title: Usefulness of lipoprotein ratios in assessing carotid atherosclerosis in Japanese type 2 diabetic patients.
abstract: OBJECTIVE
  It is indicated that total/HDL cholesterol and LDL/HDL cholesterol ratios have more predictive power for cardiovascular disease compared to classic lipid parameters. However, there have been few reports about the usefulness of these indices for the assessment of early stage atherosclerosis in Japanese type 2 diabetic subjects.
  
  
  METHODS
  We examined the relation between various lipid parameters and carotid atherosclerosis in 934 type 2 diabetic subjects without apparent atherosclerotic diseases (males, 71.7%; age, 59.6 ± 10.5 years (mean ± SD)). Serum concentrations of total cholesterol (TC), HDL cholesterol (HDL-C), and triglyceride were measured. LDL cholesterol (LDL-C) level was calculated using the Friedewald formula. The presence of carotid plaque and intima-media thickness (IMT) were evaluated by ultrasonography.
  
  
  RESULTS
  A stepwise multivariate regression analysis demonstrated that HDL-C (β = -0.110, p<0.001), TC/HDL-C (β = 0.132, p < 0.001) and LDL-C/HDL-C ratios (β = 0.132, p < 0.001) were independent determinants of IMT even after adjustment of other conventional risk factors. However, there was no significant correlation between IMT and TC, triglyceride, LDL-C, and non-HDL-C levels. TC/HDL-C and LDL-C/HDL-C ratios and non-HDL-C levels were significantly higher, but HDL-C levels were significantly lower in patients with carotid plaque than those without it (p < 0.05). There was no significant difference between the groups regarding TC, LDL-C, and triglyceride levels. Furthermore, TC/HDL-C (OR; 1.34, p < 0.001) and LDL-C/HDL-C (OR; 1.54, p < 0.001) ratios showed a positive and linear relationship with the prevalence of carotid plaque, whether covariates were adjusted or not.
  
  
  CONCLUSIONS
  TC/HDL-C and LDL-C/HDL-C ratios are useful as a tool to assess the risk of early stage atherosclerosis in Japanese type 2 diabetic patients.
authors.affiliation: Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan. katakami@medone.med.osaka-u.ac.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Katakami
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Osonoi
authors.forename: Miyoko
authors.initials: M
authors.lastname: Saitou
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Takahara
authors.forename: Fumie
authors.initials: F
authors.lastname: Sakamoto
authors.forename: Kaoru
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Tetsuyuki
authors.initials: T
authors.lastname: Yasuda
authors.forename: Taka-Aki
authors.initials: TA
authors.lastname: Matsuoka
authors.forename: Munehide
authors.initials: M
authors.lastname: Matsuhisa
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Iichiro
authors.initials: I
authors.lastname: Shimomura
mesh_terms: D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology / Q000209:etiology; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology / Q000209:etiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL