Non-HDL-cholesterol/HDL-cholesterol is a better predictor of metabolic syndrome and insulin resistance than apolipoprotein B/apolipoprotein A1
Non-HDL-cholesterol/HDL-cholesterol is a better predictor of metabolic syndrome and insulin resistance than apolipoprotein B/apolipoprotein A1
复制标题
DOI：
10.1016/j.ijcard.2013.03.027
复制
发表时间：
2013-10-03
影响因子：
3.5
通讯作者：
Kim, Jae Hyeon
中科院分区：
文献类型：
--
作者：
Kim, Se Won;Jee, Jae Hwan;Kim, Jae Hyeon
背景资料：载脂蛋白B（apoB）与载脂蛋白A1（apoA 1）的比值与代谢综合征（MetS）和胰岛素抵抗（IR）有关。在常规临床实践中，非HDL-C被认为是apoB的替代标志物。然而，目前还不清楚非HDL-C的HDL-C的比例是否是一个相等的或更好的预测比载脂蛋白B/载脂蛋白A1的比例为识别代谢综合征和IR.Methods：我们进行了一项回顾性研究，41,821韩国成年人谁参加了常规的健康筛查检查。结果：分析apoB/apoA 1和non-HDL-C/HDL-C比值对代谢综合征的预测价值。ROC曲线分析显示非HDL-C/HDL-C的AUC男性为0.75 [95%CI = 0.74-0.76]，女性为0.84 [95%CI = 0.83-0.85]，显著高于apoB/apoA 1（男性0.66 [95% CI = 0.65-0.67]，女性0.77 [95% CI = 0.76-0.78]）。与apoB/apoA 1比值相比，非HDL-C/HDL-C比值与HOMA-IR的相关性也显著更强。男性非HDL-C/HDL-C比值检测MetS的最佳临界值为3.39，敏感性为66.7%，特异性为71.8%，而女性非HDL-C/HDL-C比值检测MetS的最佳临界值为2.89，敏感性为75.7%，特异性为78.1%。我们的研究结果表明，非HDL-C/HDL-C的比率是一个更好的标记比载脂蛋白B/载脂蛋白A1的比率，确定IR和代谢综合征在韩国人。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Background: The ratio of apolipoprotein B (apoB) to apolipoprotein A1 (apoA1) has been reported to be associated with metabolic syndrome (MetS) and insulin resistance (IR). Non-HDL-C is regarded as a surrogate marker for apoB in routine clinical practice. However, it is unclear whether the ratio of non-HDL-C to HDL-C is an equal or a better predictor than the apoB/apoA1 ratio for the identification of MetS and IR.Methods: We performed a retrospective study of 41,821 Korean adults who participated in a routine health screening examination. Anthropometry, fasting glucose, fasting insulin, HOMA-IR, CRP, lipid profiles, apoB, and apoA1 were measured.Results: To compare the predictive value for MetS between different lipid ratios, we analyzed the ROC curves of apoB/apoA1 and non-HDL-C/HDL-C ratios. ROC analysis showed that the AUCs of non-HDL-C/HDL-C (0.75 [95% CI = 0.74-0.76] in men and 0.84 [95% CI = 0.83-0.85] in women) were significantly higher than those of apoB/apoA1 (0.66 [95% CI = 0.65-0.67] in men and 0.77 [95% CI = 0.76-0.78] in women). The non-HDL-C/HDL-C ratio also showed a significantly stronger association with HOMA-IR than the apoB/apoA1 ratio. The optimal cutoff value of the non-HDL-C/HDL-C ratio for detection of MetS in men was 3.39, with a sensitivity of 66.7% and a specificity of 71.8%, whereas the optimal ratio cutoff value in women was 2.89, with a sensitivity of 75.7% and a specificity of 78.1%.Conclusions: Our findings indicate that the non-HDL-C/HDL-C ratio is a better marker than the apoB/apoA1 ratio for identifying IR and MetS in Koreans. (C) 2013 Elsevier Ireland Ltd. All rights reserved.