Study Of Association Between APOB/APOA1 Ratio And Metabolic Syndrome Or Insulin Resistance

Objective: To assess if the ratio of ApoB/ApoA1 is related to the metabolic syndrome(MS) and insulin resistance(IR).Methods: The investigation was conducted from March to July 2008. Stratified sampling in a population aged above 20 years was applied in a community of Chongqing downtown area. 709 subjects were enrolled. The investigation content included:①Questionnaire survey: general condition, history of present illness, medical history, smoking and drinking status, and physical work condition.②Physical examination: height, weight, waist circumference, hip circumference and blood pressure, etc. Body mass indexes were calculated.③Laboratory: Fasting plasma glucose(FPG), 2 hours plasma glucose after oral 75g glucose (2hPG), Fasting serum insulin(FINS), total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol (HDL-c) , low density lipoprotein cholesterol (LDL-c), apolipoprotein B and apolipoprotein A1 were measured. ApoB/ApoA1 ratio and insulin resistance index (HOMA-IR) were calculated. MS was defined according to the criteria made by the International Diabetes Federation in 2005. The insulin resistance (IR) was determined as the highest quartile of the insulin resistance index. In the first part, we defined a high ApoB/ApoA1 ratio as the highest gender-specific quartile of the ApoB/ApoA1 ratio, the remaining 3 quartiles were defined a low ApoB/ApoA1 ratio. In the second part, Subjects were divided into four groups according to the quartiles of ApoB/ApoA1 ratio.Results:①ApoB/ApoA1 ratio was significantly increased in subjects with MS.②Compared with the low ApoB/ApoA1 group, the high ApoB/ApoA1 group was more likely to get MS (OR=3.5) (P<0.001).③ApoB/ApoA1 ratio increased significantly as the number of MS components increasing ( P<0.001).④Compared with the non-insulin resistant group, the insulin resistant group was older and has on average greater mean values for BMI, systolic and diastolic blood pressure, fasting plasma glucose, triglycerides, LDL-cholesterol, and ApoB/ApoA1 ratio. In contrast, insulin resistant subjects had significantly lower HDL-cholesterol than insulin sensitive subjects (P<0.05).⑤Homeostasis model assessment increased significantly as ApoB/ApoA1 ratio increasing (P<0.001).⑥Compared with the lowest quartile of ApoB/ApoA1 ratio, the highest quartile of ApoB/ApoA1 ratio was more likely to get IR, and the risk increased 2.586 times (P=0.001).Conclusion: ApoB/ApoA1 ratio is strongly associated with IR, MS and its components, and a high ApoB/ApoA1 ratio is a valuable marker of MS and IR.