Serum apolipoprotein C-III in high-density lipoproteins as key diabetogenic risk factor in Turks
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Apolipoprotein C-III (apoC-III) is associated with the atherothrombogenicity of TG-rich lipoproteins, and is also found on certain high-density lipoprotein (HDL) subfractions. This population-based study involving 802 Turks was aimed at investigating whether serum levels of apoC-III or its fractions predicted incident metabolic syndrome, type 2 diabetes, and coronary heart disease (CHD). The mean duration of follow-up was 4.4 years. Total apoC-III and its fractions were significantly, linearly, and inversely related to smoking, and positively to alcohol usage and serum complement C3. Mid and high tertiles of total or non-HDL apoC-III significantly and independently predicted incident metabolic syndrome. After adjusting for HDL cholesterol and body mass index (BMI), these tertiles predicted CHD with risk ratios of 1.6 for 1 standard deviation (SD) increment. After adjusting for waist circumference, HDL cholesterol, and other confounders, the highest tertile of HDL apoC-III was a major independent predictor of new-onset diabetes, with a 2.5-fold risk ratio for 1 SD increment. In conclusion, the presumably dysfunctional HDL apoC-III is a stronger predictor of type 2 diabetes than waist girth in Turks. Independent of HDL cholesterol, BMI, and non-lipid factors, non-HDL apoC-III strongly predicts the development of both metabolic syndrome and incident CHD.
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