Type 2 diabetes risk may fall in men when ApoA-I levels rise
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Men with elevated apolipoprotein A-I levels may be less likely to develop type 2 diabetes, and those with a certain polymorphism may be the best candidates for the prediction of the disease’s development via homeostasis model assessment of insulin resistance and the avoidance of the condition via exercise, according to findings published in Nutrition, Metabolism & Cardiovascular Diseases.
“Markers of lipids and apolipoproteins were associated with risk of developing type 2 diabetes only in males in this Greek cohort,” Demosthenes B. Panagiotakos, PhD, DrMed, professor of biostatistics, research methods and epidemiology in the department of nutrition and dietetics at the School of Health Science and Education at Harokopio University in Athens, Greece, and colleagues wrote. “Additional ApoA-I polymorphisms appear to influence the predictive effect of HOMA-IR on type 2 diabetes incidence and the potential moderating role of physical activity, suggesting the potential for more targeted and individualized approaches for diabetes prevention strategies based on taking into account the influencing effects of genetic factors, lipid and apolipoprotein levels.”
Panagiotakos and colleagues assessed levels of total cholesterol, HDL cholesterol, triglycerides, apolipoprotein B, ApoA-I and LDL cholesterol using blood samples from 1,485 participants without baseline diabetes in the ATTICA study (mean age, 45 years; 51% women). The researchers also determined three ApoA-I gene polymorphisms (GG, GA and AA) within DNA from the blood samples. The researchers then followed participants for 10 years and assessed the development of type 2 diabetes.
There were 191 cases of type 2 diabetes among all participants, but the 10-year risk for the condition fell when ApoA-I levels went up by 1 mg/dL (OR = 0.98; 95% CI, 0.97-1) and rose when the ApoB/LDL cholesterol ratio went up by 1 U (OR = 4.03; 95% CI, 1.05-15.5) and when the triglycerides/ApoA-I ratio went up by 1 U (OR = 1.85; 95% CI, 1.2-2.87) for men only, according to the researchers.
“Higher ApoA-I levels were seen to be protective for males, while the increase in ApoB/LDL cholesterol ratio and increase in triglycerides/ApoA-I ratio were aggravating factors independent of age, smoking, physical activity status, HOMA-IR, family history of diabetes and BMI,” the researchers wrote.
The GG polymorphism was the most common (68.7%) followed by GA (28.4%) and AA (2.9%). The researchers noted that unlike those with other polymorphisms, in those with the GG polymorphism, “HOMA-IR was an independent predictor of 10-year incidence of type 2 diabetes” and “physical activity was found to be protective against type 2 diabetes.”
“Although effects of the polymorphism were not seen with respect to the risk of developing type 2 diabetes, interactions were observed with HOMA-IR only being associated with increased risk of developing type 2 diabetes in those with GG polymorphism,” the researchers wrote. “This suggests that identifying insulin resistance and then treating it in carriers of the GG polymorphism may provide a potentially more focused and effective intervention. The potential for targeted interventions for the prevention of type 2 diabetes was further highlighted by modulating effects of physical activity.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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