Endocrine Abstracts

Background: Retrospective, transversal and analytical study was designed to determine the relationship between ApoB/ApoA1 ratio, Non-HDL-Cholesterol/HDL-Cholesterol ratio and Metabolic Syndrome (MetS) in type 2 diabetes mellitus (T2DM) patients attending routine follow-up in outpatient clinic from Madrid.

Methods: The study was performed at the University Hospital Infanta Leonor, a public health center, and specialized secondary referal, which provides services to the 31 urban district of Madrid, Spain (Vallecas district, 300 000 people). 100 T2DM and high cardiovascular risk subjects, who attended the clinic between January of 2014 and June of 2017 for a routine follow-up were enrolled in this study. A blood sample was taken every 6 months in all patients and an average of 4-5 values prior to analysis were performed. Diagnosis of MetS was made according to definition of modified NCEP-ATPIII (National Cholesterol Education Program’s Adult Treatment Panel III) 2. The following variables were measured in serum or plasma samples: Colesterol, HDL-Cholesterol, ApoB, ApoA1, triglycerides, high-sensitivity C Reactive Protein, ferritin, and transferrin. LDL-Cholesterol was calculated (Friedewald). Median comparisons were done with the Mann Whitney U test. Relationships between variables were measured with Spearman correlation test. Multivariate regression analysis was performed with ApoB/ApoA1 and Non-HDL-Cholesterol/HDL-Cholesterol ratios as dependent variables and age, gender and other cardiovascular risk factors as independent variables, after an outlier identification. A level of P<0.05 was considered statistically significant (SPSS, v. 21.0).

Results: We found associations, that remain after adjusting comorbidities and risk factors, between MetS and ApoA1 (R²=0.164, P=0.028), ApoB/ApoA1 ratio (R²=0.187, P=0.001); and Non-HDL-Cholesterol/HDL-Cholesterol ratio (R²=0.269, P=0.0001). Moreover, there is an association between women with MetS and ApoB/ApoA1 ratio and ischemic cardiomyopathy that remain also after adjusting comorbidities and risk factors (R²=0.160, P=0.032).

Conclusions: We found that both lipidic ratios are adequate for predicting MetS in T2DM patients of the population studied. ApoB/ApoA1 ratio shows to be a better cardiovascular risk marker, in women with MetS than in men. New studies should be carried out to confirm this finding.