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The association between the apolipoprotein B/A-I ratio and coronary calcification may differ depending on kidney
Seok-Hyung Kim1, Donghwan Oh1, Kwon Soo Jung1
1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Insights
The apolipoprotein B/A-I ratio is a strong cardiovascular risk predictor, but its association with coronary artery calcification differs based on kidney function. In individuals with normal kidney function, a higher ratio indicates increased risk, but this link is lost in mild renal insufficiency.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Biochemistry
Background:
- The apolipoprotein B/A-I ratio is a recognized predictor of cardiovascular events.
- Its prognostic significance in cardiovascular disease, particularly in patients with chronic kidney disease, remains under investigation.
- Understanding how kidney function influences this association is crucial for accurate risk assessment.
Purpose of the Study:
- To examine the relationship between the apolipoprotein B/A-I ratio and coronary artery calcification.
- To determine if this association is modified by varying levels of kidney function in a healthy population.
Main Methods:
- Cross-sectional analysis of 1,800 participants with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m².
- Participants were categorized based on kidney function: normal (eGFR ≥ 90) and mild renal insufficiency (eGFR 60-90 mL/min/1.73 m²).
- Logistic regression analyses adjusted for confounders assessed the association between the apolipoprotein B/A-I ratio and coronary artery calcification (CAC).
Main Results:
- A higher apolipoprotein B/A-I ratio was observed in participants with coronary artery calcification.
- The ratio significantly predicted coronary artery calcification in individuals with normal kidney function (OR = 2.411, p = 0.011).
- This significant association was not observed in participants with mild renal insufficiency.
Conclusions:
- The predictive value of the apolipoprotein B/A-I ratio for coronary artery calcification is dependent on kidney function.
- In individuals with mild renal insufficiency, the apolipoprotein B/A-I ratio may not be a reliable indicator of coronary artery calcification.
- Further research is needed to clarify the role of this ratio in diverse kidney function populations.
Background:
The apolipoprotein B/A-1 ratio has been reported to be one of the strongest risk predictors of cardiovascular events. However, its prognostic value for cardiovascular disease is still uncertain, especially in patients with chronic kidney disease. This study aimed to investigate whether the association between the apolipoprotein B/A-I ratio and coronary artery calcification differed according to kidney function in a healthy population.
Methods:
Of the data from 7,780 participants from the medical records database in Gangnam Severance Hospital from 2005 through 2016, a cross-sectional analysis included participants with an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 determined based on the Chronic Kidney Disease -Epidemiology Collaboration equation (n = 1,800). Mild renal insufficiency was defined as an eGFR of 60-90 mL/min/1.73 m2. Coronary artery calcification measured with computed tomography was defined as an above-zero score. Logistic regression analyses were used to determine the association between coronary calcification and the apolipoprotein B/A-I ratio according to eGFR by adjusting for the influence of confounders.
Results:
The mean apolipoprotein B/A-I level was significantly higher in the participants with coronary artery calcification than in the participants without coronary artery calcification. The apolipoprotein B/A-I ratio was significantly different according to coronary artery calcification in the participants with normal kidney function, but in the participants with mild renal insufficiency, it was not different. After adjusting for age, male sex, systolic blood pressure, body mass index, current smoking status, and fasting plasma glucose, the apolipoprotein B/A-I ratio was significantly associated with an increased risk of coronary artery calcification in participants with normal kidney function (odds ratio = 2.411, p = 0.011), while in the participants with mild renal insufficiency, the apolipoprotein B/A-I ratio was not associated with coronary artery calcification.
Conclusion:
Our study showed that the predictive value of apolipoprotein B/A-I ratio for coronary artery calcification may differ according to kidney function.
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