Relationship between apolipoprotein A levels and chronic kidney disease stage 4-5 in Chinese type 2 diabetes...

Current evidence regarding the association between apolipoprotein A (ApoA) and chronic kidney disease (CKD) stages 4-5 in the Chinese population is scarce. Clarifying this relationship holds critical clinical significance for public health interventions. This study aimed to evaluate whether ApoA levels are associated with CKD stage 4-5 in type 2 diabetes patients.

This cross-sectional study included T2DM patients with CKD from Guangdong Provincial People's Hospital (2017-2018), using data from the Dryad database. Logistic regression, smooth-curve fitting, and subgroup analyses were performed. Propensity score matching (PSM) and doubly robust tests were used to validate the findings.

A total of 503 individuals were included in the study after applying the inclusion and exclusion criteria. Higher ApoA levels were associated with older age, longer diabetes duration, and worse lipid profiles. Multivariable regression showed an independent inverse association: compared with T1, highest ApoA (T3) was associated with 87% lower odds of prevalent CKD (OR = 0.13, 95%CI 0.03-0.51, p = 0.003). No significant interactions were found for age, sex, diabetes mellitus (DM) duration and presence of diabetic retinopathy (DR) (p for interaction > 0.05). These associations persisted after PSM and doubly robust analyses.

Higher serum ApoA levels were independently correlated with a lower odds of advanced CKD stages 4-5 in Chinese patients with type 2 diabetes.