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J Clin Lipidol. 2020 Oct 31:S1933-2874(20)30325-1. doi: 10.1016/j.jacl.2020.10.006. Online ahead of print.
ABSTRACT
BACKGROUND: Apolipoprotein C3 (APOC3) is a risk factor for incident coronary artery disease in people with type 1 diabetes (T1D). The pathways that link elevated APOC3 levels to an increased risk of incident cardiovascular disease in people with T1D are not understood.
OBJECTIVE: To explore potential mechanisms, we investigated the association of APOC3 with insulin resistance and coronary artery calcium (CAC).
METHODS: In a random subcohort of participants with T1D from Coronary Artery Calcification in Type 1 Diabetes (n = 134), serum APOC3, high-density lipoprotein (HDL)-associated APOC3, and retinol binding protein 4 (RBP4; a potential marker of insulin resistance) were measured by targeted mass spectrometry. We used linear regression to evaluate associations of serum APOC3 and HDL-APOC3 with APOB, non-HDL cholesterol, serum- and HDL-associated RBP4, and estimated insulin sensitivity and logistic regression to evaluate association with presence of CAC, adjusted for age, sex, and diabetes duration.
RESULTS: Serum APOC3 correlated positively with APOB and non-HDL cholesterol and was associated with increased odds of CAC (odds ratio: 1.68, P = .024). Estimated insulin sensitivity was not associated with serum- or HDL-RBP4 but was negatively associated with serum APOC3 in men (ß estimate: -0.318, P = .0040) and decreased odds of CAC (odds ratio: 0.434, P = .0023).
CONCLUSIONS: Serum APOC3 associates with increased insulin resistance and CAC in T1D.
PMID:33257283 | DOI:10.1016/j.jacl.2020.10.006
