Glycated apolipoprotein B—A surrogate marker of subclinical atherosclerosis

•Sustained hyperglycemia is important factor for glycation of various proteins.•Diabetic and control obese group underwent analysis for fasting post prandial glucose, HbA1c, insulin, HOMA IR, lipid profile parameters glycated apo B, apo B, sdLDL and CIMT.•Presence of hyperglycemia and sdLDL are independently associated with glycation of apo B.•Presence of plaques and increased thickness of carotid intima further highlights that glycation play important role in predisposing diabetic patients to atherosclerosis.

AimsSustained hyperglycemia is a causative factor for glycation of proteins. Glycated low-density lipoprotein (LDL) is strongly associated with an increased risk of CAD (Coronary Artery Disease) in diabetics. Hence, we planned to evaluate the association of glycated apo B with subclinical atherosclerosis.MethodForty-five non obese and 45 obese diabetics were recruited. Glycated hemoglobin (HbA1c) levels were estimated by HPLC (High Pressure Liquid Chromatography) and small dense low-density lipoprotein (sdLDL) was calculated using standard formula. Plasma Insulin was done by RIA. Insulin resistance was calculated using homeostatic model assessment insulin resistance (HOMA-IR) model. Glycated apo B in serum was estimated using ELISA. Carotid intimal media thickness (CIMT) was estimated using B mode USG of carotid arteries.ResultsGlycated apo B levels were correlated significantly with fasting blood glucose (FBG) (p = 0.001), post prandial glucose (PPG) (p = 0.001), HbA1c (p = 0.013). The percent glycated apo B levels correlated significantly with FBG (p = 0.032), PPG (p = 0.004) in obese diabetic group.Multivariate regression analysis of glycated apo B and percent glycated apo B, showed that glycated apo B (p = 0.009) and percent glycated apo B (p = 0.006) were significantly correlated to FPG in diabetic population. The percent glycated apo B was also significantly correlated to PPG (p = 0.003) and sdLDL (p = 0.009). CIMT levels were higher in obese diabetics with 2 plaques positive when compared to obese non diabetic controls; however levels were not statistically significant.ConclusionPersistent hyperglycemia and sdLDL are independently associated with glycation of apo B. Presence of plaques and increased thickness of intima indicates that glycated apo B predisposes diabetics to atherosclerosis.