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Apolipoprotein B/apolipoprotein A-I in relation to the metabolic syndrome and change in carotid artery intima-media thickness during 3 years in middle-aged men

Journal article
Authors Karin Wallenfeldt
Lena Bokemark
John Wikstrand
Johannes Hulthe
Björn Fagerberg
Published in Stroke
Volume 35
Issue 10
Pages 2248-52
ISSN 1524-4628 (Electronic)
Publication year 2004
Published at Wallenberg Laboratory
Cardiovascular Institute
Institute of Internal Medicine, Dept of Medicine
Pages 2248-52
Language en
Keywords Apolipoprotein A-I/*blood, Apolipoproteins B/*blood, Arteriosclerosis/blood, Body Mass Index, Carotid Arteries/*pathology/ultrasonography, Humans, Lipoproteins/blood, Male, Metabolic Syndrome X/*blood, Middle Aged, Obesity/*blood, Tunica Intima/*pathology/ultrasonography, Waist-Hip Ratio
Subject categories Medical and Health Sciences


BACKGROUND AND PURPOSE: The apolipoprotein B (apoB)/apolipoprotein A-I (apoA-I) ratio is a measure of the relationship between different lipoprotein particles and a powerful predictor of coronary death. The aim was to examine whether apoB/apoA-I was associated with the metabolic syndrome (MetS) at baseline and also with the future change in carotid artery intima-media thickness (IMT). METHODS: In 313 58-year-old men, carotid artery IMT was measured bilaterally by high-resolution B-mode ultrasound at baseline and after 3 years of follow-up. Serum apolipoprotein concentrations and the components of MetS were measured at study entry. RESULTS: ApoB/apoA-I showed statistically significant associations with body mass index, waist-to-hip ratio, high-density lipoprotein (HDL) cholesterol, triglycerides, low-density lipoprotein (LDL) particle size, insulin, and diastolic blood pressure. Two thirds of the patients with MetS had high apoB/apoA-I ratios (>0.90) compared with one third of those without the syndrome (P<0.001). The IMT change was associated with apoB, total cholesterol, LDL cholesterol, triglycerides, and inversely with HDL cholesterol and LDL particle size at entry, and there was a strong colinearity between these variables. The subjects with apoB/apoA-I above the first tertile (0.74) had a 20-microm-higher (95% CI, 7 to 33) annual increase in IMT compared with those below this level after adjustment for blood pressure and smoking. CONCLUSIONS: The apoB/apoA-I ratio was strongly associated with MetS and its components at baseline. ApoB/apoA-I at baseline was related to the change in carotid artery IMT during 3 years of follow-up. There was a strong colinearity between apoB/apoA and the atherogenic lipids.

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