Huang Weihua, Lv Tianming, Li Huanmin, Du Shuhua, Yang Canhong, Yuan Shiqi
Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2018 Jul 30;38(8):992-996. doi: 10.3969/j.issn.1673-4254.2018.08.15.
To investigate the correlation of apolipoprotein AI (ApoAI), ApoB, ApoB/ApoAI and the severity of brain white matter lesions (WML).
A total of 648 patients with WML confirmed by brain magnetic resonance imaging (MRI) were divided into mild WML group (=386) and moderate to severe WML group (=262) according to evaluations with the Fazekas scale. The demographic data, blood biochemical parameters and the levels of ApoAI, ApoB and ApoB/AI ratio were compared between the two groups to identify the risk factors of moderate to severe WML.
Univariate analysis showed that age, gender, hypertension, diabetes, coronary heart disease, previous stroke, homocysteine, HDL-C, ApoAI, and ApoB/AI ratio all differed significantly between the two groups ( < 0.05), but ApoB levels were similar between them ( > 0.05). Multivariate logistic regression analysis revealed that with ApoAI and ApoB/AI ratio as the continuous variables, after adjustment for the compounding factors, ApoB/AI ratio was an independent risk factor (OR=11.456, 95% : 3.622-36.229, < 0.001) and ApoAI was an independent protective factor for moderate to severe WML (OR=0.068, 95% : 0.018-0.262, < 0.001). With the upper quartiles of ApoAI level (1.38 g/L) and ApoB/AI ratio (0.58) as their respective cutoff values, patients with a high ApoAI level and a low ApoB/AI ratio were found to have the lowest incidence of moderate to severe WML ( < 0.001).
An increased ApoB/AI ratio is an independent risk factor and an increased ApoAI level is an independent protective factor for moderate to severe WML.
探讨载脂蛋白AI(ApoAI)、载脂蛋白B(ApoB)、ApoB/ApoAI与脑白质病变(WML)严重程度的相关性。
选取648例经脑磁共振成像(MRI)确诊为WML的患者,根据 Fazekas量表评估分为轻度WML组(n = 386)和中度至重度WML组(n = 262)。比较两组的人口统计学数据、血液生化参数以及ApoAI、ApoB和ApoB/AI比值水平,以确定中度至重度WML的危险因素。
单因素分析显示,两组间年龄、性别、高血压、糖尿病、冠心病、既往卒中、同型半胱氨酸、高密度脂蛋白胆固醇(HDL-C)、ApoAI以及ApoB/AI比值均有显著差异(P < 0.05),但ApoB水平相似(P > 0.05)。多因素logistic回归分析显示,以ApoAI和ApoB/AI比值作为连续变量,校正混杂因素后,ApoB/AI比值是中度至重度WML的独立危险因素(比值比[OR]=11.456,95%可信区间[CI]:3.622 - 36.229,P < 0.001),而ApoAI是中度至重度WML的独立保护因素(OR = 0.068,95%CI:0.018 - 0.262,P < 0.001)。以ApoAI水平的上四分位数(1.38 g/L)和ApoB/AI比值的上四分位数(0.58)分别作为各自的截断值,发现ApoAI水平高且ApoB/AI比值低的患者中度至重度WML的发生率最低(P < 0.001)。
ApoB/AI比值升高是中度至重度WML的独立危险因素,而ApoAI水平升高是其独立保护因素。