The Correlation Between Serum Lipoprotein(a)and the Progression of Chronic Kidney Disease with the Exploration of Risk Factors
Objective To investigate the correlation between serum lipoprotein(a)[Lipoprotein(a),Lp(a)]and the progression of chronic kidney disease(Chronic kidney disease,CKD),so as to evaluate the value of Lp(a)in predicting the progression of CKD,and to further identify risk factors that influence CKD progression.Methods A total of 866 CKD patients who were admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from June,2019 to October,2023 were selected as the CKD group,while 84 healthy individuals who underwent physical examination in our hospital during the same period were selected as the healthy control group.Serum Lp(a)levels were measured by the immunoturbidimetric technique.Serum lipid metabolism and renal function indicators,including total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),apolipoprotein A(ApoA),apolipoprotein B(ApoB),creatinine(CREA),cystatin C(CysC),urea(UREA),uric acid(URIC),and estimated glomerular filtration rate(eGFR),were detected by the enzyme colorimetric method.Results The serum Lp(a)level in the CKD group was significantly higher than that in the healthy control group(P＜0.01).There were also significant differences in Lp(a)and other blood lipid indicators,such as TC,HDL,LDL,ApoA,and ApoB,among different stages of CKD groups(all P＜0.01).Correlation analysis showed that the serum Lp(a)level in stage 1-5 CKD group increased,and they were positively correlated(r=0.938,P＜0.05).ROC curve analysis showed that the optimal cutoff value of serum Lp(a)was 13.45 mg/dL.The area under ROC curve(AUC)for predicting CKD progression was 0.732,with the sensitivity of 67.47％,and the specificity of 67.27％.Logistic regression analysis showed that Lp(a),ApoA,CysC,and UREA were independent risk factors for the progression of CKD(all P＜0.05).Furthermore,HDL,ApoB,CREA,and eGFR were protective factors for the progression of CKD(all P＜0.05).Conclusion Elevated serum Lp(a)is an independent risk factor for the progression of CKD.Lp(a)level is closely related to the CKD stages,which is of great significance for controlling CKD progression,delaying end-stage renal failure,and improving the survival rate of CKD patients.
Chronic kidney diseaseLipoprotein(a)Lipid metabolismKidney function
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