Abstract

The study was designed to assess the association between insulin resistance (IR) and apolipoprotein B/apolipoprotein A-I ratio (ApoB/ApoA-I ratio), metabolic syndrome (MetS) components, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) in the nondiabetic population of Georgia. The subjects were 1522 Georgians of Caucasian origin (mean age = 45 years, 653 women) without diabetes who had visited the clinics for a related health checkup between 2012 and 2013. IR was calculated using the computer homeostasis model assessment (HOMA2-IR) and was defined as the upper quartile. MetS was diagnosed using the updated ATP-III definition of the metabolic syndrome. Logistic and multiple regression models were used to estimate the association between IR and other components. IR was positively correlated with age, ApoB, ApoB/ApoA-I ratio, MetS components (excluding high-density lipoprotein cholesterol—HDL-C), LDL-C, fasting insulin, and TC and negatively correlated with HDL-C and ApoA-I in both sexes (all P < 0.001). In the logistic regression models, gender, age, ApoB/ApoA-I ratio, diastolic pressure, HDL-C, LDL-C, fasting glucose, and triglycerides were the covariates significantly associated with IR (OR: 8.64, 1.03, 17.95, 1.06, 0.13, 1.17, 3.75, and 2.29, resp.; all P < 0.05). Multiple regression models demonstrated that these components (except for HDL-C) made an independent contribution to the prediction of HOMA2 (all P < 0.05).

Highlights

  • Insulin resistance (IR) is a metabolic disorder independently associated with cardiovascular disease [1,2,3]

  • International Journal of Endocrinology obesity. Both low-density lipoprotein cholesterol (LDL-C) and ApoB/ApoA-I ratio were independent risk factors for Mets, and ApoB/ApoA-I ratio was stronger in this regard for obese population [18]

  • The ApoB/ApoA-I ratio, ApoB, blood pressure levels, Waist circumference (WC), Body mass index (BMI), low-density lipoproteins (LDL)-C, fasting blood glucose (FG), FIns, TG, total cholesterol (TC), HOMA2-IR, the prevalence of metabolic syndrome (MetS), AH, and dyslipidemia were all significantly higher but high-density lipoprotein cholesterol (HDL-C) and ApoA-I levels were significantly lower in men than in women

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Summary

Introduction

Insulin resistance (IR) is a metabolic disorder independently associated with cardiovascular disease [1,2,3]. Accurate and early prediction and detection of IR are very important in clinical practice so as to identify patients at high risk for cardiovascular disorders. Evaluation and revealing of the potential additional metabolic markers can help predict cardiovascular risk better. Prospective risk studies, such as AMORIS [9,10,11], INTERHEART [12], EPIC-Norfolk study [13, 14], and ULSAM [15], indicate that apolipoprotein B/apolipoprotein A-I ratio (ApoB/ApoA-I ratio) is a strong predictor of risk of myocardial infarction (MI). A recent review of existing evidence by Walldius supports the use of ApoB/ApoA-I ratio as a strong predictor of cardiovascular risk [16]

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