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ApoB and HOMA-IR best for atherosclerosis prediction in Type 2 diabetics
11 August 2008
MedWire News: Apolipoprotein (apo)B and the homeostasis model of insulin resistance (HOMA-IR) are better markers of atherosclerosis in patients with Type 2 diabetes than low-density lipoprotein (LDL) cholesterol alone, report investigators.
Recent evidence suggests that apoB may be a better measure for calculating atherosclerosis risk in the general population than LDL cholesterol, as recently reported by MedWire News.
In addition, lead researcher Kazunari Matsumoto and colleagues from Sasebo Chuo Hospital in Nagasaki, Japan, comment that as diabetics are at increased risk for atherosclerosis, "insulin resistance is currently considered an important risk factor for the development of atherosclerotic vascular disease."
Matsumoto and team recruited 66 Type 2 diabetic patients with carotid atherosclerosis aged 63 years on average, as well as 66 age- and gender-matched controls without atherosclerosis.
They compared the effectiveness of LDL cholesterol and apoB, and also the simultaneous combination of both of these measurements with insulin resistance, for predicting atherosclerosis.
The researchers report in the journal Diabetes Research and Clinical Practice that according to area under the receiver operator curve analysis, apoB level distinguished between patients with and without atherosclerosis most accurately, at 70%, followed by 69% and 66% for HOMA-IR and LDL cholesterol, respectively.
They found that 60.7% of patients with atherosclerosis also had high LDL cholesterol (more than 108 mg/dl, 2.79 mmol/l). In addition, 77.4% of those with high LDL cholesterol and HOMA-IR, and 90.9% of those with high apoB and HOMA-IR had atherosclerosis.
Matsumoto et al caution: "Although apoB is a better predictor of cardiovascular disease than LDL cholesterol, verification of apoB as a therapeutic marker of statins or fibrate is needed."
They conclude: "It is essential that the target level of apoB to prevent cardiovascular disease should be determined," but add that "further large-scale prospective studies are needed to confirm our results."
