Article

Application and validation of a diagnostic algorithm for the atherogenic apoB dyslipoproteinemias

Department of Endocrinology
European Journal of Clinical Investigation (Impact Factor: 3.37). 03/2011; 41(4):423 - 433. DOI: 10.1111/j.1365-2362.2010.02426.x

ABSTRACT Eur J Clin Invest 2011; 41 (4): 423–433AbstractBackground We applied a diagnostic algorithm using apolipoprotein B (apoB) in combination with triglycerides (TG) and total cholesterol to determine the prevalence of dyslipoproteinemias in the general population. We also characterized the overall cardiovascular (CV) risk profiles, including arterial structure and function as measured with a panel of noninvasive parameters.Design Clinical and biochemical characteristics and noninvasive measurements of atherosclerosis (NIMA) were determined in 1517 individuals, aged 50–70 years.Results In general, all dyslipoproteinemias were characterized by a worse CV risk profile and deteriorated outcomes of NIMA compared to those with normal apolipoprotein B (< 1·2 g L−1) and TG (< 1·5 mM) levels. The prevalence of hyperapoB–hyperTG was 15·1%, and these individuals showed the most abnormal atheroma-related parameters: reduced ankle-brachial-index at rest (−3·5%) and after exercise (−9·8%), increased intima-media thickness (+5·5%) and more carotid plaques (+39·1%). The prevalence of normoapoB–hyperTG because of increased VLDL was 18·1% and 2·3% because of increased chylomicrons and VLDL, and in these groups, the parameters related to stiffness (e.g. pulse-wave-velocity +7·6% and +5·2%, respectively) were most abnormal. Adjustment for apolipoprotein B (apoB) reduced differences in NIMA in the hyperapoB–hyperTG group, whereas adjustment for TG reduced differences in NIMA in the normoapoB–hyperTG group.Conclusions The overall prevalence of dyslipoproteinemias according to the algorithm was approximately 40% in the Dutch population. The different dyslipoproteinemias showed a less favourable CV risk profile and deteriorated NIMA parameters, reflecting increased subclinical atherosclerosis. Furthermore, different effects on different NIMA parameters were observed in the different dyslipoproteinemias.

1 Bookmark
 · 
119 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES: There is sparse data on apoB dyslipoproteinemia in Asian population. The purpose of this study was to assess apoB dyslipoproteinemia and to compare the LDL-C, non-HDL and apoB for risk assessment with percentile equivalent cut off in Korean population. METHODS: With 1,193 Korean adult subjects, the prevalence and characteristics of different types of dyslipoproteinemias were analyzed in each age and gender group. The percentile values of direct LDL-C, calculated LDL-C, non HDL-C, HDL-C, apoAI, apoB and apoB/apoAI ratio were estimated. RESULTS: The prevalences of normoapoB-hyperTG, hyperapoB-normoTG and hyperapoB-hyperTG dyslipoproteinemia were 6.9, 8.9 and 10.9% in men and 3.7, 6.4 and 2.8% in women. The 40th percentile of direct LDL-C, calculated LDL-C, non-HDL-C and apo B were 108, 104.2, 126 and 85 mg/dl, respectively. The individual above optimal cut off was significantly underestimated with LDL-C than with non-HDL and apoB, in groups with adverse risk factors. CONCLUSIONS: This study firstly shows the prevalence of various types of dyslipoproteinemias in Asian population. The percentile values of Korean population were similar to those of NHANES. Integration of lipid markers is needed for making clinical decisions and further research involving various populations and methodologies should be performed.
    Clinical biochemistry 05/2013; · 2.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Glucose, the conventional osmotic agent in peritoneal dialysis (PD) solutions, may contribute to atherogenic dyslipoproteinemia and increased cardiovascular risk. Objective To determine whether or not a low-glucose PD regimen may improve the serum lipid and lipoprotein profile in patients with diabetes. Methods A prospective, open-label, parallel group, multi-national, randomized, controlled trial with a 6-month follow-up, comprising 251 patients with diabetes receiving PD. Patients were randomized to a low glucose-PD regimen (dextrose-based PD solution plus icodextrin, a starch polymer, and amino acids) or a conventional PD regimen (dextrose PD solutions). Serum lipid and apolipoprotein profiles were determined at baseline, 3, and 6 months. Results Serum triglycerides, very low-density-lipoprotein-cholesterol (VLDL-C) and apolipoprotein B (apoB) decreased significantly in the intervention group at both 3 and 6 months compared with baseline (serum triglycerides: median change at 3 months -0.5 mmol/L, P <.001, at 6 months -0.3 mmol/L, P <.001; VLDL-C: -0.3 mg/dL, P <.001; -0.3 mg/dL, P <.001; and apoB: -8.5 mg/dL, P <.001; -3.6 mg/dL, P=.043, respectively) and also compared with the control group. In contrast, apoB levels increased significantly in the control group at 3 and 6 months compared with baseline (5.3 mg/dl, P =.041; 5.2 mg/dl, P =.007, respectively). Percentage of patients on lipid-lowering medications at baseline and intensity of therapy was equivalent in each group. The apoB decrease was not affected by lipid-lowering medications in the intervention group. Conclusion A low glucose-PD regimen significantly improved the atherogenic lipoprotein phenotype compared with PD patients treated with a conventional glucose regimen.
    Journal of Clinical Lipidology. 01/2014;

Full-text

Download
51 Downloads
Available from
Jun 4, 2014