Published Online
on September 2, 2004

A more recent version of this article appeared on October 1, 2004

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Submitted on February 9, 2004
Revised on June 1, 2004
Accepted on June 30, 2004

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

Karin Wallenfeldt MD^*; Lena Bokemark MD, PhD; John Wikstrand MD, PhD; Johannes Hulthe MD, PhD; and Björn Fagerberg MD, PhD

From the Institute of Internal Medicine (K.W., L.B., B.F.) and the Wallenberg Laboratory for Cardiovascular Research (J.W., J.H., B.F.), Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.

^* To whom correspondence should be addressed. E-mail: karin.wallenfeldt{at}wlab.gu.se.

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-µm-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.

Key words: apolipoproteins • atherosclerosis • intima-media thickness

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