ApoB/ApoA1 Ratio and Non-HDL-cholesterol/HDL-cholesterol Ratio Are Associated to Metabolic Syndrome in Patients with Type 2 Diabetes Mellitus Subjects and to Ischemic Cardiomyopathy in Diabetic Women

Background And Aim: Presence of metabolic syndrome (MS) in patients with type 2 diabetes mellitus (T2DM) involves an increased risk of cardiovascular disease and death. Markers such as ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios have been used to predict this risk with conflicting results. The study objective was to establish the relationship between the apoB/apoA1 and non-HDL-cholesterol/HDL-cholesterol ratios and MS in T2DM patients from a Madrid (Spain) district.

Patients And Methods: One hundred patients with T2DM who attended University Hospital Infanta Leonor (Vallecas, Madrid, Spain) between January 2014 and June 2017 were enrolled. A blood sample was taken every 6 months from all patients to measure the different lipid parameters and to calculate ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. A Mann-Whitney's U test to compare means and a Spearman's correlation test for correlations between variables were used, and a multivariate regression analysis was performed to determine the association between MS and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Values of p<0.05 were considered significant.

Results: Associations were found between MS and ApoA1 (R=0.164, p=0.028), ApoB/ApoA1 (R=0.187, p=0.001), and non-HDL-cholesterol/HDL-cholesterol (R= 0.269, p=0.0001) ratios and, in women with MS, between ApoB/ApoA1 ratio and ischemic cardiomyopathy (IC) (R=0.160, p=0.032). Associations remained after adjusting for comorbidities and risk factors.

Conclusions: In the T2DM patients studied, MS was independently associated to ApoA1 and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Both ratios were better predictors of MS in T2DM subjects that its components alone. The ApoB/ApoA1 ratio could be used as a cardiovascular risk marker in women with MS.