ApoB/apoA-I ratio: an independent predictor of insulin resistance in US non-diabetic subjects
Key result
High apoB/apoAI ratio linked to ~4-fold higher odds of insulin resistance in non-diabetic adults.
- OR 4.12 (men), OR 3.69 (women)
- 95% CI 1.97-8.81 (men), 1.94-7.27 (women)
- P<0.0001
- n=2,955
Why the study?
Does a high apoB/apoA-I ratio predict insulin resistance in US non-diabetic adults?
Population
2955 adults without diabetes from the Third National Health and Nutrition Examination Survey.
Comparison
High apoB/apoA-I ratio (highest quartile) vs Low apoB/apoA-I ratio (lowest quartile)
Design
Cross-sectional
Authors
Discussion
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Implication
The apoB/apoA-I ratio is significantly associated with insulin resistance in non-diabetic subjects, independently of traditional risk factors and metabolic syndrome components.
Key Points
- To assess whether the apoB/apoA-I ratio is independently associated with insulin resistance in non-diabetic individuals after adjusting for traditional metabolic and inflammatory risk factors.
- Analyzed cross-sectional data from 2,955 non-diabetic adults (mean age 47 years; 1,457 women) participating in the Third National Health and Nutrition Examination Survey (NHANES III).
- Evaluated insulin resistance using the computerized homeostatic model assessment (HOMA2), defining resistance as the highest quartile.
- Performed multivariable logistic and linear regression adjusting for age, race, traditional cardiovascular risk factors, inflammatory markers, and metabolic syndrome components (excluding glucose).
- Median apoB/apoA-I ratio was significantly higher in subjects with insulin resistance compared to those without (0.85, IQR 0.69–0.99 vs. 0.69, IQR 0.56–0.85; P < 0.0001).
- The highest versus lowest apoB/apoA-I quartile independently correlated with insulin resistance in men (OR 4.12, 95% CI 1.97–8.81) and women (OR 3.69, 95% CI 1.94–7.27) after comprehensive multivariable adjustment.
- Modeling apoB/apoA-I as a continuous trait significantly improved the prediction of HOMA2 values beyond standard risk factors in both men (additional R² = 0.09, P < 0.001) and women (additional R² = 0.05, P < 0.001).
Study Design
Type
Cross-Sectional (n=2,955)
Structured PICO
Does a high apoB/apoA-I ratio predict insulin resistance in US non-diabetic adults?
P
Population
2,955 non-diabetic adults (mean age 47 years, 49.3% female) from the US NHANES survey assessed for the cross-sectional association between apoB/apoAI ratio and insulin resistance.
E
Exposure
High apoB/apoA-I ratio (highest quartile)
C
Comparator
Low apoB/apoA-I ratio (lowest quartile)
O
Outcome
Insulin resistance (estimated using HOMA2, defined as upper quartile)surrogate
Main Result
Effect estimate: OR 4.12 (men), OR 3.69 (women) (95% CI 1.97-8.81 (men), 1.94-7.27 (women))
p-value: p=<0.0001
The apoB/apoA-I ratio is significantly associated with insulin resistance in non-diabetic subjects, independently of traditional risk factors and metabolic syndrome components.
Cite This Study
Sierra-Johnson et al. (2007) conducted a cross-sectional in Insulin resistance in non-diabetic subjects (n=2,955). High apoB/apoAI ratio vs. Lowest quartile of apoB/apoAI ratio was evaluated on Insulin resistance (upper quartile of HOMA2) (OR 4.12 (men), OR 3.69 (women), 95% CI 1.97-8.81 (men), 1.94-7.27 (women), p=<0.0001). A high apoB/apoAI ratio was independently associated with insulin resistance in non-diabetic adults, with an OR of 4.12 (95% CI 1.97-8.81) in men and 3.69 (95% CI 1.94-7.27) in women.