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Low Prevalence of Elevated ApoB Levels in Patients with Type 2 Diabetes Not Receiving Lipid-Lowering Therapy

Hugh Tildesley1, Tyler Fraser2, Stephanie Wise2

  • 1University of British Columbia, Vancouver, British Columbia, Canada; St. Paul's Hospital, Vancouver, British Columbia, Canada.

Canadian Journal of Diabetes
|May 23, 2015
PubMed

Insights

Apolipoprotein B (apoB) is a better cardiovascular disease (CVD) marker than LDL-C in type 2 diabetes. Many patients not meeting LDL-C targets still meet apoB goals, suggesting revised risk assessment is needed.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Syndrome

Background:

  • Cardiovascular disease (CVD) is the primary cause of mortality in individuals with type 2 diabetes.
  • Apolipoprotein B (apoB) is recognized as a superior predictor of CVD risk compared to low-density lipoprotein cholesterol (LDL-C).

Purpose of the Study:

  • To investigate apolipoprotein B (apoB) levels in patients with type 2 diabetes.
  • To compare patient classification based on apoB and LDL-C targets.

Main Methods:

  • Blood samples were analyzed from 507 individuals with type 2 diabetes not on lipid-lowering medication and without prior CVD history.
  • Participants were stratified into three groups: men (M), women under 50 (W1), and women 50 and over (W2).
  • Lipid parameters, focusing on apoB, were assessed, with secondary analysis classifying patients against Canadian Diabetes Association targets for apoB, LDL-C, and triglycerides (TG).

Main Results:

  • The mean apoB level across all participants was 0.92 g/L.
  • Among those not meeting LDL-C targets, a significant proportion (28% M, 39% W1, 30% W2) achieved the apoB target.
  • Significant differences (p<0.01) were observed in the proportions of individuals exceeding LDL-C and apoB targets across all groups.
  • When LDL-C was below target and TG <1.5 mmol/L, nearly all participants (100% M/W1, 93% W2) met the apoB target.

Conclusions:

  • Discrepancies in meeting LDL-C versus apoB targets can lead to misclassification of CVD risk.
  • ApoB and LDL-C show strong correlation when TG levels are below 1.5 mmol/L, but this correlation diminishes with TG levels of 1.5 mmol/L or higher.
  • Only about one-third of patients achieved both LDL-C and apoB goals, indicating that not all type 2 diabetes patients should automatically be categorized as high CVD risk.
Abstract

Keywords:
C-LDLLDL-Capolipoprotein Bapolipoprotéine Bdiabéte de type 2type 2 diabetes

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