Document Detail


Ability of traditional lipid ratios and apolipoprotein ratios to predict cardiovascular risk in people with type 2 diabetes.
MedLine Citation:
PMID:  20526762     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-06-06
Journal Detail:
Title:  Diabetologia     Volume:  53     ISSN:  1432-0428     ISO Abbreviation:  Diabetologia     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1846-55     Citation Subset:  IM    
Affiliation:
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:
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:
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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