ABSTRACT
AIMS: Metabolic syndrome (MetS) is a risk factor for cardiovascular disease (CVD). Apolipoproteins are emerging as powerful predictors of CVD. We aimed to study associations of metabolic syndrome and apoB, apoAI, apoB/AI ratio in young Sri Lankans with type 2 diabetes. MATERIALS & METHODS: Blood samples were available from 690 patients with type 2 diabetes in Sri Lanka Young Diabetes Study, and were analysed for apoB, apoAI, total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), triglycerides (TG) and glycated haemoglobin (HbA1c). Their associations with MetS as perNCEP/ATPIII criteria were studied. RESULTS: MetS was present in 60.9% of subjects. Of those with MetS, 76.0% were women. Those with MetS had higher apoB (1.27â¯Vâ¯s 1.19â¯mmol/L; pâ¯=â¯0.001), apoB/AI (0.80â¯Vâ¯s 0.75; pâ¯=â¯0.001), non-HDL cholesterol (NHDLC) (4.15â¯Vâ¯s 3.98â¯mmol/L; pâ¯=â¯0.002),and triglycerides (1.51â¯Vâ¯s 1.31â¯mmol/L; pâ¯<â¯0.001) and lower apoAI (1.58â¯Vâ¯s 1.60â¯mmol/L; pâ¯=â¯0.03) and HDLC (1.02â¯Vâ¯s 1.16â¯mmol/L, pâ¯<â¯0.001). ApoB and apoB/AIlevels increased significantly as the number of MetS components increased. ApoB and apoB:AI ratio were independently associated with MetS and components. CONCLUSION: MetS showed a high prevalence among young Sri Lankans with diabetes. Elevated apoB is commonly clustered with other risk indicators in MetS.
Subject(s)
Apolipoprotein B-100/blood , Biomarkers/blood , Diabetes Mellitus, Type 2/complications , Lipids/blood , Metabolic Syndrome/blood , Metabolic Syndrome/epidemiology , Adolescent , Adult , Case-Control Studies , Cholesterol/blood , Cholesterol, HDL/blood , Female , Follow-Up Studies , Humans , Male , Metabolic Syndrome/etiology , Prevalence , Prognosis , Sri Lanka/epidemiology , Young AdultABSTRACT
BACKGROUND: Apolipoproteins B (apoB) and AI (apoAI) are strong predictors of cardiovascular disease (CVD). We describe apolipoprotein distributions and their associations with lipids and diabetes subtype in diabetic young adult South Asians. METHODS: In 995 subjects with diabetes, we measured fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), triglycerides (TG), apoB and apoAI, glycosylated haemoglobin (HbA1c) and glutamic acid decarboxylase antibodies (GADA). Low-density lipoprotein cholesterol (LDLC) and non-HDLC (NHDLC) were calculated. We compared values in subjects aged 15-50 y from the United States National Health and Nutrition Examination Survey (NHANES). RESULTS: Median age and duration of diabetes were 38 (range 14-45) and 4 (0-24) y. Men had significantly higher TC, TG, NHDLC, TC/HDLC, apoB/AI and NHDLC/apoB, and lower apoAI than women. Compared with the reference group, patients with type 1 diabetes had lower TG, apoB:apoAI and HDLC:apoAI, and higher HDLC and apoAI. Patients with type 2 diabetes had higher TG, TC, LDLC, NHDLC, TC:HDL, apoB, apoAI and apoB:apoAI, and lower HDLC, LDLC:apoB and HDLC:apoAI. Among patients with type 2 diabetes, 54% had high apoB (>1.2 g/L) and 33% also had high TG (>1.5 mmol/L). Measures of obesity (body mass index and waist circumference) were weakly correlated with lipid and apoprotein parameters, suggesting a modest contribution to dyslipidaemia. CONCLUSIONS: A large proportion of young adult Sri Lankan patients with type 2 diabetes has a low LDLC:apoB and high apoB and/or TG, suggesting that these patients are at increased risk of CVD.