O P Ganda1, C G Jumes, M J Abrahamson, M Molla. 1. 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
Abstract
AIMS: 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.
AIMS: 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: Jacques Genest; Ruth McPherson; Jiri Frohlich; Todd Anderson; Norm Campbell; André Carpentier; Patrick Couture; Robert Dufour; George Fodor; Gordon A Francis; Steven Grover; Milan Gupta; Robert A Hegele; David C Lau; Lawrence Leiter; Gary F Lewis; Eva Lonn; G B John Mancini; Dominic Ng; Glen J Pearson; Allan Sniderman; James A Stone; Ehud Ur Journal: Can J Cardiol Date: 2009-10 Impact factor: 5.223
Authors: William E Boden; Jeffrey L Probstfield; Todd Anderson; Bernard R Chaitman; Patrice Desvignes-Nickens; Kent Koprowicz; Ruth McBride; Koon Teo; William Weintraub Journal: N Engl J Med Date: 2011-11-15 Impact factor: 91.245
Authors: Emanuele Di Angelantonio; Nadeem Sarwar; Philip Perry; Stephen Kaptoge; Kausik K Ray; Alexander Thompson; Angela M Wood; Sarah Lewington; Naveed Sattar; Chris J Packard; Rory Collins; Simon G Thompson; John Danesh Journal: JAMA Date: 2009-11-11 Impact factor: 56.272
Authors: Matthew J McQueen; Steven Hawken; Xingyu Wang; Stephanie Ounpuu; Allan Sniderman; Jeffrey Probstfield; Krisela Steyn; John E Sanderson; Mohammad Hasani; Emilia Volkova; Khawar Kazmi; Salim Yusuf Journal: Lancet Date: 2008-07-19 Impact factor: 79.321
Authors: John H Contois; Joseph P McConnell; Amar A Sethi; Gyorgy Csako; Sridevi Devaraj; Daniel M Hoefner; G Russell Warnick Journal: Clin Chem Date: 2009-01-23 Impact factor: 8.327
Authors: Ken Williams; Andre Tchernof; Kelly J Hunt; Lynne E Wagenknecht; Steven M Haffner; Allan D Sniderman Journal: Diabetes Date: 2008-09-22 Impact factor: 9.461
Authors: Jing Cao; Sarah O Nomura; Brian T Steffen; Weihua Guan; Alan T Remaley; Amy B Karger; Pamela Ouyang; Erin D Michos; Michael Y Tsai Journal: J Clin Lipidol Date: 2019-11-29 Impact factor: 4.766