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ApoB/apoA-I ratio is related to femoral artery plaques in 64-year-old women also in cases with low LDL cholesterol

      Abstract

      Introduction

      The apolipoproteinB (apoB)/apolipoproteinA-I (apoA-I) ratio mirrors the number of pro-atherogenic and anti-atherogenic lipoprotein particles. This ratio may carry more information on risk for atherosclerosis than LDL in cohorts with impaired glucose tolerance. The aim was to examine the association between the apoB/apoA-I ratio and ultrasound-assessed atherosclerosis in the carotid and femoral arteries in women with varying degrees of glucose tolerance.

      Methods

      Plaque occurrence, and intima-media thickness in the carotid and femoral arteries were examined by B-mode ultrasound in a random sample of 64-year-old women (n = 646) living in Gothenburg, Sweden, representing different degrees of glucose intolerance (diabetes (n = 234), impaired (n = 212) and normal glucose tolerance (n = 200)). Traditional risk factors and serum concentrations of apolipoproteins were analysed.

      Results

      For subjects in the lowest LDL tertile, the risk of having a plaque in the femoral artery was three times greater for subjects in the highest apoB/apoA-I tertile compared to subjects in the lowest tertile (OR: 3.0, 95% CI: 1.2–7.5). A clear increase in the occurrence of femoral plaque was observed already at a cut-off value of 0.63 (OR: 1.8, 95% CI: 1.2–2.6). ApoB/apoA-I was also related to femoral plaque occurrence in women with low HbA1c. ApoB/A-I ratio was associated with carotid and femoral IMT but not carotid plaques.

      Conclusion

      The apoB/apoA-I ratio improved the identification of cases with femoral artery atherosclerosis in a cohort of women with varying degrees of glucose tolerance. Such cases could also be identified in women with normal LDL and HbA1c levels. The results indicate that an apoB/apoA-I ratio above 0.63 should be used as a marker of increased risk.

      Keywords

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      References

        • Wallenfeldt K.
        • Bokemark L.
        • Wikstrand J.
        • et al.
        Apolipoprotein B/apolipoprotein A-I in relation to the metabolic syndrome and change in carotid artery intima-media thickness during 3 years in middle-aged men.
        Stroke. 2004; 35: 2248-2252
        • Walldius G.
        • Jungner I.
        The apoB/apoA-I ratio: a strong new risk factor for cardiovascular disease and a target for lipid-lowering therapy—a review of the evidence.
        J Intern Med. 2006; 259: 493-519
        • Walldius G.
        • Jungner I.
        Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets of lipid-modifying therapy.
        J Intern Med. 2004; 255: 188-205
        • Duprez D.A.
        • Cohn J.N.
        Monitoring vascular health beyond blood pressure.
        Curr Hypertens Rep. 2006; 4: 287-291
        • Lonn E.
        Carotid intima-media thickness—a new non-invasive gold standard for assessing the anatomic extent of atherosclerosis and cardiovascular risk?.
        Clin Invest Med. 1999; 22: 158-160
        • Wendelhag I.
        • Wiklund O.
        • Wikstrand J.
        On quantifying plaque size in carotid and femoral arteries. Comments on results from a prospective study in patients with familial hypercholesterolemia.
        Arterioscler Thromb Vasc Biol. 1996; 16: 843-850
        • Jadhav U.M.
        • Kadam N.N.
        Apolipoproteins: correlation with carotid intima media thickness and coronary artery disease.
        J Assoc Physician India. 2004; 52: 370-375
        • Snehalatha C.
        • Vijay V.
        • Suresh M.R.
        • et al.
        Lack of association of insulin resistance and carotid intimal medial thickness in non-diabetic Asian Indian subjects.
        Diabetes Metab Res Rev. 2001; 17: 444-447
        • Schott L.L.
        • Wildman R.P.
        • Brockwell S.
        • et al.
        Segment-specific effects of cardiovascular risk factors on carotid artery intima-medial thickness in women at midlife.
        Arterioscler Thromb Vasc Biol. 2004; 24: 1951-1956
        • Schmidt C.
        • Fagerberg B.
        • Wikstrand J.
        • et al.
        ApoB/apoA-I is related to femoral artery plaques and is predictive for future cardiovascular events in healthy men.
        Atherosclerosis. 2006; 189: 178-185
        • Brohall G.
        • Behre C.J.
        • Hulthe J.
        • et al.
        Prevalence of diabetes and impaired glucose tolerance in 64-year-old Swedish women: experiences of using repeated oral glucose tolerance tests.
        Diabetes Care. 2006; 29: 363-367
      1. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of WHO consultation. Part 1. Diagnosis and classification of diabetes mellitus; 1999.

        • Wendelhag I.
        • Wiklund O.
        • Wikstrand J.
        Atherosclerosic changes in the femoral and carotid arteries in familial hypercholesterolemia. Ultrasonographic assessment of intima-media thickness and plaque occurrence.
        Atheroscler Thromb. 1993; 13: 1404-1411
        • Schmidt C.
        • Wendelhag I.
        How can the variability in ultrasound measurement of intima-media thickness be reduced? Studies of interobserver variability in carotid and femoral arteries.
        Clin Physiol. 1999; 19: 45-55
        • Hulthe J.
        • Wikstrand J.
        • Fagerberg B.
        Relationship between C-reactive protein and intima-media thickness in the carotid and femoral arteries and to antibodies against oxidized low-density lipoprotein in healthy men: the atherosclerosis and insulin resistance (AIR) study.
        Clin Sci. 2001; 100: 371-378
        • Walldius G.
        • Jungner I.
        • Aastveit A.H.
        • et al.
        The apoB/apoA-I ratio is better than the cholesterol ratios to estimate the balance between plasma proatherogenic and antiatherogenic lipoproteins and to predict coronary risk.
        Clin Chem Lab Med. 2004; 42: 1355-1363
        • Walldius G.
        • Jungner I.
        Rationale for using apolipoprotein B and apolipoprotein A-I as indicators of cardiac risk and as targets for lipid-lowering therapy.
        Eur Heart J. 2005; 26: 210-212
        • Joensuu T.
        • Salonen R.
        • Winblad I.
        • et al.
        Determinants of femoral and carotid artery atherosclerosis.
        J Intern Med. 1994; 236: 79-84
        • van den Berkmortel F.W.P.J.
        • van der Steen M.
        • Hoogenboom H.
        • et al.
        Progressive arterial wall stiffening in patients with increasing diastolic blood pressure.
        J Hum Hypertens. 2001; 15: 685-691
        • Kawakami A.
        • Yoshida M.
        Remnant lipoproteins and atherosclerosis.
        J Atheroscler Thromb. 2005; 12: 73-76
        • McNamara J.R.
        • Shah P.K.
        • Nakajima K.
        • et al.
        Remnant-like particle (RLP) cholesterol is an independent cardiovascular disease risk factor in women: results from the Framingham heart study.
        Atherosclerosis. 2001; 154: 229-236
        • Wallenfeldt K.
        • Hulthe J.
        • Bokemark L.
        • et al.
        Carotid and femoral atherosclerosis, cardiovascular risk factors and C-reactive protein in relation to smokeless tobacco use or smoking 58-year-old men.
        J Intern Med. 2001; 250: 492-501
        • Danese C.
        • Vestri A.R.
        • D́Alfonso V.
        • et al.
        Do hypertension and diabetes mellitus influence the site of atherosclerotic plaques?.
        Clin Ter. 2006; 157: 9-13