Exploring the value of apoB48 as a marker for atherosclerosis in clinical practice.
BACKGROUND
Postprandial accumulation of atherogenic remnants has been described in patients with type 2 diabetes mellitus (T2DM), familial combined hyperlipidaemia (FCH), familial hypercholesterolaemia (FH) and coronary artery disease (CAD). Scarce data are available on fasting plasma apolipoprotein (apo) B48 levels in relation to these conditions and atherosclerosis.


METHODS
Treated patients with FCH (18), FH (20), T2DM (26), CAD (65), T2DM with CAD (T2DM/CAD) (28) and 33 healthy controls were included. Intima-media thickness (IMT) measurements were carried out to investigate subclinical atherosclerosis.


RESULTS
LDL-C and total apoB were lowest in patients with T2DM/CAD owing to the more frequent use of lipid-lowering medication. Fasting plasma apoB48 was elevated in patients with FCH (11·38 ± 1·50 mg/L) and T2DM/CAD (9·65 ± 1·14 mg/L) compared with the other groups (anova, P < 0·01). CAD patients (8·09 ± 0·57 mg/L) had higher apoB48 levels than controls (5·74 ± 0·55 mg/L) and FH patients (5·40 ± 0·51 mg/L) (P = 0·02). IMT was highest in subjects with T2DM/CAD (0·77 ± 0·03 mm) (P < 0·01). The lowest IMT was measured in controls (0·56 ± 0·02 mm) and FCH patients (0·60 ± 0·03 mm). In the total group, the best association for apoB48 was found with fasting triglyceride (Pearson's r = 0·72, P < 0·001). In the subjects not using statins (n = 74), the best correlation was found with IMT (r = 0·52; P < 0·001), whereas total apoB was not associated with IMT (r = 0·20, P = 0·12).


CONCLUSIONS
ApoB48 concentrations are highest in patients with FCH and in atherosclerotic subjects with T2DM. In patients not using statins, the surrogate atherosclerosis marker IMT correlates best with apoB48, suggesting that fasting apoB48 may help to detect subjects at risk.
Department of Internal Medicine, Center for Diabetes and Vascular Medicine, St Franciscus Gasthuis, Rotterdam, The Netherlands.
Arash
A
Alipour
Pedro
P
Valdivielso
Jan Willem F
JW
Elte
Hans W
HW
Janssen
Jose
J
Rioja
Noëlle
N
van der Meulen
Rob
R
van Mechelen
Tjin L
TL
Njo
Pedro
P
González-Santos
Arie P
AP
Rietveld
Manuel Castro
MC
Cabezas
D000368:Aged; D000704:Analysis of Variance; D053283:Apolipoprotein B-48 / Q000097:blood*; D050197:Atherosclerosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005215:Fasting; D005260:Female; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000097:blood*; D008297:Male; D008875:Middle Aged
D053283:Apolipoprotein B-48; D015415:Biomarkers