Department of Nephrology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Ren Fail. 2020 Nov;42(1):323-328. doi: 10.1080/0886022X.2020.1745235.
Few studies have investigated the association of apolipoprotein B (ApoB) with the progression of diabetic kidney disease (DKD) and the risk of renal replacement therapy (RRT). In this retrospective cohort study, a group of 258 DKD patients with stage 3-5chronic kidney disease(CKD)were divided into low ApoB (<1.1 g/L) and high ApoB (≥1.1 g/L) groups and followed-up for 20.51 ± 6.11 months. The association of the serum ApoB concentration with RRT was determined by Kaplan-Meier and Cox regression analysis. ApoB was measured in the serum. Ninety-three of the 258 DKD patients needed RRT during follow-up. Kaplan-Meier analysis showed that patients with high ApoB were significantly more likely to progress to RRT than those with low ApoB (log-rank = 16.62, < 0.001). The presence of high ApoB increased the risk of RRT. Analysis of ApoB as either a categorical (<1.1 g/L or ≥1.1 g/l) or continuous variable by univariate and multivariate regression found that ApoB was an independent risk factor of DKD progression to RRT in this group of DKD patients with stage 3-5 CKD ( < 0.05). Increased ApoB was an independent predictor of progression to RRT. A larger study is needed to confirm the unfavorable prognosis of increased ApoB in DKD patients.
很少有研究调查载脂蛋白 B (ApoB) 与糖尿病肾病 (DKD) 进展和肾脏替代治疗 (RRT) 风险的关系。在这项回顾性队列研究中，将 258 例患有 3-5 期慢性肾脏病 (CKD) 的 DKD 患者分为低 ApoB(<1.1g/L) 和高 ApoB(≥1.1g/L) 组，并随访 20.51±6.11 个月。通过 Kaplan-Meier 和 Cox 回归分析确定血清 ApoB 浓度与 RRT 的关系。检测血清中的 ApoB。在随访期间，258 例 DKD 患者中有 93 例需要 RRT。Kaplan-Meier 分析显示，高 ApoB 组患者进展为 RRT 的可能性明显高于低 ApoB 组(log-rank = 16.62， < 0.001)。高 ApoB 的存在增加了 RRT 的风险。通过单因素和多因素回归分析将 ApoB 作为分类变量(<1.1g/L 或≥1.1g/L)或连续变量进行分析，发现 ApoB 是该组 3-5 期 CKD DKD 患者进展为 RRT 的独立危险因素( < 0.05)。ApoB 升高是 RRT 进展的独立预测因子。需要更大的研究来证实 ApoB 升高对 DKD 患者预后不利。
