Prognostic Value of Apolipoprotein E in Predicting One-year Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

IF 2.7 3区 医学 Q2 RESPIRATORY SYSTEM
Yuqun Li, Qilan Wu, Zhenxing Li, Yang Xiao, Liping Wei
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Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) is a serious disease with significantly higher mortality. Evidence suggests that there may be a co-relation between ApoE and the mortality risk in individuals who are diagnosed with COPD. This study sought to investigate the correlation between the levels of ApoE and all-cause mortality over one year in individuals who are diagnosed with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).

Methods: In this study, we checked serum ApoE concentrations of AECOPD patients on admission and collected the patients' laboratory and clinical information. The co-relation between the concentration of ApoE and one year risk of all-cause mortality was analyzed by univariate, multivariate Cox regression and Subgroup analysis. Restricted Cubic Spline (RCS) were employed to illustrate the connection between ApoE levels and the hazard ratio (HR) for one-year total mortality rate.

Results: Of the 449 participants who were enrolled, 358 patients were included in the study. The mean age was 76 (±9.46) years old, of which 65.92% were male. The body-mass index was 22.18 (±4.66). Of the participants, 24.86% were non-smokers, 54.75% were former smokers, and 20.39% were active smokers, with a smoking history of 28.68 (±20.43) years. The restricted cubic spline curve revealed that patients exhibiting ApoE concentrations exceeding the mean value of 41.50 mg/L faced a notably higher risk of mortality in comparison to individuals with lower levels. In univariate analysis, the HR was 2.663 (95% CI 1.533-4.627, P = 0.001), but in adjusted analyses, the HR was 2.103 (95% CI 1.19-3.716, P = 0.01).

Conclusion: Elevated levels of ApoE were independently risk factor for one-year mortality in patients with AECOPD. Subgroup analyses revealed that the association was stronger in younger patients (<76 years) and male, as well as in those without comorbidities such as congestive heart failure or cerebrovascular disease. This suggests that ApoE may be a potential prognostic biomarker for AECOPD.

载脂蛋白E在预测慢性阻塞性肺疾病急性加重患者一年死亡率中的预后价值。
目的:慢性阻塞性肺疾病(COPD)是一种病死率较高的严重疾病。有证据表明,ApoE与慢性阻塞性肺病患者的死亡风险之间可能存在相关关系。本研究旨在调查诊断为慢性阻塞性肺疾病急性加重期(AECOPD)的个体一年内ApoE水平与全因死亡率之间的相关性。方法:检测AECOPD患者入院时血清ApoE浓度,收集患者实验室及临床资料。采用单因素、多因素Cox回归和亚组分析分析ApoE浓度与1年全因死亡风险的相关关系。采用限制性三次样条(RCS)分析ApoE水平与1年总死亡率的危险比(HR)之间的关系。结果:在入组的449名参与者中,358名患者被纳入研究。平均年龄76(±9.46)岁,男性占65.92%。体质指数为22.18(±4.66)。不吸烟者占24.86%,戒烟者占54.75%,活跃吸烟者占20.39%,吸烟史28.68(±20.43)年。限制性三次样条曲线显示,ApoE浓度超过41.50 mg/L的患者的死亡率明显高于ApoE浓度较低的患者。在单因素分析中,风险比为2.663 (95% CI 1.533-4.627, P = 0.001),而在调整分析中,风险比为2.103 (95% CI 1.19-3.716, P = 0.01)。结论:ApoE水平升高是AECOPD患者1年死亡的独立危险因素。亚组分析显示,年轻患者的相关性更强(
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来源期刊
CiteScore
4.80
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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