The aim of this study was to compare the performance of various lipid and apolipoprotein ratios in predicting cardiovascular risk in 9,795 patients with type 2 diabetes from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study for a median follow-up of 5 years. Results showed that ratios that take into account concentrations of atherogenic and anti-atherogenic lipoproteins such as total cholesterol/HDL cholesterol, non-HDL cholesterol/HDL cholesterol, LDL cholesterol/HDL cholesterol and apolipoprotein B/apolipoprotein AI performed better than any single lipid and apolipoprotein in predicting cardiovascular events. The hazard ratio (HR) for the apolipoprotein B/ apolipoprotein AI ratio was found to be as strong as HRs for traditional lipid ratios in this cohort. These findings do not support the necessity to replace traditional lipids and their ratios with apolipoprotein B, apolipoprotein AI and their ratio to predict cardiovascular risk.
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