TY - JOUR
T1 - Association of apolipoprotein A1 and B with kidney function and chronic kidney disease in two multiethnic population samples
AU - Goek, Oemer Necmi
AU - Köttgen, Anna
AU - Hoogeveen, Ron C.
AU - Ballantyne, Christie M.
AU - Coresh, Josef
AU - Astor, Brad C.
N1 - Funding Information:
Acknowledgements. The ARIC Study is carried out as a collaborative study supported by National Heart, Lung and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN2682011000 07C, HHSN268201100008C, HHSN268201100009C, HHSN2682 01100010C, HHSN268201100011C and HHSN268201100012C) with the ARIC carotid MRI examination funded by U01HL075572-01. The authors thank the staff and participants of the ARIC study for their important contributions. The NHANES III dataset is publicly available, provided by The National Center for Health Statistics of the United States Centers for Disease Control and Prevention. The authors thank the staff and participants of the NHANES III study for their important contributions. Siemens Healthcare Diagnostics provided the reagents and loan of a BNII instrument to conduct the apolipoprotein assays. A poster based on these results was presented at the 2011 annual meeting of the German Society of Nephrology. O.-N.G. and A.K. were supported by the Emmy Noether Program of the German Research Foundation (KO 3598/2-1).
PY - 2012/7
Y1 - 2012/7
N2 - Background Circulating lipoproteins and their protein constituents, apolipoproteins, are risk factors for chronic kidney disease (CKD). The associations between apolipoprotein A1, apolipoprotein B and their ratio with glomerular filtration rate estimated from the new CKD Epidemiology Collaboration (CKD-EPI) equation (eGFR) are not well studied in the general population. Methods Associations between apolipoprotein A1, B and their ratio with the outcomes of eGFR, CKD (eGFR <60 mL/min/1.73m2) and albuminuria were examined in the Atherosclerosis Risk in Communities study (ARIC, n 10 292, 199698) and the Third National Health and Nutrition Examination Survey (NHANES III, n = 7023, 198891). Cross-sectional multivariable-adjusted analyses were performed using linear and logistic regression. Prospective analyses related baseline apolipoprotein levels to subsequent CKD incidence over 10 years using the ARIC Carotid MRI follow-up cohort (n = 1659). Results Higher apolipoprotein A1 quartiles were associated with a lower prevalence of CKD [Q4 versus Q1: odds ratio (OR) 0.73, P-trend 0.02 in ARIC; Q4 versus Q1: OR 0.53, P-trend <0.01 in NHANES III] as well as with higher eGFR (P-trend <0.01 in ARIC and NHANES III). No consistent significant associations were found for apolipoprotein B in either study. The apolipoprotein B/A1 ratio was significantly associated with eGFR across quartiles in both studies (P-trend <0.01) and with CKD in ARIC (Q4 versus Q1: OR 1.23, P-trend = 0.01). Prospectively, there were trends for the association of apolipoproteins with incident CKD [Q4 versus Q1: incidence rate ratio (IRR) 0.68 for apolipoprotein A1, P-trend 0.1; Q4 versus Q1: IRR 1.35 for apolipoprotein B, P-trend 0.2]. Associations were not systematically stronger when comparing traditional lipids (total cholesterol, low-density lipoprotein or high-density lipoprotein) to apolipoproteins. Conclusions Higher serum apolipoprotein A1 was associated with lower prevalence of CKD and higher eGFR estimated by the CKD-EPI equation in two large multiethnic population-based samples. While apolipoprotein B showed no consistent associations, a higher apolipoprotein B/A1 ratio was significantly associated with lower eGFR in both studies. The direction and magnitude of the longitudinal associations between apolipoproteins and CKD incidence were overall similar to those observed cross-sectionally. No consistent differences became apparent between traditional lipids and apolipoproteins.
AB - Background Circulating lipoproteins and their protein constituents, apolipoproteins, are risk factors for chronic kidney disease (CKD). The associations between apolipoprotein A1, apolipoprotein B and their ratio with glomerular filtration rate estimated from the new CKD Epidemiology Collaboration (CKD-EPI) equation (eGFR) are not well studied in the general population. Methods Associations between apolipoprotein A1, B and their ratio with the outcomes of eGFR, CKD (eGFR <60 mL/min/1.73m2) and albuminuria were examined in the Atherosclerosis Risk in Communities study (ARIC, n 10 292, 199698) and the Third National Health and Nutrition Examination Survey (NHANES III, n = 7023, 198891). Cross-sectional multivariable-adjusted analyses were performed using linear and logistic regression. Prospective analyses related baseline apolipoprotein levels to subsequent CKD incidence over 10 years using the ARIC Carotid MRI follow-up cohort (n = 1659). Results Higher apolipoprotein A1 quartiles were associated with a lower prevalence of CKD [Q4 versus Q1: odds ratio (OR) 0.73, P-trend 0.02 in ARIC; Q4 versus Q1: OR 0.53, P-trend <0.01 in NHANES III] as well as with higher eGFR (P-trend <0.01 in ARIC and NHANES III). No consistent significant associations were found for apolipoprotein B in either study. The apolipoprotein B/A1 ratio was significantly associated with eGFR across quartiles in both studies (P-trend <0.01) and with CKD in ARIC (Q4 versus Q1: OR 1.23, P-trend = 0.01). Prospectively, there were trends for the association of apolipoproteins with incident CKD [Q4 versus Q1: incidence rate ratio (IRR) 0.68 for apolipoprotein A1, P-trend 0.1; Q4 versus Q1: IRR 1.35 for apolipoprotein B, P-trend 0.2]. Associations were not systematically stronger when comparing traditional lipids (total cholesterol, low-density lipoprotein or high-density lipoprotein) to apolipoproteins. Conclusions Higher serum apolipoprotein A1 was associated with lower prevalence of CKD and higher eGFR estimated by the CKD-EPI equation in two large multiethnic population-based samples. While apolipoprotein B showed no consistent associations, a higher apolipoprotein B/A1 ratio was significantly associated with lower eGFR in both studies. The direction and magnitude of the longitudinal associations between apolipoproteins and CKD incidence were overall similar to those observed cross-sectionally. No consistent differences became apparent between traditional lipids and apolipoproteins.
KW - ARIC
KW - NHANES
KW - apolipoprotein
KW - chronic kidney disease
KW - epidemiology
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U2 - 10.1093/ndt/gfr795
DO - 10.1093/ndt/gfr795
M3 - Article
C2 - 22287661
AN - SCOPUS:84864403743
SN - 0931-0509
VL - 27
SP - 2839
EP - 2847
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 7
ER -