Relation of Combined Non-High-Density Lipoprotein Cholesterol and Apolipoprotein B With Atherosclerosis in Adults With Type 1 Diabetes Mellitus
Relation of Combined Non-High-Density Lipoprotein Cholesterol and Apolipoprotein B With Atherosclerosis in Adults With Type 1 Diabetes Mellitus
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DOI：
10.1016/j.amjcard.2015.07.020
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发表时间：
2015-10-01
影响因子：
2.8
通讯作者：
Snell-Bergeon, Janet K.
中科院分区：
文献类型：
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作者：
Bjornstad, Petter;Eckel, Robert H.;Snell-Bergeon, Janet K.
载脂蛋白B （apoB）和非高密度脂蛋白胆固醇（non- hdl - c）是心血管疾病的危险标志物，尽管成人1型糖尿病（DM）的数据有限。我们假设apoB和非hdl - c升高与成年1型糖尿病患者冠状动脉钙化进展（CACp）相关，CACp是冠状动脉粥样硬化的一种衡量指标。我们将1型糖尿病患者（n = 652）分为4组：apoB升高（>= 90 mg/dl）和非hdl - c升高（>= 1.30 mg/dl），非hdl - c升高，apoB升高，apoB和非hdl - c正常。我们使用逻辑回归来检验6年期间各组与CACp之间的关联。我们对载脂蛋白ob升高和非hdl - c重新定义为等于或大于队列平均值（分别为91.4和119.0 mg/dl）的患者进行了敏感性分析。经年龄、性别、病程、血红蛋白A1c和染色等因素调整后，载脂蛋白ob和非hdl - c升高的受试者与载脂蛋白ob和非hdl - c正常的受试者相比（优势比1.90,95%可信区间1.15至3.15）和仅载脂蛋白ob升高的受试者相比（优势比2.86,95%可信区间1.43至5.74）发生CACp的几率更大。载脂蛋白ob和非hdl - c升高的定义等于或大于队列平均值，也获得了类似的结果。总之，在1型糖尿病成人患者中，在非hdl -C不升高的情况下，载脂蛋白ob和非hdl -C升高比载脂蛋白ob升高带来更大的动脉粥样硬化风险。这些数据表明，载脂蛋白ob和非hdl -C应被视为1型糖尿病心血管疾病风险的互补指标，而不是竞争指标。版权所有。
Apolipoprotein B (apoB) and non high-density lipoprotein cholesterol (non-HDL-C) are cardiovascular disease risk markers, although data in adults with type 1 diabetes mellitus (DM) are limited. We hypothesized that elevated apoB and non-HDL-C would be associated with greater odds of coronary artery calcification progression (CACp), a measure of coronary atherosclerosis, than either category alone in adults with type 1 DM. We grouped subjects with type 1 DM (n = 652) into 4 groups: elevated apoB (>= 90 mg/dl) and elevated non-HDL-C (>= 1.30 mg/dl), elevated non-HDL-C alone, elevated apoB alone, and normal apoB and non-HDL-C. We used logistic regression to examine the associations between the groups and CACp for a period of 6 years. We performed sensitivity analyses with elevated apoB and non-HDL-C redefined as at or more than the cohort means (91.4 and 119.0 mg/dl, respectively). Subjects with elevated apoB and non-HDL-C had greater odds of CACp compared with those with normal apoB and non-HDL-C (odds ratio 1.90, 95% confidence interval 1.15 to 3.15) and compared with subjects with elevated apoB alone (odds ratio 2.86, 95% confidence interval 1.43 to 5.74) adjusting for age, gender, duration, hemoglobin A1c, and stains. Similar results were obtained with elevated apoB and non-HDL-C defined as at or more than the cohort means. In conclusion, elevated apoB and non-HDL-C carry a greater risk of atherosclerosis than elevated apoB in the absence of elevated non-HDL-C in adults with type 1 DM. These data suggest that apoB and non-HDL-C should be viewed as complementary rather than competitive indexes of cardiovascular disease risk in type 1 DM. (C) 2015 Elsevier Inc. All rights reserved.