title: Relation of Combined Non-High-Density Lipoprotein Cholesterol and Apolipoprotein B With Atherosclerosis in Adults With Type 1 Diabetes Mellitus.
abstract: Apolipoprotein B (apoB) and non-high-density lipoprotein cholesterol (non-HDL-C) are cardiovascular disease risk markers, although data in adults with type 1 diabetes mellitus (DM) are limited. We hypothesized that elevated apoB and non-HDL-C would be associated with greater odds of coronary artery calcification progression (CACp), a measure of coronary atherosclerosis, than either category alone in adults with type 1 DM. We grouped subjects with type 1 DM (n = 652) into 4 groups: elevated apoB (≥90 mg/dl) and elevated non-HDL-C (≥130 mg/dl), elevated non-HDL-C alone, elevated apoB alone, and normal apoB and non-HDL-C. We used logistic regression to examine the associations between the groups and CACp for a period of 6 years. We performed sensitivity analyses with elevated apoB and non-HDL-C redefined as at or more than the cohort means (91.4 and 119.0 mg/dl, respectively). Subjects with elevated apoB and non-HDL-C had greater odds of CACp compared with those with normal apoB and non-HDL-C (odds ratio 1.90, 95% confidence interval 1.15 to 3.15) and compared with subjects with elevated apoB alone (odds ratio 2.86, 95% confidence interval 1.43 to 5.74) adjusting for age, gender, duration, hemoglobin A1c, and statins. Similar results were obtained with elevated apoB and non-HDL-C defined as at or more than the cohort means. In conclusion, elevated apoB and non-HDL-C carry a greater risk of atherosclerosis than elevated apoB in the absence of elevated non-HDL-C in adults with type 1 DM. These data suggest that apoB and non-HDL-C should be viewed as complementary rather than competitive indexes of cardiovascular disease risk in type 1 DM.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado. Electronic address: petter.m.bjornstad@ucdenver.edu.
authors.forename: Petter
authors.initials: P
authors.lastname: Bjornstad
authors.affiliation: Department of Endocrinology, University of Colorado Denver, Aurora, Colorado.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Eckel
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Laura
authors.initials: L
authors.lastname: Pyle
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado.
authors.forename: Marian
authors.initials: M
authors.lastname: Rewers
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado.
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Snell-Bergeon
mesh_terms: D000328:Adult; D001055:Apolipoproteins B / Q000097:blood*; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002114:Calcinosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood*; D003120:Colorado / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D001055:Apolipoproteins B; D015415:Biomarkers; D008076:Cholesterol, HDL