Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuchang district, Wuhan, 430060, Hubei, China.
Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China.
Lipids Health Dis. 2021 Oct 9;20(1):130. doi: 10.1186/s12944-021-01535-4.
High serum Lipoprotein(a) (Lp(a)) level and Apolipoprotein B/Apolipoprotein AΙ (ApoB/ApoA-Ι) ratio are risk factors for cardiovascular disease and kidney disease and have been found to be correlated with the prevalence and prognosis of various kidney diseases. However, it is not clear whether the serum Lp(a) level and ApoB/ApoA-Ι ratio pre-PCI are correlated with the prevalence of contrast-induced acute kidney injury (CI-AKI).
A total of 931 participants undergoing emergency PCI from July 2018 to July 2020 were included. According to whether the serum creatinine concentration was higher than the baseline concentration (by ≥25% or ≥ 0.5 mg/dL) 48-72 h after contrast exposure, these participants were divided into a CI-AKI group (n = 174) and a non-CI-AKI group (n = 757). Serum Lp(a), ApoA-Ι and ApoB concentration were detected in the patients when they were admitted to hospital, and the ApoB/ApoA-Ι ratio was calculated. Logistic regression and restricted cubic spline analyses were used to explore the correlation between the Lp(a) concentration or the ApoB/ApoA-Ι ratio and the risk of CI-AKI.
Among the 931 participants undergoing emergency PCI, 174 (18.69%) participants developed CI-AKI. Compared with the non-CI-AKI group, the Lp(a) level and ApoB/ApoA-Ι ratio pre-PCI in the CI-AKI group were significantly higher (P < 0.05). The incidence of CI-AKI was positively associated with the serum Lp(a) level and ApoB/ApoA-Ι ratio pre-PCI in each logistic regression model (P < 0.05). After adjusting for all the risk factors included in this study, restricted cubic spline analyses found that the Lp(a) level and the ApoB/ApoA-Ι ratio before PCI, within certain ranges, were positively associated with the prevalence of CI-AKI.
High Lp(a) levels and high ApoB/ApoA-Ι ratios before PCI are potential risk factors for CI-AKI.
高血清脂蛋白（a）（Lp(a)）水平和载脂蛋白 B/载脂蛋白 AΙ（ApoB/ApoA-Ι）比值是心血管疾病和肾脏疾病的危险因素，并且已经发现与各种肾脏疾病的患病率和预后相关。然而，目前尚不清楚经皮冠状动脉介入治疗（PCI）前的血清 Lp(a)水平和 ApoB/ApoA-Ι 比值是否与对比剂诱导的急性肾损伤（CI-AKI）的患病率相关。
本研究纳入了 2018 年 7 月至 2020 年 7 月期间行急诊 PCI 的 931 名患者。根据造影剂暴露后 48-72 小时血清肌酐浓度是否高于基线浓度（≥25%或≥0.5mg/dL），将这些患者分为 CI-AKI 组（n=174）和非 CI-AKI 组（n=757）。患者入院时检测血清 Lp(a)、ApoA-Ι 和 ApoB 浓度，并计算 ApoB/ApoA-Ι 比值。采用 logistic 回归和限制性立方样条分析探讨 Lp(a)浓度或 ApoB/ApoA-Ι 比值与 CI-AKI 风险之间的相关性。
在 931 例行急诊 PCI 的患者中，174 例（18.69%）患者发生 CI-AKI。与非 CI-AKI 组相比，CI-AKI 组 PCI 前的 Lp(a)水平和 ApoB/ApoA-Ι 比值显著升高（P<0.05）。在每个 logistic 回归模型中，CI-AKI 的发生率与 PCI 前的血清 Lp(a)水平和 ApoB/ApoA-Ι 比值呈正相关（P<0.05）。在校正了本研究中包含的所有危险因素后，限制性立方样条分析发现，在一定范围内，PCI 前的 Lp(a)水平和 ApoB/ApoA-Ι 比值与 CI-AKI 的患病率呈正相关。
PCI 前高 Lp(a)水平和高 ApoB/ApoA-Ι 比值是 CI-AKI 的潜在危险因素。
