Conditional Associations of
ApoB
and
LDL
‐C With Incident Type 2 Diabetes in
UK
Biobank: A Prospe
Bohao Xue, Cheng Shen, Teng Ma, Lei Qian, Yichen Ling, Liangyu Chu, Xin Pan, Yuxing Chen, Ningjian Wang, Dachun Xu, Jin Li ABSTRACT
Aims
Although closely correlated, apolipoprotein B (apoB) reflects atherogenic particle number, whereas low‐density lipoprotein cholesterol (LDL‐C) measures cholesterol carried by LDL particles. We examined whether their associations with incident Type 2 diabetes (T2D) diverged after accounting for each other.
Materials and Methods
We included UK Biobank participants recruited in 2006–2010 without identified baseline diabetes. ApoB and LDL‐C were assessed in baseline blood samples, and incident T2D was ascertained through 19 December 2022. Cause‐specific Cox models estimated hazard ratios (HRs) per 10 mg/dL higher concentration. Primary models used the same participants and nonlipid covariates, with each biomarker entered individually and both entered in one model. Additional analyses assessed combined metabolic adjustment and time‐varying associations.
Results
Among 402 144 participants followed for 5.33 million person‐years, 16 537 developed T2D. ApoB and LDL‐C were highly correlated ( r = 0.958). When modelled individually, HRs per 10 mg/dL were 1.059 (95% CI: 1.052–1.066) for apoB and 1.018 (95% CI: 1.013–1.023) for LDL‐C. When included together, summary HRs over the full follow‐up were 1.502 (95% CI: 1.468–1.537) for apoB and 0.759 (95% CI: 0.745–0.772) for LDL‐C. Combined cardiometabolic and HbA1c adjustment attenuated both conditional associations, with HRs of 1.151 (95% CI: 1.122–1.181) for apoB and 0.890 (0.873–0.908) for LDL‐C. Time‐varying HRs at Years 1 and 10 were 1.658 and 1.464 for apoB, and 0.691 and 0.777 for LDL‐C, respectively.
Conclusions
Higher apoB at a given LDL‐C was associated with a higher hazard of incident T2D, whereas higher LDL‐C at a given apoB was associated with a lower hazard.