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ApoB predicts metabolic syndrome risk in Chinese adults
High serum apolipoprotein B levels can increase the risk for metabolic syndrome and predict its development in Chinese adults, especially those with normal weight, according to findings published in the Journal of Diabetes.
“Apolipoprotein B has been shown to be a superior marker of vascular diseases than conventional lipid indices, including LDL-C and non-HDL-C,” Min Xu, MD, PhD, of the Shanghai Institute of Endocrine and Metabolic Diseases, and colleagues wrote. “This finding was followed by emerging evidence indicating an intimate association between serum ApoB concentrations and an increased risk of diabetes and metabolic alterations, such as hyperinsulinemia, insulin resistance, dyslipidemia and hypertension. Given that diabetes and [metabolic syndrome] share many similar risk factors and experience overlapping pathogenesis, and that [metabolic syndrome] is associated with an increased risk of coronary heart disease and chronic kidney disease, the association between serum ApoB concentrations and the risk of [metabolic syndrome] deserves further investigation.”
Xu and colleagues analyzed data from 4,627 adults (mean age, 58.5 years; 61.9% women) from the Jiading district in Shanghai for a population-based survey examining the association of ApoB with metabolic syndrome. Participants were recruited in 2010 and followed until 2015. At baseline, participants completed questionnaires about demographics, smoking and drinking status, and physical activity levels. In addition, height and weight were measured, and a 75-g oral glucose tolerance test was conducted in those who did not self-report with diabetes.
When determining metabolic syndrome, the researchers used the National Cholesterol Education Program Adult Treatment Panel III definition, which requires blood pressure of at least 130/85 mm Hg or taking antihypertensive medication; a waist circumference of at least 102 cm in men or at least 88 cm in women; triglycerides of at least 1.69 mM; HDL cholesterol of less than 1.03 mM in men or less than 1.29 mM in women; and/or fasting blood glucose of at least 6.1 mM or the presence of glucose-lowering medications.
After follow-up, participants were grouped into five quintiles according to ApoB levels, with the first used as a reference (mean, 0.68 ± 0.08 g/L) and the fifth indicating the highest measurements (mean, 1.33 ± 0.16 g/L). Increasing levels of ApoB were associated with higher odds for prevalent metabolic syndrome, with quintile five having the highest (OR = 2.05; 95% CI, 1.39-3.03) compared with the reference quintile. A similar association was found between increasing ApoB quintiles and incident metabolic syndrome risk, with the fifth quintile having the highest odds (OR = 1.79; 95% CI, 1.2-2.68). The researchers also noted that the association was more prominent for participants with a BMI of less than 25 kg/m2 compared with participants with a BMI of at least 25 kg/m2.
Risk for metabolic syndrome components such as high BP, central obesity, hypertriglyceridemia and increased fasting blood glucose was higher for participants in the fifth quintile of ApoB (P < .0001). In addition, ApoB performed better as a predictive tool for incident metabolic syndrome in comparison with HDL cholesterol (P = .03) and LDL cholesterol (P < .0001).
“Given that the measurement of ApoB is standardized, the American Association of Clinical Chemistry has determined that ApoB can be measured more accurately in routine clinical laboratories than either LDL-C or non-HDL-C,” the researchers wrote. “Our findings support the hypothesis that serum ApoB could be a reliable predictor for metabolic disorders.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.