Li Yuqun, Wu Qilan, Li Zhenxing, Xiao Yang, Wei Liping
The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China.
Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 May 23;20:1639-1650. doi: 10.2147/COPD.S512096. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) is a serious disease with significantly higher mortality. Evidence suggests that there may be a co-relation between ApoE and the mortality risk in individuals who are diagnosed with COPD. This study sought to investigate the correlation between the levels of ApoE and all-cause mortality over one year in individuals who are diagnosed with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).
In this study, we checked serum ApoE concentrations of AECOPD patients on admission and collected the patients' laboratory and clinical information. The co-relation between the concentration of ApoE and one year risk of all-cause mortality was analyzed by univariate, multivariate Cox regression and Subgroup analysis. Restricted Cubic Spline (RCS) were employed to illustrate the connection between ApoE levels and the hazard ratio (HR) for one-year total mortality rate.
Of the 449 participants who were enrolled, 358 patients were included in the study. The mean age was 76 (±9.46) years old, of which 65.92% were male. The body-mass index was 22.18 (±4.66). Of the participants, 24.86% were non-smokers, 54.75% were former smokers, and 20.39% were active smokers, with a smoking history of 28.68 (±20.43) years. The restricted cubic spline curve revealed that patients exhibiting ApoE concentrations exceeding the mean value of 41.50 mg/L faced a notably higher risk of mortality in comparison to individuals with lower levels. In univariate analysis, the HR was 2.663 (95% CI 1.533-4.627, P = 0.001), but in adjusted analyses, the HR was 2.103 (95% CI 1.19-3.716, P = 0.01).
Elevated levels of ApoE were independently risk factor for one-year mortality in patients with AECOPD. Subgroup analyses revealed that the association was stronger in younger patients (<76 years) and male, as well as in those without comorbidities such as congestive heart failure or cerebrovascular disease. This suggests that ApoE may be a potential prognostic biomarker for AECOPD.
慢性阻塞性肺疾病（COPD）是一种死亡率显著更高的严重疾病。有证据表明，载脂蛋白E（ApoE）与被诊断为COPD的个体的死亡风险之间可能存在关联。本研究旨在调查被诊断为慢性阻塞性肺疾病急性加重（AECOPD）的个体中ApoE水平与一年全因死亡率之间的相关性。
在本研究中，我们检测了AECOPD患者入院时的血清ApoE浓度，并收集了患者的实验室和临床信息。通过单因素、多因素Cox回归和亚组分析，分析了ApoE浓度与一年全因死亡风险之间的相关性。采用限制立方样条（RCS）来阐明ApoE水平与一年总死亡率的风险比（HR）之间的关系。
在纳入的449名参与者中，358名患者被纳入研究。平均年龄为76（±9.46）岁，其中65.92%为男性。体重指数为22.18（±4.66）。在参与者中，24.86%为非吸烟者，54.75%为既往吸烟者，20.39%为当前吸烟者，吸烟史为28.68（±20.43）年。限制立方样条曲线显示，与水平较低的个体相比，ApoE浓度超过平均值41.50mg/L的患者面临的死亡风险显著更高。在单因素分析中，HR为2.663（95%CI 1.533 - 4.627，P = 0.001），但在调整分析中，HR为2.103（95%CI 1.19 - 3.716，P = 0.01）。
ApoE水平升高是AECOPD患者一年死亡率的独立危险因素。亚组分析显示，这种关联在年龄较小（<76岁）的患者、男性以及没有充血性心力衰竭或脑血管疾病等合并症的患者中更强。这表明ApoE可能是AECOPD的一种潜在预后生物标志物。
