Is the ratio of apoB/apoA-1 the best predictor for the severity of coronary artery lesions in Chinese diabetics with stable angina pectoris? An assessment based on Gensini scores.
BACKGROUND
There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease (CAD) in patients with diabetes mellitus. We determined the relationship between five conventional lipid ratios and the extent of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris (SAP).


METHODS
A prospective cohort study within 373 type 2 diabetic patients diagnosed with stable CAD by coronary angiography was performed. All patients were classified into three groups according to the tertiles of Gensini scores (GS, low group < 8 points n = 143; intermediate group 8-28 points, n = 109; high group > 28 points, n = 121). Association between the ratios of apolipoprotein (apo) B and apoA-1, total cholesterol and high density lipoprotein cholesterol (TC/HDL-C), triglycerides and HDL-C (TG/HDL-C), low density lipoprotein cholesterol and HDL-C (LDL-C/HDL-C), Non-HDL-C/HDL-C and GS were evaluated using the receivers operating characteristic (ROC) curves and multivariate logistic regression models.


RESULTS
The ratio of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C, and Non-HDL-C/HDL-C were correlated with Gensini scores. Area under the ROC curves for predicting high Gensini scores in the ratios of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C and Non-HDL-C/HDL-C were 0.62, 0.60, 0.59 and 0.60, respectively (P < 0.005 for all). According to multivariate logistic regression analysis after adjusted with demographic characteristic and other lipid parameters, the ratio of apoB/apoA-1 is qualified as an independent discriminator for the severity of CAD. However, after further adjusting different baseline variables, such as left ventricular ejective fraction, hemoglobin A1c, leukocytes count and serum creatinine, none of the above lipid ratios remained.


CONCLUSIONS
Compared with other lipid parameters, the ratio of apoB/apoA-1 appears to be more significantly correlated with the extent of coronary artery lesions in Chinese diabetics, but it was not an independent predictor in these settings.
Department of Cardiology, the Fifth Hospital of Wuhan & Cardiovascular Institute of Jianghan University, Wuhan, Hubei, China.
Li-Feng
LF
Hong
Department of Cardiology, the Fifth Hospital of Wuhan & Cardiovascular Institute of Jianghan University, Wuhan, Hubei, China.
Xiao-Ni
XN
Yan
Department of Cardiology, the Fifth Hospital of Wuhan & Cardiovascular Institute of Jianghan University, Wuhan, Hubei, China.
Ying
Y
Fan
Department of Cardiology, the Fifth Hospital of Wuhan & Cardiovascular Institute of Jianghan University, Wuhan, Hubei, China.
Qiong
Q
Wu
Department of Cardiology, the Fifth Hospital of Wuhan & Cardiovascular Institute of Jianghan University, Wuhan, Hubei, China.
Song-Hui
SH
Luo
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Bo
B
Yang
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Jian-Jun
JJ
Li
Coronary artery disease; Diabetic mellitus; Gensini scores; Lipid disorder