Correlation of fasting serum apolipoprotein B-48 with coronary artery disease prevalence

Background Postprandial hyperlipidemia partially refers to the postprandial accumulation of chylomicrons and chylomicron remnants (CM-R). Many in vitro studies have shown that CM-R has highly atherogenic properties, but consensus is lacking on whether CM-R accumulation correlates with the development of atherosclerotic cardiovascular diseases. We investigated the correlation between CM-R accumulation and the prevalence of coronary artery disease (CAD). Design Subjects who received a coronary angiography and did not take any lipid-lowering drugs (n=189) were enrolled. Subjects with coronary artery stenosis (≥75%) were diagnosed as CAD. Biochemical markers for glucose and lipid metabolism including fasting apolipoprotein (apo) B-48 concentration were compared between CAD patients (n=96) and age-, sex-, and body mass index (BMI)-matched non-CAD subjects without overt coronary stenosis (<75%) (n=67). We tried to determine which metabolic parameters were correlated with the prevalence of CAD by multiple logistic regression analysis, and whether or not the combination of high apo B-48 and other coronary risk factors (high triglyceride, low HDL-C, high HbA1c or low adiponectin levels) increased the prevalence of CAD. Results Fasting serum apo B-48 levels were significantly higher in CAD patients than in non-CAD subjects (3·9±2·4 vs. 6·9±2·6μg/mL, P<0·0001) and had the most significant correlation with the existence of CAD. The clustering of high fasting apo B-48 levels (>4·34μg/mL, the cut-off value) and other coronary risk factors were found to be associated with a stronger risk of CAD compared with single high fasting apo B-48 levels. Conclusion Fasting serum apo B-48 levels significantly correlated with the prevalence of CAD.