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血清脂蛋白(a)与轻度降低的 eGFR 之间的关联:一项横断面研究。

Association between serum lipoprotein(a) and mildly reduced eGFR: a cross-sectional study.

机构信息

Department of Endocrine and Metabolic Diseases, The First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, 185 Juqianjie Road, Changzhou, Jiangsu, 213000, China.

Department of Endocrine and Metabolic Diseases, The First People's Hospital of Hefei, Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, China.

出版信息

BMC Nephrol. 2023 Dec 8;24(1):364. doi: 10.1186/s12882-023-03417-6.


DOI:10.1186/s12882-023-03417-6
PMID:38066475
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10709843/
Abstract

Lipoprotein(a) [Lp(a)] is a risk factor for cardiovascular disease (CVD) and aortic stenosis. However, the data on the relationship between Lp(a) and mildly reduced estimated glomerular filtration rate (eGFR) has been disputed. This study was conducted to assess the relationship between Lp(a) concentrations and mildly reduced eGFR in healthy subjects.This community-based, cross-sectional study enrolled 1,064 volunteers aged ≥ 40 years who lived in Yonghong Community, Zhonglou District, Changzhou, China, between December 2016 and December 2017. A mildly reduced eGFR was defined as eGFR between 60 and 90 mL/min/1.73m. A standardized questionnaire and biochemical measurements were used to gather information about participants. The serum concentration of Lp(a) was determined using the latex-enhanced immunoturbidimetric test. Of the total study population, 34.8% (n = 370) were men, and the mean age was 66.8 ± 8.5 years. A significant association existed between Lp(a) levels and the risk of mildly reduced eGFR. Individuals with the highest tertile of Lp(a) had higher odds of mildly reduced eGFR after adjusting for various confounders (adjusted odds ratio [OR]: 1.80, 95% confidence interval [CI]: 1.24-2.60, P = 0.0025) compared to those with the lowest tertile of Lp(a). Multivariable logistic regression of studies in which Lp(a) was presented as continuous variables showed consistent results (adjusted OR: 1.23 for 1-SD increment of Ln-Lp(a), 95% CI: 1.05-1.43). Subgroup analyses showed that study characteristics such as age, sex, obesity, diabetes, and hypertension status did not significantly affect the association (P for all interactions > 0.05). These results suggest that higher serum Lp(a) level was an independent risk factor for mildly reduced eGFR.

摘要

脂蛋白(a) [Lp(a)] 是心血管疾病 (CVD) 和主动脉瓣狭窄的一个风险因素。然而,关于 Lp(a) 与轻度降低的估算肾小球滤过率 (eGFR) 之间的关系的数据一直存在争议。本研究旨在评估健康受试者中 Lp(a) 浓度与轻度降低的 eGFR 之间的关系。

这项基于社区的横断面研究招募了 2016 年 12 月至 2017 年 12 月期间居住在中国常州市钟楼区永红社区的 1064 名年龄≥40 岁的志愿者。轻度降低的 eGFR 定义为 eGFR 在 60 至 90 mL/min/1.73m 之间。使用标准化问卷和生化测量收集参与者的信息。使用乳胶增强免疫比浊法测定血清 Lp(a) 浓度。在总研究人群中,34.8%(n=370)为男性,平均年龄为 66.8±8.5 岁。Lp(a) 水平与轻度降低的 eGFR 风险之间存在显著关联。在校正了各种混杂因素后,Lp(a) 水平最高三分位的个体发生轻度降低的 eGFR 的可能性高于 Lp(a) 水平最低三分位的个体(校正优势比[OR]:1.80,95%置信区间[CI]:1.24-2.60,P=0.0025)。对以连续变量形式呈现 Lp(a) 的研究进行多变量逻辑回归分析,结果一致(校正 OR:Ln-Lp(a) 增加 1-SD 时为 1.23,95%CI:1.05-1.43)。亚组分析表明,年龄、性别、肥胖、糖尿病和高血压状态等研究特征并未显著影响这种关联(所有交互作用的 P 值均>0.05)。这些结果表明,较高的血清 Lp(a) 水平是轻度降低的 eGFR 的一个独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764d/10709843/e1e44cd06288/12882_2023_3417_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764d/10709843/ea6aee78e3c6/12882_2023_3417_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764d/10709843/cedf4aa82e41/12882_2023_3417_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764d/10709843/e1e44cd06288/12882_2023_3417_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764d/10709843/ea6aee78e3c6/12882_2023_3417_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764d/10709843/cedf4aa82e41/12882_2023_3417_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764d/10709843/e1e44cd06288/12882_2023_3417_Fig3_HTML.jpg

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[1]
Association between serum lipoprotein(a) and mildly reduced eGFR: a cross-sectional study.

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引用本文的文献

[1]
Association between lipoprotein(a) plasma levels and diabetic nephropathy in Han Chinese patients with type 2 diabetes mellitus.

PLoS One. 2024

本文引用的文献

[1]
Metabolically healthy obesity is associated with higher risk of both hyperfiltration and mildly reduced estimated glomerular filtration rate: the role of serum uric acid in a cross-sectional study.

J Transl Med. 2023-3-23

[2]
Sex Differences in Dementia.

Curr Top Behav Neurosci. 2023

[3]
Difference in the Standard and Novel Lipid Profile Parameters Between Patients With Alzheimer's Disease and Vascular Dementia Stratified by the Degree of Cognitive Impairment.

Mater Sociomed. 2022-6

[4]
Sex and Gender Differences in Kidney Transplantation.

Semin Nephrol. 2022-3

[5]
Lipoprotein(a) and Subclinical Vascular and Valvular Calcification on Cardiac Computed Tomography: The Atherosclerosis Risk in Communities Study.

J Am Heart Assoc. 2022-6-7

[6]
Effects of high-intensity interval training on improving arterial stiffness in Chinese female university students with normal weight obese: a pilot randomized controlled trial.

J Transl Med. 2022-2-2

[7]
Association of Lipoprotein(a)-Associated Mortality and the Estimated Glomerular Filtration Rate Level in Patients Undergoing Coronary Angiography: A 51,500 Cohort Study.

Front Cardiovasc Med. 2021-11-17

[8]
Association of Mildly Reduced Kidney Function With Cardiovascular Disease: The Framingham Heart Study.

J Am Heart Assoc. 2021-8-17

[9]
Chronic kidney disease.

Lancet. 2021-8-28

[10]
Beyond Lipoprotein(a) plasma measurements: Lipoprotein(a) and inflammation.

Pharmacol Res. 2021-7

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