Comparison of Apolipoprotein (ApoB/ApoA-1) and Lipoprotein (Total Cholesterol/HDL) Ratios in Obese Adolescents.

Background: Serum (ApoB/ApoA-1) ratio is considered a stronger predictor of systemic inflammation and atherosclerosis than serum total cholesterol/HDL (TC/HDL) ratio among adults. We evaluated the relationships between ApoB/ApoA-1 and TC/HDL ratios with surrogate markers of inflammation and insulin resistance (IR) among obese adolescents.

Methods: Body mass index z-score (BMI-z), body composition, fasting glucose, insulin, lipids, high-sensitive c-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) were evaluated in 143 obese adolescents.

Results: Male subjects had higher BMI-SDS, fat-free mass (FFM), and glucose than female subjects (P < 0.01). Furthermore, 54.5% met diagnostic criteria for metabolic syndrome (MS) and displayed higher SBP, BMI-SDS, fat mass (FM), HOMA-IR, hs-CRP, TG, TC/HDL, TG/HDL, ApoB/ApoA-1, and HbA1c, but lower HDL and ApoA-1 than the non-MS group (P < 0.05) with similar gender distribution. In the entire cohort, TC/HDL and ApoB/ApoA-1 ratios were strongly correlated (r = 0.81, P < 0.0001). Receiver operating characteristic analysis indicated that the area under the curve in MS subjects for ApoB/ApoA-1 and TC/HDL-C ratios was not statistically different. ApoB/ApoA-1 and TC/HDL-C ratios were positively correlated with SBP (r = 0.29; P = 0.0004) and (r = 0.43; P < 0.0001), respectively. Finally, ApoB/ApoA-1 and TC/HDL-C ratios were correlated with hs-CRP (r = 0.21; P = 0.014) and (r = 0.26; P = 0.0016), respectively. However, the relationships between ApoB/ApoA-1 and TC/HDL ratios with HOMA-IR were not statistically significant.

Conclusions: Unlike in the adult population, serum ApoA-1, ApoB, and ApoB/ApoA-1 ratio may not have significant advantage over conventional lipoproteins in evaluating the presence of systemic inflammation, MS, and risk of atherosclerosis in obese adolescents.