Association of apolipoproteins with incidence of decreased estimated GFR in Korean men

Abstract

Background: Serum apolipoprotein level recently has been suggested to be associated with decreased eGFR (estimated glomerular filtration rate). However, it is not known whether serum apolipoprotein level is prospectively associated with the development of decreased eGFR.

Study design: Prospective cohort study.

Setting & participants: A cohort of 30,488 apparently healthy Korean men, who had participated in a medical health checkup program in 2005, was followed up until 2010.

Predictor: Apolipoprotein B (Apo-B), apolipoprotein A-I (Apo-AI), and Apo-B:AI ratio.

Outcomes & measurements: Decreased eGFR was defined as <60 mL/min/1.73 m(2). Analysis was performed with Cox proportional hazards models.

Results: During 104,742.8 person-years of follow-up, 147 incident cases of decreased eGFR developed between 2006 and 2010. Higher quartile groups of serum Apo-B were associated with lower baseline eGFR. After adjusting for multiple covariates, the risk of subsequent decreased eGFR was higher with higher quartile groups of serum Apo-B (compared with quartile 1 as the reference group, HRs for quartiles 2, 3, and 4 were 2.94 (95% CI, 1.40-6.17), 2.54 (95% CI, 1.07-6.01), and 5.65 (95% CI, 2.19-14.59), respectively (P for trend <0.001). Results were similar for Apo-B:AI ratio (P for trend = 0.003). However, after additional adjustment for baseline eGFR, associations were no longer significant.

Limitations: Measured GFR was not available.

Conclusions: Higher serum Apo-B and Apo-B:AI ratio values are associated with lower baseline eGFR and greater risk of subsequent decreased eGFR during 5 years of follow-up. Further studies are required to determine the causal relationships underlying these associations.