Apolipoprotein A-IV concentrations and cancer in a large cohort of chronic kidney disease patients: results from the...

Area of Science:

• Nephrology
• Oncology
• Biochemistry

Background:

• Chronic kidney disease (CKD) is associated with increased inflammation and oxidative stress, elevating cancer risk.
• Serum apolipoprotein A-IV (apoA-IV) is a potential biomarker for kidney impairment with known antioxidant and anti-inflammatory properties.
• Previous studies suggest low apoA-IV may indicate cancer, but prospective data in CKD cohorts are lacking.

Purpose of the Study:

• To investigate the association between serum apoA-IV concentrations and cancer incidence in a large prospective cohort of patients with CKD.
• To determine if apoA-IV levels predict the risk of developing, or dying from, cancer in the context of chronic kidney disease.

Main Methods:

• Analysis of 5039 Caucasian patients from the German Chronic Kidney Disease (GCKD) study with a follow-up of 6.5 years.
• Inclusion criteria: eGFR 30-60 mL/min/1.73m² or eGFR >60 mL/min/1.73m² with proteinuria.
• Serum apoA-IV concentrations were measured and correlated with cancer history, incident cancer events, and fatal cancer outcomes.

Main Results:

• ApoA-IV concentrations above the median were associated with a lower odds of a prior cancer history (OR=0.79, p=0.02) after adjustment for confounders.
• Patients with apoA-IV above the median showed a significantly lower risk of developing incident cancer (HR=0.72, p=0.004).
• Higher apoA-IV levels were independently associated with a reduced risk of fatal cancer events (HR=0.62 per 10 mg/dL increase, p=0.007).

Conclusions:

• Elevated serum apoA-IV concentrations are associated with a decreased risk of prevalent cancer history and incident cancer events in CKD patients.
• High apoA-IV levels correlate with a lower risk of fatal cancer outcomes in this cohort.
• Serum apoA-IV may serve as a promising prognostic biomarker for cancer risk and outcomes in individuals with chronic kidney disease.