Non-HDL-cholesterol/HDL-cholesterol is a better predictor of metabolic syndrome and insulin resistance than apolipoprotein B/apolipoprotein A1

医学 胰岛素抵抗 载脂蛋白B 胆固醇 内科学 代谢综合征 载脂蛋白C2 内分泌学 载脂蛋白A1 低密度脂蛋白胆固醇 胰岛素 脂蛋白 肥胖 极低密度脂蛋白
作者
Se Won Kim,Jae Hwan Jee,Hye Jeong Kim,Sang‐Man Jin,Sunghwan Suh,Ji Cheol Bae,Sun Wook Kim,Jae Hoon Chung,Yong‐Ki Min,Myung‐Shik Lee,Moon‐Kyu Lee,Kwang‐Won Kim,Jae Hyeon Kim
出处
期刊:International Journal of Cardiology [Elsevier BV]
卷期号:168 (3): 2678-2683 被引量:133
标识
DOI:10.1016/j.ijcard.2013.03.027
摘要

Background The ratio of apolipoprotein B (apoB) to apolipoprotein A1 (apoA1) has been reported to be associated with metabolic syndrome (MetS) and insulin resistance (IR). Non-HDL-C is regarded as a surrogate marker for apoB in routine clinical practice. However, it is unclear whether the ratio of non-HDL-C to HDL-C is an equal or a better predictor than the apoB/apoA1 ratio for the identification of MetS and IR. Methods We performed a retrospective study of 41,821 Korean adults who participated in a routine health screening examination. Anthropometry, fasting glucose, fasting insulin, HOMA-IR, CRP, lipid profiles, apoB, and apoA1 were measured. Results To compare the predictive value for MetS between different lipid ratios, we analyzed the ROC curves of apoB/apoA1 and non-HDL-C/HDL-C ratios. ROC analysis showed that the AUCs of non-HDL-C/HDL-C (0.75 [95% CI = 0.74–0.76] in men and 0.84 [95% CI = 0.83–0.85] in women) were significantly higher than those of apoB/apoA1 (0.66 [95% CI = 0.65–0.67] in men and 0.77 [95% CI = 0.76–0.78] in women). The non-HDL-C/HDL-C ratio also showed a significantly stronger association with HOMA-IR than the apoB/apoA1 ratio. The optimal cutoff value of the non-HDL-C/HDL-C ratio for detection of MetS in men was 3.39, with a sensitivity of 66.7% and a specificity of 71.8%, whereas the optimal ratio cutoff value in women was 2.89, with a sensitivity of 75.7% and a specificity of 78.1%. Conclusions Our findings indicate that the non-HDL-C/HDL-C ratio is a better marker than the apoB/apoA1 ratio for identifying IR and MetS in Koreans.
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