title: Association of apolipoprotein B, LDL-C and vascular stiffness in adolescents with type 1 diabetes.
abstract: OBJECTIVE
  LDL cholesterol (LDL-C) is the current lipid standard for cardiovascular disease (CVD)-risk assessment in type 1 diabetes. Apolipoprotein B (apoB) may be helpful to further stratify CVD risk. We explored the association between apoB and pulse wave velocity (PWV) to determine if apoB would improve CVD-risk stratification, especially in type 1 diabetes adolescents with borderline LDL-C (100-129 mg/dL). We hypothesized that type 1 diabetes adolescents with borderline LDL-C and elevated apoB (≥90 mg/dL) would have increased PWV compared to those with borderline LDL-C and normal apoB (<90 mg/dL), and that apoB would explain more of the variability of PWV than alternative lipid indices.
  
  
  METHODS
  Fasting lipids, including apoB, were collected in 267 adolescents, age 12-19 years, with diabetes duration >5 years and HbA1c 8.9 ± 1.6 %. Triglyceride to HDL-C ratio (TG/HDL-C) and nonHDL-cholesterol (nonHDL-C) were calculated. PWV was measured in the carotid-femoral segment.
  
  
  RESULTS
  ApoB, nonHDL-C and TG/HDL-C correlated with PWV (p < 0.0001). ApoB, nonHDL-C and TG/HDL-C remained significantly associated with PWV in fully adjusted models. In adolescents with borderline LDL-C (n = 61), PWV was significantly higher in those with elevated apoB than in those with normal apoB (5.6 ± 0.6 vs. 5.2 ± 0.6 m/s, p < 0.01) and also remained significant after adjustment for CVD-risk factors (p = 0.0002). Moreover, in those with borderline LDL-C, apoB explained more of the variability of PWV than nonHDL-C and TG/HDL-C.
  
  
  CONCLUSIONS
  Elevated apoB is associated with increased arterial stiffness in type 1 diabetes adolescents. Measurement of apoB in addition to LDL-C may be helpful in stratifying CVD risk in type 1 diabetes adolescents, especially in those with borderline LDL-C.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA, Petter.Bjornstad@childrenscolorado.org.
authors.forename: Petter
authors.initials: P
authors.lastname: Bjornstad
authors.forename: Nhung
authors.initials: N
authors.lastname: Nguyen
authors.forename: Christina
authors.initials: C
authors.lastname: Reinick
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
authors.forename: Franziska K
authors.initials: FK
authors.lastname: Bishop
authors.forename: Scott A
authors.initials: SA
authors.lastname: Clements
authors.forename: Janet K
authors.initials: JK
authors.lastname: Snell-Bergeon
authors.forename: Rachel
authors.initials: R
authors.lastname: Lieberman
authors.forename: Laura
authors.initials: L
authors.lastname: Pyle
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.forename: R
authors.initials: R
authors.lastname: Paul Wadwa
mesh_terms: D000293:Adolescent; D001055:Apolipoproteins B / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D002648:Child; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D014280:Triglycerides / Q000378:metabolism; D059289:Vascular Stiffness; D055815:Young Adult
chemical_list: D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides