins B; 0/Cholesterol, HDL; 0/Lipids; 0/Triglycerides; 49562-28-9/Procetofen; 57-88-5/Cholesterol |
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