Association of apolipoprotein B, LDL-C and vascular stiffness in adolescents with type 1 diabetes

作者：Bjornstad Petter^*; Nhung Nguyen; Reinick Christina; Maahs David M; Bishop Franziska K; Clements Scott A; Snell Bergeon Janet K; Lieberman Rachel; Pyle Laura; Daniels Stephen R; Wadwa R Paul

来源：ACTA DIABETOLOGICA, 2015, 52(3): 611-619.

DOI：10.1007/s00592-014-0693-9

• Diabetes mellitus
• Lipids and lipoproteins
• Arterial stiffness

LDL cholesterol (LDL-C) is the current lipid standard for cardiovascular disease (CVD)-risk assessment in type 1 diabetes. Apolipoprotein B (apoB) may be helpful to further stratify CVD risk. We explored the association between apoB and pulse wave velocity (PWV) to determine if apoB would improve CVD-risk stratification, especially in type 1 diabetes adolescents with borderline LDL-C (100-129 mg/dL). We hypothesized that type 1 diabetes adolescents with borderline LDL-C and elevated apoB (a parts per thousand yen90 mg/dL) would have increased PWV compared to those with borderline LDL-C and normal apoB (< 90 mg/dL), and that apoB would explain more of the variability of PWV than alternative lipid indices.
Fasting lipids, including apoB, were collected in 267 adolescents, age 12-19 years, with diabetes duration > 5 years and HbA1c 8.9 +/- A 1.6 %. Triglyceride to HDL-C ratio (TG/HDL-C) and nonHDL-cholesterol (nonHDL-C) were calculated. PWV was measured in the carotid-femoral segment.
ApoB, nonHDL-C and TG/HDL-C correlated with PWV (p < 0.0001). ApoB, nonHDL-C and TG/HDL-C remained significantly associated with PWV in fully adjusted models. In adolescents with borderline LDL-C (n = 61), PWV was significantly higher in those with elevated apoB than in those with normal apoB (5.6 +/- A 0.6 vs. 5.2 +/- A 0.6 m/s, p < 0.01) and also remained significant after adjustment for CVD-risk factors (p = 0.0002). Moreover, in those with borderline LDL-C, apoB explained more of the variability of PWV than nonHDL-C and TG/HDL-C.
Elevated apoB is associated with increased arterial stiffness in type 1 diabetes adolescents. Measurement of apoB in addition to LDL-C may be helpful in stratifying CVD risk in type 1 diabetes adolescents, especially in those with borderline LDL-C.

• 出版日期2015-6