Key result
The apoB/apoA-1 ratio correlated with high Gensini scores (AUC 0.62; P<0.005) in Chinese diabetics with stable angina, but was not an independent predictor after adjusting for baseline variables.
Why the study?
There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease in patients with diabetes mellitus.
Does the apoB/apoA-1 ratio independently predict the severity of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris?
Cohort (n=373)
Does the apoB/apoA-1 ratio independently predict the severity of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris?
While the apoB/apoA-1 ratio correlates with coronary lesion severity in Chinese diabetics with stable angina, it does not serve as an independent predictor when accounting for other clinical variables.
Answers are grounded in this paper and cite their sources.
ApoB/apoA-1 ratio should not yet inform lesion severity assessment in diabetic stable angina; leaves open its independent value in larger prospective cohorts.
BACKGROUND: There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease (CAD) in patients with diabetes mellitus. We determined the relationship between five conventional lipid ratios and the extent of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris (SAP). METHODS: A prospective cohort study within 373 type 2 diabetic patients diagnosed with stable CAD by coronary angiography was performed. All patients were classified into three groups according to the tertiles of Gensini scores (GS, low group < 8 points n = 143; intermediate group 8-28 points, n = 109; high group > 28 points, n = 121). Association between the ratios of apolipoprotein (apo) B and apoA-1, total cholesterol and high density lipoprotein cholesterol (TC/HDL-C), triglycerides and HDL-C (TG/HDL-C), low density lipoprotein cholesterol and HDL-C (LDL-C/HDL-C), Non-HDL-C/HDL-C and GS were evaluated using the receivers operating characteristic (ROC) curves and multivariate logistic regression models. RESULTS: The ratio of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C, and Non-HDL-C/HDL-C were correlated with Gensini scores. Area under the ROC curves for predicting high Gensini scores in the ratios of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C and Non-HDL-C/HDL-C were 0.62, 0.60, 0.59 and 0.60, respectively (P < 0.005 for all). According to multivariate logistic regression analysis after adjusted with demographic characteristic and other lipid parameters, the ratio of apoB/apoA-1 is qualified as an independent discriminator for the severity of CAD. However, after further adjusting different baseline variables, such as left ventricular ejective fraction, hemoglobin A1c, leukocytes count and serum creatinine, none of the above lipid ratios remained. CONCLUSIONS: Compared with other lipid parameters, the ratio of apoB/apoA-1 appears to be more significantly correlated with the extent of coronary artery lesions in Chinese diabetics, but it was not an independent predictor in these settings.
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Hong et al. (2015) conducted a cohort in Type 2 diabetes with stable angina pectoris (n=373). apoB/apoA-1 ratio vs. Other lipid ratios was evaluated on High Gensini scores (> 28 points) (AUC 0.62, p=< 0.005). The apoB/apoA-1 ratio correlated with high Gensini scores (AUC 0.62; P<0.005) in Chinese diabetics with stable angina, but was not an independent predictor after adjusting for baseline variables.
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