Comparative Assessment of hsCRP and Apolipoprotein B as ASCVD Risk Biomarkers

IF 3.6 3区 医学 Q2 PHARMACOLOGY & PHARMACY
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引用次数: 0

Abstract

Background/Synopsis

According to the American Heart Association, the accumulation of plaque in the walls of arteries is identified as the primary cause of atherosclerotic cardiovascular disease (ASCVD). Currently, ASCVD-related conditions remain the leading cause of morbidity and mortality globally. Apolipoprotein B has been identified as a more precise cardiovascular risk marker than LDL-C, while hsCRP has shown potential as a cardiovascular disease indicator. This study aims to investigate the diagnostic performance and routine screening cut-off of hsCRP for early atherosclerosis vascular diseases (ASCVD) risk in adult patients, comparing it with Apo B.

Objective/Purpose

To compare the diagnostic performance of high-sensitivity C-reactive protein (hsCRP) with apolipoprotein B in assessing ASCVD risk.

Methods

A sample of 494 individuals from the NHANES 2015-2016 laboratory dataset, with a mean age greater than 17 years, was used for this study. ASCVD risk was measured by non-HDL-C, categorized into low and high risk based on the Mayo Clinic reference range. Predictors included Apo B, and hs-CRP. Binomial logistic regression and ROC curve analyses were conducted using the generalised linear models and pROC packages in RStudio IDE. Hypotheses were validated at p≤0.05, and diagnostic performance metrics such as ROC AUC, sensitivity, and specificity were measured on a scale of 0-1.

Results

The findings revealed that for every 1g/L increase in apo B concentration, the odds of high ASCVD risk were approximately 3.8 × 1011 times higher. Additionally, the model indicated that the odds of high ASCVD risk were 1.03 times higher for every 1mg/L increase in hsCRP concentration. However, this indicate that hsCRP level was not associated with odds of ASCVD risk. The ROC AUC for apo B and hsCRP were approximately 0.9739 and 0.6165, respectively, with cut-off values (sensitivity, specificity) of approximately 0.9g/L (0.927, 0.897) and 2.4 mg/L (0.596, 0.601), respectively. Thus, levels above these thresholds for both apo B and hsCRP are associated with high ASCVD risk.

Conclusions

The study demonstrates that apo B exhibits high discriminatory and diagnostic accuracy, making it a suitable ASCVD risk biomarker compared to hsCRP. While hsCRP shows moderate diagnostic accuracy, it is not sufficient as a standalone ASCVD risk diagnostic marker. Therefore, apo B could serve as a replacement for LDL-C, while hsCRP could possibly serve as an add-on test in ASCVD risk assessment.

将 hsCRP 和载脂蛋白 B 作为 ASCVD 风险生物标记物的比较评估
背景/简介据美国心脏协会称,动脉壁上斑块的堆积被认为是动脉粥样硬化性心血管疾病(ASCVD)的主要原因。目前,ASCVD 相关疾病仍是全球发病率和死亡率的主要原因。载脂蛋白 B 已被确定为比低密度脂蛋白胆固醇更精确的心血管风险标志物,而 hsCRP 则显示出作为心血管疾病指标的潜力。Objective/Purpose To compare the diagnostic performance of highensitivity C-reactive protein (hsCRP) with apolipoprotein B in assessing ASCVD risk.Methods本研究使用了 NHANES 2015-2016 实验室数据集中的 494 个样本,这些样本的平均年龄大于 17 岁。ASCVD风险通过非高密度脂蛋白胆固醇(non-HDL-C)进行测量,根据梅奥诊所的参考范围分为低风险和高风险。预测因子包括载脂蛋白 B 和 hs-CRP。使用 RStudio IDE 中的广义线性模型和 pROC 软件包进行了二项式逻辑回归和 ROC 曲线分析。结果发现,载脂蛋白 B 浓度每增加 1 克/升,ASCVD 高风险几率就会增加约 3.8 × 1011 倍。此外,模型还显示,hsCRP 浓度每增加 1 毫克/升,ASCVD 高风险几率就会增加 1.03 倍。然而,这表明 hsCRP 水平与 ASCVD 风险几率无关。载脂蛋白 B 和 hsCRP 的 ROC AUC 分别约为 0.9739 和 0.6165,临界值(敏感性、特异性)分别约为 0.9g/L (0.927, 0.897) 和 2.4 mg/L (0.596, 0.601)。因此,载脂蛋白 B 和 hsCRP 的水平超过这些阈值就与高 ASCVD 风险相关。虽然 hsCRP 显示出中等程度的诊断准确性,但它不足以单独作为 ASCVD 风险诊断标志物。因此,载脂蛋白 B 可作为低密度脂蛋白胆固醇的替代物,而 hsCRP 可作为 ASCVD 风险评估的附加检测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.00
自引率
6.80%
发文量
209
审稿时长
49 days
期刊介绍: Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.
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