Lipoprotein(a) and the Risk of Chronic Kidney Disease in Hospitalized Japanese Patients
Lipoprotein(a) and the Risk of Chronic Kidney Disease in Hospitalized Japanese Patients
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DOI：
10.2169/internalmedicine.4503-20
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发表时间：
2020-01-01
影响因子：
1.2
通讯作者：
Kawashiri, Masa-aki
中科院分区：
文献类型：
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作者：
Tada, Hayato;Yamagami, Kan;Kawashiri, Masa-aki
目的脂蛋白(a)或Lp(a)已被证明与不同种族人群中慢性肾脏疾病（CKD）的发展相关。本研究旨在探讨日本患者血清Lp(a)与CKD之间的关系。方法回顾性分析2004年4月至2014年3月在金泽大学医院因任何原因（如任何类型的手术需要长时间卧床休息或动脉粥样硬化的危险因素，如高血压或糖尿病）接受血清Lp(A)水平评估的6130例受试者。其中，1895名受试者因缺乏临床资料而被排除。评估受试者的Lp(a)、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯、高血压、糖尿病、吸烟、体重指数（BMI）、冠状动脉疾病（CAD）和CKD（>= 3期）。当研究对象按Lp(a)水平分成四分位数时，观察到CKD存在的显著趋势（p = 2.7x10(-13)）。多元回归分析显示Lp(A)与CKD显著相关[比值比（OR）， 1.12；95%置信区间（CI）， 1.08-1.17；p = 1.3x10(-6)，每10mg /dL]，独立于其他经典危险因素，包括年龄、性别、BMI、高血压、糖尿病、吸烟、低密度脂蛋白胆固醇和甘油三酯。在这些条件下，Lp(a)与CAD显著相关（OR = 1.11, 95% CI = 1.06-1.16; p = 1.7x10(-6)，每10 mg/dL），独立于其他危险因素。结论血清Lp(a)与CKD相关，独立于日本人群中的其他经典危险因素。
Objective Lipoprotein(a), or Lp(a), has been shown to be associated with the development of chronic kidney disease (CKD) in populations of various ethnicities. This study aimed to investigate the association between serum Lp(a) and CKD in Japanese patients.Methods A total of 6,130 subjects who underwent a serum Lp(a) level assessment for any reason (e.g. any type of surgery requiring prolonged bed rest or risk factors for atherosclerosis, such as hypertension or diabetes) were retrospectively investigated at Kanazawa University Hospital from April 2004 to March 2014. Of these, 1,895 subjects were excluded because of the lack of clinical data. Subjects were assessed for Lp(a), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, hyperten-sion, diabetes, smoking, body mass index (BMI), coronary artery disease (CAD), and CKD (stage >= 3).Results When the study subjects were divided into quartiles of Lp(a) levels, significant trends were observed with regard to the presence of CKD (p = 2.7x10(-13)). A multiple regression analysis showed that Lp(a) was significantly associated with CKD [odds ratio (OR), 1.12; 95% confidence interval (CI), 1.08-1.17; p = 1.3x10(-6), per 10 mg/dL], independent of other classical risk factors, including age, gender, BMI, hypertension, diabetes, smoking, LDL cholesterol, and triglycerides. Under these conditions, Lp(a) was significantly associated with CAD (OR = 1.11, 95% CI = 1.06-1.16; p = 1.7x10(-6), per 10 mg/dL), independent of other risk factors.Conclusion Serum Lp(a) was associated with CKD, independent of other classical risk factors in a Japanese population.