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The Egyptian Journal of Internal Medicine
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Apolipoprotein B level and diabetic microvascular complications: is there a correlation?

The Egyptian Journal of Internal Medicine volume 25, pages 137–142 (2013)Cite this article

Abstract

Introduction

Dyslipidemia has long been implicated in diabetic complications. However, many subgroups have been considered to be responsible. Furthermore, a cause and effect relationship has long been debated. Apolipoprotein B (Apo B) is an exact measure of the total number of very low-density lipoprotein and low-density lipoprotein particles; thus, total plasma Apo B is a reliable surrogate for actual low-density lipoprotein particle number irrespective of its size. Hence, it is a better indicator of the correlation between dyslipidemia and diabetic microvascular complications.

Aim of the work

Our aim is to study the correlation between Apo B and diabetic microvascular complications, namely, nephropathy and retinopathy.

Materials and methods

A cross sectional study was carried out of 56 diabetic patients, 36 men and 20 women, both type 1 and 2, who were chosen randomly from the outpatient Endocrinology Clinic in Cairo University. Serum creatinine, estimated glomerular filtration rate, urine albumin/ creatinine ratio (A/C ratio), and Apo B levels were determined. Groups were divided according to the A/C ratio as follows: no proteinuria (A/C ratio<30mg/g), incipient proteinuria (30–300mg/g), and overt proteinuria (>300mg/g). We performed fundus examination as well as fluorescein angiography in patients with retinopathy. Patients on dialysis, HBA1c more than 7.5, on lipid-lowering treatment, or with familial hyperlipidemia were excluded. Calculations were carried out using the SPSS v.10 statistical software.

Results

We found a significant positive correlation between Apo B levels and microvascular complications. Apo B was higher with overt nephropathy than incipient nephropathy (1.75 ±0.38), and higher in patients with incipient nephropathy (1.4± 0.48) than in patients without nephropathy (1.02 ± 0.34, P<0.01).

A highly significant correlation was detected between the grades of retinopathy and the Apo B level. Finally, a significant positive correlation was detected between the presence of maculopathy and Apo B. Apo B levels were significantly higher in the presence of both nephropathy and retinopathy (1.26 ± 0.389) than in the absence of both complications (0.77± 0.361, P<0.05).

Conclusion

Apo B levels are strongly correlated to diabetic microvascular complications. The higher the degree of nephropathy, the higher the Apo B level. The presence of more than one microvascular complication correlates positively with high levels of Apo B. This suggests the possible use of Apo B as a sensitive biomarker of the presence of early diabetic microvascular complications.

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Authors and Affiliations

  1. Department of Internal Medicine, Cairo University, 26 st.18 Mokattam, Cairo, Egypt

    Mary N. Rizk & Hala Aly

  2. National Institute of Diabetes, Cairo University, Cairo, Egypt

    Pierre Samir

  3. Department of Ophthalmology, Cairo University, Cairo, Egypt

    Hala el Mofty

  4. Department of Clinical Pathology, Cairo University, Cairo, Egypt

    Osama K. Allah

Authors
  1. Mary N. Rizk
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  2. Hala Aly
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  3. Pierre Samir
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  4. Hala el Mofty
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  5. Osama K. Allah
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Corresponding author

Correspondence to Mary N. Rizk.

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Rizk, M.N., Aly, H., Samir, P. et al. Apolipoprotein B level and diabetic microvascular complications: is there a correlation?. Egypt J Intern Med 25, 137–142 (2013). https://doi.org/10.7123/01.EJIM.0000432236.92356.43

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  • DOI: https://doi.org/10.7123/01.EJIM.0000432236.92356.43

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