title: Quantification of concordance and discordance between apolipoprotein-B and the currently recommended non-HDL-cholesterol goals for cardiovascular risk assessment in patients with diabetes and hypertriglyceridemia.
abstract: OBJECTIVE
  In patients with diabetes and hypertriglyceridemia, LDL-cholesterol (LDL-C) provides an inaccurate reflection of LDL particle burden. The relative value of non-HDL-cholesterol (non-HDL-C) and apolipoprotein-B (Apo-B) in estimating cardiovascular risk is controversial. We assessed the discordance between non-HDL-C and Apo-B targets in patients with diabetes with TG 200-499 mg/dl.
  
  
  METHODS
  Data from 1430 determinations of LDL-C, non-HDL-C, and Apo-B in ambulatory patients with diabetes were analyzed. Rates of discordance were calculated, based on the currently recommended LDL-C, non-HDL-C, and Apo-B goals.
  
  
  RESULTS
  In patients with non-HDL-C goal of <130 mg/dl, there was a discordance with Apo-B level goal of <90 mg/dl, in 31% of samples. In patients with non-HDL-C goal of <100 mg/dl, 6% of samples had Apo-B ≥80 and 18% had Apo-B <80 mg/dl. Using the Apo-B goal of <70 mg/dl, these numbers were 37% and 3.5% respectively. There was also a significant gender difference, i.e. under-estimation of risk by suggested non-HDL-C cut-offs, in females, compared to males.
  
  
  CONCLUSIONS
  In patients with diabetes and hypertriglyceridemia, a considerable discordance exists between non-HDL-C and Apo-B. Our data suggest a need for prospective studies to compare the relative merits of non-HDL-C and Apo-B targets in the assessment of cardiovascular risk.
authors.affiliation: Sections of Adult Medicine, Clinical Research, and Bioinformatics at Joslin Diabetes Center, and Department of Medicine, Beth-Israel Medical Center, and Harvard Medical School, 1, Joslin Place, Rm # 242, Boston, MA 02215, United States. om.ganda@joslin.harvard.edu
authors.forename: O P
authors.initials: OP
authors.lastname: Ganda
authors.forename: C G
authors.initials: CG
authors.lastname: Jumes
authors.forename: M J
authors.initials: MJ
authors.lastname: Abrahamson
authors.forename: M
authors.initials: M
authors.lastname: Molla
mesh_terms: D001055:Apolipoproteins B / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003925:Diabetic Angiopathies / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D018570:Risk Assessment; D017678:Sex Distribution; D014481:United States
chemical_list: D001055:Apolipoproteins B; D008078:Cholesterol, LDL