School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China.
Department of General Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, 169 Hushan Road, Nanjing 211166, China.
Eur J Prev Cardiol. 2024 Jul 23;31(9):1183-1194. doi: 10.1093/eurjpc/zwae080.
Research has shown that apolipoproteins (Apos) are potential indicators of heart health and death. We investigated the associations of Apo levels with all-cause and cardiovascular mortality.
We systematically searched the Cochrane Library, PubMed, and Web of Science for English language studies up to 28 November 2022. We used Stata 17.0 to summarize the estimated effects with 95% confidence intervals (CIs). We also conducted subgroup analyses according to study location, year of publication, individual age, follow-up years, and sample size. Moreover, we performed a sensitivity analysis to evaluate bias in our study. This study included 23 studies with 152 854 individuals in total. The level of ApoA was negatively related to cardiovascular mortality [odds ratio (OR) = 0.69, 95% CI = 0.52-0.93]. An increased ratio of ApoB/A1 was a risk factor for cardiovascular mortality (OR = 2.13, 95% CI = 1.48-3.07) and all-cause mortality (OR = 2.05, 95% CI = 1.52-2.77). The level of ApoB was positively related to cardiovascular mortality (OR = 1.12, 95% CI = 0.85-1.47), but the difference was not statistically significant. However, the associations between ApoB or ApoA1 and all-cause mortality were not obvious. Our subgroup analyses showed that the location, year of publication, individual age, and follow-up years of the studies affected the heterogeneity of our study to varying degrees. The sensitivity analysis showed that our results were almost robust, apart from excluding the article by Nomikos (OR = 0.77, 95% CI = 0.65-0.92) and Zeng (OR = 0.77, 95% CI = 0.65-0.91), when investigating the relationship between ApoA1 and all-cause mortality.
In this study, we found that Apo levels were linked to cardiovascular and all-cause mortality. Our study strengthens the evidence on the association between the level of Apos and cardiac health and may provide ideas for regulating the level of Apos to promote public health.
研究表明载脂蛋白（Apos）是心脏健康和死亡的潜在指标。我们研究了 Apo 水平与全因和心血管死亡率的关系。
我们系统地检索了 Cochrane 图书馆、PubMed 和 Web of Science 上截至 2022 年 11 月 28 日的英文研究。我们使用 Stata 17.0 汇总了 95%置信区间（CI）的估计效应。我们还根据研究地点、发表年份、个体年龄、随访年限和样本量进行了亚组分析。此外，我们进行了敏感性分析以评估我们研究中的偏差。本研究共纳入 23 项研究，共纳入 152854 人。ApoA 水平与心血管死亡率呈负相关[比值比（OR）=0.69，95%CI=0.52-0.93]。ApoB/A1 比值升高是心血管死亡率（OR=2.13，95%CI=1.48-3.07）和全因死亡率（OR=2.05，95%CI=1.52-2.77）的危险因素。ApoB 水平与心血管死亡率呈正相关（OR=1.12，95%CI=0.85-1.47），但差异无统计学意义。然而，ApoB 或 ApoA1 与全因死亡率之间的关联并不明显。我们的亚组分析表明，研究的地点、发表年份、个体年龄和随访年限在不同程度上影响了我们研究的异质性。敏感性分析表明，除了排除 Nomikos（OR=0.77，95%CI=0.65-0.92）和 Zeng（OR=0.77，95%CI=0.65-0.91）的文章外，我们的研究结果几乎是稳健的，当调查 ApoA1 与全因死亡率之间的关系时。
在这项研究中，我们发现 Apo 水平与心血管和全因死亡率有关。我们的研究加强了 Apos 水平与心脏健康之间关联的证据，可能为调节 Apos 水平以促进公众健康提供思路。
