Correlation between serum apoCⅢ, residual lipoprotein cholesterol and coronary heart disease complicated with type 2 diabetes mellitus

Objective To investigate the changes of serum apolipoprotein C Ⅲ（apoCⅢ） and residual lipoprotein cholesterol（RLP-C） in patients with type 2 diabetes mellitus（T2 DM） and coronary artery disease（CAD）. Methods A total of 816 hospitalized patients of the Cardiology Department of the Second Affiliated Hospital of Shanxi Medical University from January 2017 to May 2018 were included and divided into four groups: T2 DM+CAD group（n=192）, CAD group（n=198）, T2 DM group（n=200）, and control group（n=226）. Factorial analysis of variance was used to analyze the effects of interaction between CAD and T2 DM on the level of serum apoCⅢ. The mediating effect of RLP-C between apoCⅢ and Gensini score was analyzed by Bootstrap test. Logistic regression was applied to analyze the effect of apoCⅢ on the incidence of T2 DM, CAD and T2 DM+CAD in each group. Results The levels of serum apoCⅢ and RLP-C were significantly higher in CAD group, T2 DM group and CAD+T2 DM group compared to that in control group（all P＜0.05）. Fractional analysis of variance showed that there was interaction between CAD and T2 DM in the elevation of serum apoCⅢ and RLP-C（F=7.460, P=0.006;F=4.641, P=0.032）. Serum levels of apoCⅢ and RLP-C were positively correlated with Gensini score in CAD and CAD+T2 DM group（both P＜0.05）. Bootstrap test revealed that RLP-C exerted a partial mediating effect between apoCⅢ and Gensini score. Multivariate Logistic regression analysis showed that apoCⅢ was an independent risk factor for CAD+T2 DM group（OR=1.890, 95% CI 1.424-2.508, P＜0.05）. Conclusion CAD and T2 DM have an interactive effect on the elevation of serum apoCⅢ and RLP-C. RLP-C exerted a partial mediating effect between apoCⅢ and Gensini score. ApoCⅢ was an independent risk factor for CAD compliacted with T2 DM.