Association of HDL-Cholesterol Level and ApoB/ApoA Ratio with Coronary Artery Disease Severity and Type 2 Diabetes Mellitus.

ABSTRACT

The ApoB/ApoA-I ratio reflects the balance between pro- and anti-atherogenic particles, all of which contain cholesterol. The ApoB/A ratio is valid in both genders of all ages and is independent of the lipid levels and phenotypes. This study has been designed to investigate the association between the ratio of apolipoprotein B (apo B)/ apolipoprotein A1 (apo A1) and HDL-C with severity of coronary artery disease in patients with and without type 2 diabetes mellitus.METHODSThe present case control study was carried out in departments of Cardiology and Biochemistry, Vinayaka Missions Hospital, Salem. Fasting blood samples have been collected from 109 CAD patients and 71 control subjects. Serum lipids were measured enzymatically, ApoA-I and Apo B were analysed by immunoturbidimetric method. The study was approved by ethics committee and informed consent was obtained.RESULTSIn our study, Apo A-1 level was significantly low (1.187±0.20) and Apo B was found to be significantly high (1.64±0.62) in CAD with diabetes subjects, when compared to CAD without diabetes. HDL level was found to be significantly lowered in CAD patients. A significant positive association was observed between ApoA-1 and lipid parameters in CAD subjects with HDL-C at (p= 0.00).CONCLUSIONSApo B/Apo A1 ratio may be a healthier forecaster than conventional lipid markers to explore the severity of CAD. This study suggests that instead of measurement of lipid profiles alone, a better indicator apo B, A-I and B/A-I ratio measurement, which in turn highlights the cholesterol balance, can reduce the delay in the recognition of CAD.