小的阿波利波蛋白 (a) 尺寸预测末期脏疾病的死亡率:CHOICE研究
J Craig Longenecker1, Michael J Klag, Santica M Marcovina
1Johns Hopkins University, Baltimore, Md 21205, USA. jlongene@jhsph.edu
Circulation
|November 27, 2002
概括
小小的阿波利波蛋白[a] [a] 异形大小,而不是脂蛋白[a] [Lp] 水平,独立预测透析患者的死亡率. 这一发现对于理解末期脏疾病中心血管疾病风险至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 遗传学 是一个遗传学.
背景情况:
- 末期脏疾病 (ESRD) 与高死亡率有关,特别是由于动脉样硬化心血管疾病 (ASCVD).
- 升高的脂蛋白 (a) [Lp (a) ]水平和小的阿波利波蛋白 (a) [阿波 (a) ]异形大小被认为是ESRD中ASCVD风险因素.
- 透患者的死亡率Lp (a) 水平和apo (a) 大小对透析患者的独立影响尚不清楚.
研究的目的:
- 调查Lp(a) 水平,apo(a) 尺寸和发生性透析患者的全因死亡率之间的关系.
- 确定Lp(a) 水平或apo(a) 尺寸是否是这种高风险人群中死亡率的独立预测指标.
主要方法:
- 展望性队列研究 864 个事件透析患者.
- Lp (a) 值是用一个 apo (a) 尺寸独立的 ELISA 测量.
- Apo (((a) 尺寸由SDS-糖凝电泳后的西部斑点确定.
- 使用考克斯回归的生存分析,根据人口统计和临床因素进行调整.
主要成果:
- 在Lp (a) 水平和死亡率之间没有发现显著的关联.
- 一个小的apo(a) 异形大小独立地与增加的总死亡率有关 (危险比,1.36;P=0.004).
- 这种关联在白人和黑人患者中都被观察到,在黑人患者中效果更强.
结论:
- 独立于Lp (a) 水平的小apo (a) 尺寸是透析患者总死亡率的重要预测指标.
- 这些发现凸显了apo (a) 异型大小在评估ESRD心血管风险方面的重要性.
- 进一步的研究可能会阐明将小鱼与这一群体的死亡率联系在一起的机制.
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