Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Anesthesiology, Changsha Central Hospital, Changsha, China.
Front Endocrinol (Lausanne). 2023 Apr 12;14:1083614. doi: 10.3389/fendo.2023.1083614. eCollection 2023.
Whether serum apolipoprotein B (ApoB) is a risk factor for the development of Chronic kidney disease (CKD) has not been fully established in the general population. Therefore, our study evaluated the correlation between serum ApoB level and CKD to look for an alternative approach for CKD prevention and treatment in the general population.
There were 146,533 participants in this cross-sectional study. 3,325 participants with more than 2 measurements were enrolled in the retrospective longitudinal study with at least a 3-year follow-up. ApoB was measured by the immunoturbidimetric method in 6 centers. Our study defined CKD as an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m. The Spearman rank correlation analysis and the Random Forest algorithm were applied to rank the importance of variables determining the levels of eGFR. We used the logistic regression model to explain the correlation between serum ApoB and CKD. We used the Cox model to detect the correlation between baseline serum ApoB and the subsequent occurrence of CKD.
Based on a cross-sectional study, 66.5% of the participants were males, with a median age of 49 (interquartile range [IQR] 43-55). Compared to the non-CKD group, the CKD group has higher levels of lipid profile and fasting glucose as well as the proportion of hypertension and hyperuricemia. The Spearman rank correlation analysis and the Random Forest algorithm revealed that ApoB has the highest correlation with eGFR decline among lipid profiles. The logistic regression analysis revealed that ApoB had a positive correlation with the prevalence of CKD after fully controlling confounders (odds ratio [OR], 1.07; 95% confidence interval [CI]: 1.02-1.11). Moreover, baseline ApoB level was correlated with a new-onset CKD in the longitudinal cohort after full adjustment for confounding factors (hazard ratio [HR], 1.61; 95% CI: 1.02-2.54). The correlation between ApoB level and the new-onset CKD was consistently observed in all sensitivity analyses.
Serum ApoB had the strongest correlation with CKD among all lipid variables. Moreover, high serum ApoB levels might precede the occurrence of CKD, suggesting that monitoring and reducing serum ApoB levels may provide an alternative method to prevent and treat CKD.
血清载脂蛋白 B（ApoB）是否是慢性肾脏病（CKD）发展的危险因素，在普通人群中尚未完全确定。因此，我们的研究评估了血清 ApoB 水平与 CKD 之间的相关性，以期为普通人群的 CKD 预防和治疗提供一种替代方法。
本横断面研究纳入了 146533 名参与者。在至少 3 年的随访后，有 3325 名参与者进行了至少 2 次测量，被纳入回顾性纵向研究。在 6 个中心采用免疫比浊法测定 ApoB。本研究将 CKD 定义为估计肾小球滤过率（eGFR）<90 mL/min/1.73 m。应用 Spearman 秩相关分析和随机森林算法对确定 eGFR 水平的变量的重要性进行排序。采用 logistic 回归模型解释血清 ApoB 与 CKD 之间的相关性。采用 Cox 模型检测基线血清 ApoB 与随后发生 CKD 的相关性。
基于横断面研究，66.5%的参与者为男性，中位年龄为 49（四分位间距[IQR]：43-55）。与非 CKD 组相比，CKD 组的血脂谱和空腹血糖水平较高，高血压和高尿酸血症的比例也较高。Spearman 秩相关分析和随机森林算法显示，ApoB 与血脂谱中 eGFR 下降的相关性最高。logistic 回归分析显示，在充分控制混杂因素后，ApoB 与 CKD 的患病率呈正相关（比值比[OR]：1.07；95%置信区间[CI]：1.02-1.11）。此外，在对混杂因素进行充分调整后，纵向队列中基线 ApoB 水平与新发 CKD 相关（风险比[HR]：1.61；95%CI：1.02-2.54）。在所有敏感性分析中，均观察到 ApoB 水平与新发 CKD 之间的相关性。
血清 ApoB 与所有血脂变量相比，与 CKD 的相关性最强。此外，高血清 ApoB 水平可能先于 CKD 的发生，提示监测和降低血清 ApoB 水平可能为 CKD 的预防和治疗提供一种替代方法。
