title: Apolipoprotein B but not LDL cholesterol is associated with coronary artery calcification in type 2 diabetic whites.
abstract: OBJECTIVE
  Evidence favors apolipoprotein B (apoB) over LDL cholesterol as a predictor of cardiovascular events, but data are lacking on coronary artery calcification (CAC), especially in type 2 diabetes, where LDL cholesterol may underestimate atherosclerotic burden. We investigated the hypothesis that apoB is a superior marker of CAC relative to LDL cholesterol.
  
  
  METHODS
  We performed cross-sectional analyses of white subjects in two community-based studies: the Penn Diabetes Heart Study (N = 611 type 2 diabetic subjects, 71.4% men) and the Study of Inherited Risk of Coronary Atherosclerosis (N = 803 nondiabetic subjects, 52.8% men) using multivariate analysis of apoB and LDL cholesterol stratified by diabetes status.
  
  
  RESULTS
  In type 2 diabetes, apoB was associated with CAC after adjusting for age, sex, and medications [Tobit regression ratio of increased CAC for 1-SD increase in apoB; 1.36 (95% CI 1.06-1.75), P = 0.016] whereas LDL cholesterol was not [1.09 (0.85-1.41)]. In nondiabetic subjects, both were associated with CAC [apoB 1.65 (1.38-1.96), P < 0.001; LDL cholesterol 1.56 (1.30-1.86), P < 0.001]. In combined analysis of diabetic and nondiabetic subjects, apoB provided value in predicting CAC scores beyond LDL cholesterol, total cholesterol, the total cholesterol/HDL cholesterol and triglyceride/HDL cholesterol ratios, and marginally beyond non-HDL cholesterol.
  
  
  CONCLUSIONS
  Plasma apoB, but not LDL cholesterol, levels were associated with CAC scores in type 2 diabetic whites. ApoB levels may be particularly useful in assessing atherosclerotic burden and cardiovascular risk in type 2 diabetes.
authors.affiliation: Cardiovascular Institute, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.forename: Atif N
authors.initials: AN
authors.lastname: Qasim
authors.forename: Nehal N
authors.initials: NN
authors.lastname: Mehta
authors.forename: Megan
authors.initials: M
authors.lastname: Wolfe
authors.forename: Karen
authors.initials: K
authors.lastname: Terembula
authors.forename: Stanley
authors.initials: S
authors.lastname: Schwartz
authors.forename: Nayyar
authors.initials: N
authors.lastname: Iqbal
authors.forename: Mark
authors.initials: M
authors.lastname: Schutta
authors.forename: Roshanak
authors.initials: R
authors.lastname: Bagheri
authors.forename: Muredach P
authors.initials: MP
authors.lastname: Reilly
mesh_terms: D000328:Adult; D000368:Aged; D001055:Apolipoproteins B / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D002114:Calcinosis / Q000097:blood / Q000503:physiopathology; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003925:Diabetic Angiopathies / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012016:Reference Values; D044465:White People
chemical_list: D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL