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. 2016 Aug;13(8):685-692.
doi: 10.11909/j.issn.1671-5411.2016.08.007.

Relationship of lipid and lipoprotein ratios with coronary severity in patients with new on-set coronary artery disease complicated with type 2 diabetics

Ying Du  1 , Juan Chen  2 , Man-Hua Chen  3 , Sheng-Hua Yang  1 , Sha Li  1 , Yuan-Lin Guo  1 , Cheng-Gang Zhu  1 , Rui-Xia Xu  1 , Qian Dong  1 , Jian-Jun Li  1
Affiliations

Relationship of lipid and lipoprotein ratios with coronary severity in patients with new on-set coronary artery disease complicated with type 2 diabetics

Ying Du et al. J Geriatr Cardiol. 2016 Aug.

Abstract

Background: Diabetes mellitus (DM) is associated with coronary artery disease (CAD) progression. Although previous studies have demonstrated the association of lipid and lipoprotein ratios with CAD, no data are currently available concerning the relationship between lipid and lipoprotein ratios and the severity of new on-set CAD in diabetics. Therefore, the aim of the present study was to investigate the usefulness of lipid and lipoprotein ratios in predicting the severity of CAD in patients with type 2 DM (T2DM).

Methods: A total of 380 consecutive T2DM patients with new on-set CAD were enrolled in the present study. Then, they were classified into the three groups according to Gensini score (GS) tertiles. The relationship between lipid and lipoprotein ratios currently used and the GS was investigated.

Results: Positive correlations of natural log-transformed GS (lnGS) with apolipoprotein B to apoA-I ratio (apoB/apoA-I), non-high-density lipoprotein cholesterol to apoA-I ratio (non-HDL-C/apoA-I), and low-density lipoprotein cholesterol to apoA-I ratio (LDL-C/apoA-I) were found (r = 0.18, 0.13, 0.12, respectively, all P < 0.05). Multivariate logistic analysis indicated apoB/apoA-I as the strongest predictor for high GS (OR = 5.67, 95% CI: 1.45-23.92, P = 0.003). Area under receivers operating characteristic curve of apoB/apoA-I was 0.63 (95% CI: 0.60-0.66, P = 0.001) for predicting high GS. The optimal cutoff value of apoB/apoA-I to predict high GS was 0.72 with the sensitivity of 61.2% and the specificity of 62.1%.

Conclusions: Lipid and lipoprotein ratios might be useful for predicting the severity of new on-set CAD in T2DM patients, and the apoB/apoA-I appeared as the most significant predictor in this population.

Keywords: Coronary artery disease; Lipid; Lipoprotein; Type 2 diabetes mellitus.

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Figures

Figure 1.
Figure 1.. The correlation of the lipid and lipoprotein ratios with lnGS in type 2 DM.
Pearson's correlation analysis was performed. ApoA-I: apolipoprotein A-I; ApoB: apolipoprotein B; DM: diabetes mellitus; GS: Gensini score; HDL-C: high density lipoprotein cholesterol; LDL-C: low density lipoprotein cholesterol; TC: total cholesterol; TG: triglycerides.
Figure 2.
Figure 2.. ROC curves analysis.
ROC curves showed discriminatory power of the lipid and lipoprotein ratios for high GS (≥ 47-point) in type 2 DM. ApoA-I: apolipoprotein A-I; ApoB: apolipoprotein B; AUC: area under the curve; DM: diabetes mellitus; GS: Gensini score; HDL-C: high density lipoprotein cholesterol; LDL-C: low density lipoprotein cholesterol; ROC: receiver-operating characteristic; TC: total cholesterol.
See this image and copyright information in PMC

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