The Association Between ApoB, ApoA â… , ApoB/apoA â…  Ratio And Diabetic Nephropathy In Type 2 Diabetes Mellitus

Objective:To investigate the association between apoB,apoAⅠ,apoB/apoAⅠratio and diabetic nephropathy in type 2 diabetes mellitus.Methods:A total of 192 (108 men,84 women) patients were selected with strict criteria to prevent confounders.Diabetic nephropathy and non-diabetic nephropathy were defined as urinary albumin-to-creatinine ratio(ACR) of≥30mg/g and < 30 mg/g,respectively. To explore the differences between the two groups,TCHO,TG,LDL and HDL cholesterol, apolipoprotein AⅠand B were measured,and apoB/apoAⅠratio and non-HDL cholesterol were calculated,then the two groups were compared.Results:TCHO,TG,non-HDL cholesterol,apoB and apo B/apoAⅠratio were significantly(p<0.05) higher in patients with diabetic nephropathy.Data showed that gender was associated with DN,so the subjects were divided into two groups based on gender.In male group,after adjusting for diabetic duration years and SBP, the result indicated that odds ratio and 95%CI for diabetic nephropathy for TCHO,non-HDL cholesterol,apoB and apoB/apoAⅠratio in men was 1.499(1.022～2.198),1.591(1.044～2.425),6.744(1.568～29.010),5.604(1.666～18.854),with p value 0.038,0.031,0.010 , 0.005 , and correlation coefficient for DN for TCHO,non-HDL cholesterol,apoB and apoB/apoAⅠratio in men was 0.210, 0.218, 0.269, 0.292,with p value 0.034,0.027, 0.006, 0.003 ; but in female group,SBP,DBP and HbA1c were associated with DN,as p value for age and diabetic duration years between the two groups was 0.074, 0.078,so SBP,DBP,HbA1c,age and diabetic duration years were adjusted in further statistic analysis,the result indicated that odds ratio for DN for apoB /apoAⅠratio was 9.772(95%CI 1.386～68.899),with p value 0.022,and correlation coefficient for DN for apoB/apoAⅠratio was 0.241,with p value 0.028. In the subjects,pearson analysis showed that correlation coefficient between apoB/apoAⅠratio and lipid parameters of TCHO,TG, LDL-C,HDL-C,non-HDL-C was 0.252, 0.356, 0.332, -0.386, 0.390, with all p value<0.05.All subjects were divided into two groups according to apoB/apoAⅠratio above or below 0.9.The incidence of DN was significantly(p<0.05) higher in patients with apoB/apoAⅠratio above 0.9 than those below 0.9,which was 57.65%,31.76%,respective, but gender, age,BMI, diabetic duration years, HbA1c between the two groups were comparable.Conclusions: 1.ApoB/apoAⅠratio is associated with diabetic nephropathy both in men and women with type 2 diabetes mellitus.2. When apoB/apoAⅠratio≥0.9,the incidence of DN was markly higher.