Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study
Abstract Background The low-density lipoprotein cholesterol/apolipoprotein B (LDL-C/apoB) ratio has conventionally been used as an index of the LDL-particle size. Smaller LDL-particle size is associated with triglyceride (TG) metabolism disorders, often leading to atherogenesis. We investigated the...
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | http://link.springer.com/article/10.1186/s12933-017-0606-7 |
| _version_ | 1828392557832306688 |
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| author | Shigemasa Tani Tsukasa Yagi Wataru Atsumi Kenji Kawauchi Rei Matsuo Atsushi Hirayama |
| author_facet | Shigemasa Tani Tsukasa Yagi Wataru Atsumi Kenji Kawauchi Rei Matsuo Atsushi Hirayama |
| author_sort | Shigemasa Tani |
| collection | DOAJ |
| description | Abstract Background The low-density lipoprotein cholesterol/apolipoprotein B (LDL-C/apoB) ratio has conventionally been used as an index of the LDL-particle size. Smaller LDL-particle size is associated with triglyceride (TG) metabolism disorders, often leading to atherogenesis. We investigated the association between the LDL-C/apoB ratio and TG metabolism in coronary artery disease (CAD) patients with diabetes mellitus (DM). Methods In the cross-sectional study, the LDL-C/apoB ratio, which provides an estimate of the LDL-particle size, was calculated in 684 consecutive patients with one additional risk factor. The patients were classified into 4 groups based on the presence or absence of CAD and DM, as follows: CAD (−) DM (−) group, n = 416; CAD (−) DM (+) group, n = 118; CAD (+) DM (−) group, n = 90; CAD (+) DM (+) group, n = 60. Results A multi-logistic regression analysis after adjustments for coronary risk factors revealed that the CAD (+) DM (+) condition was an independent predictor of the smallest LDL-C/apoB ratio among the four groups. Furthermore, multivariate regression analyses identified elevated TG-rich lipoprotein (TRL)-related markers (TG, very-LDL fraction, remnant-like particle cholesterol, apolipoprotein C-II, and apolipoprotein C-III) as being independently predictive of a smaller LDL-particle size in both the overall subject population and a subset of patients with a serum LDL-C level < 100 mg/dL. In the 445 patients followed up for at least 6 months, multi-logistic regression analyses identified increased levels of TRL-related markers as being independently predictive of a decreased LDL-C/apoB ratio, which is indicative of smaller LDL-particle size. Conclusions The association between disorders of TG metabolism and LDL heterogeneity may account for the risk of CAD in patients with DM. Combined evaluation of TRL-related markers and the LDL-C/apoB ratio may be of increasing importance in the risk stratification of CAD patients with DM. Further studies are needed to investigate the useful clinical indices and outcomes of these patients. Clinical Trial Registration UMIN (http://www.umin.ac.jp/) Study ID: UMIN000028029 retrospectively registered 1 July 2017 |
| first_indexed | 2024-12-10T07:21:57Z |
| format | Article |
| id | doaj.art-d977b22bc830473bb603b03d4ccb1dd7 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-10T07:21:57Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-d977b22bc830473bb603b03d4ccb1dd72022-12-22T01:57:47ZengBMCCardiovascular Diabetology1475-28402017-10-0116111310.1186/s12933-017-0606-7Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional studyShigemasa Tani0Tsukasa Yagi1Wataru Atsumi2Kenji Kawauchi3Rei Matsuo4Atsushi Hirayama5Department of Health Planning Center, Nihon University HospitalDepartment of Cardiology, Nihon University HospitalDepartment of Cardiology, Nihon University HospitalDepartment of Cardiology, Nihon University HospitalDepartment of Cardiology, Nihon University HospitalDivision of Cardiology, Department of Medicine, Nihon University School of MedicineAbstract Background The low-density lipoprotein cholesterol/apolipoprotein B (LDL-C/apoB) ratio has conventionally been used as an index of the LDL-particle size. Smaller LDL-particle size is associated with triglyceride (TG) metabolism disorders, often leading to atherogenesis. We investigated the association between the LDL-C/apoB ratio and TG metabolism in coronary artery disease (CAD) patients with diabetes mellitus (DM). Methods In the cross-sectional study, the LDL-C/apoB ratio, which provides an estimate of the LDL-particle size, was calculated in 684 consecutive patients with one additional risk factor. The patients were classified into 4 groups based on the presence or absence of CAD and DM, as follows: CAD (−) DM (−) group, n = 416; CAD (−) DM (+) group, n = 118; CAD (+) DM (−) group, n = 90; CAD (+) DM (+) group, n = 60. Results A multi-logistic regression analysis after adjustments for coronary risk factors revealed that the CAD (+) DM (+) condition was an independent predictor of the smallest LDL-C/apoB ratio among the four groups. Furthermore, multivariate regression analyses identified elevated TG-rich lipoprotein (TRL)-related markers (TG, very-LDL fraction, remnant-like particle cholesterol, apolipoprotein C-II, and apolipoprotein C-III) as being independently predictive of a smaller LDL-particle size in both the overall subject population and a subset of patients with a serum LDL-C level < 100 mg/dL. In the 445 patients followed up for at least 6 months, multi-logistic regression analyses identified increased levels of TRL-related markers as being independently predictive of a decreased LDL-C/apoB ratio, which is indicative of smaller LDL-particle size. Conclusions The association between disorders of TG metabolism and LDL heterogeneity may account for the risk of CAD in patients with DM. Combined evaluation of TRL-related markers and the LDL-C/apoB ratio may be of increasing importance in the risk stratification of CAD patients with DM. Further studies are needed to investigate the useful clinical indices and outcomes of these patients. Clinical Trial Registration UMIN (http://www.umin.ac.jp/) Study ID: UMIN000028029 retrospectively registered 1 July 2017http://link.springer.com/article/10.1186/s12933-017-0606-7Coronary artery diseaseDiabetes mellitusLDL-particle sizeTriglyceride-rich lipoproteins |
| spellingShingle | Shigemasa Tani Tsukasa Yagi Wataru Atsumi Kenji Kawauchi Rei Matsuo Atsushi Hirayama Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study Cardiovascular Diabetology Coronary artery disease Diabetes mellitus LDL-particle size Triglyceride-rich lipoproteins |
| title | Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study |
| title_full | Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study |
| title_fullStr | Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study |
| title_full_unstemmed | Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study |
| title_short | Relation between low-density lipoprotein cholesterol/apolipoprotein B ratio and triglyceride-rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus: a cross-sectional study |
| title_sort | relation between low density lipoprotein cholesterol apolipoprotein b ratio and triglyceride rich lipoproteins in patients with coronary artery disease and type 2 diabetes mellitus a cross sectional study |
| topic | Coronary artery disease Diabetes mellitus LDL-particle size Triglyceride-rich lipoproteins |
| url | http://link.springer.com/article/10.1186/s12933-017-0606-7 |
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