CN112750534A - Application of serum apoB as metabolic syndrome marker - Google Patents
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Abstract
The invention relates to application of serum apoB as a metabolic syndrome marker, and the invention shows that serum apoB has better prediction value on the onset risk of MetS, and the research of the invention shows that the MetS of a normal population with BMI less than 25 has higher morbidity and onset risk compared with an overweight/obese population with BMI more than or equal to 25.
Description
Technical Field
The invention belongs to the field of serum apoB, and particularly relates to application of serum apoB as a metabolic syndrome marker.
Background
Metabolic syndrome (MetS) is a clinical disease characterized by a series of Metabolic abnormalities, mainly including five components of increased waist circumference, elevated blood pressure, hypertriglyceridemia, low-high-density lipoprotein cholesterolemia and elevated fasting blood glucose. MetS is generally defined in terms of the above components, and is diagnosed if at least three or more of the above components are present. MetS has been identified as an important predictor of coronary heart disease and diabetes and a risk factor for chronic kidney disease. With the rapid development of Chinese economy and the remarkable change of the dietary habits of residents, the prevalence rate of MetS shows an increasing trend, becomes an important public health problem and draws wide attention.
Disclosure of Invention
The invention aims to solve the technical problem of providing the application of serum apoB as a metabolic syndrome marker. The invention relates to application of serum apoB as a metabolic syndrome marker.
Correlation of serum apoB with MetS risk was assessed using multiple Logistic regression analysis to calculate odds ratio OR and 95% confidence interval CI for endpoint events.
The SAS 9.4 is adopted for statistical analysis, the bilateral P value is less than 0.05, the statistical significance is achieved, the serum apoB value is not more than 0.76g/L, and the metabolic syndrome is absent.
Baseline profile data for the study subjects were expressed as mean ± standard deviation or median (interquartile range) of continuous variables, and number of instances (percentage) of categorical variables, respectively. One-way anova and χ 2 test were used for statistical comparisons between sets of continuous and categorical variables, respectively. Correlation of serum apoB with MetS risk was assessed using multivariate Logistic regression analysis to calculate Odds Ratio (OR) and 95% Confidence Interval (CI) for endpoint events. In the follow-up analysis, a relative risk regression model was used to assess the relationship between serum apoB and MetS risk of onset, with Risk Ratio (RR) and 95% CI as assessments of effector volume. In the multiple regression analysis model, potential confounding factors measured at baseline were corrected. Model 1 was corrected for age (continuous variable) and gender (male/female). Model 2 further corrected BMI (continuous variable), smoking and drinking status (past/present/never), educational status (high and above/below high), family history of diabetes (yes/no), and physical exercise status (moderate to severe exercise/below moderate exercise) on the basis of model 1. Model 3 further corrected Systolic Blood Pressure (SBP), TG and HDL-c on the basis of model 2. A two-sided P value <0.05 was considered statistically significant. Serum apoB levels were pentagraded in regression analysis and the trend P values for the pentagraded serum apoB were calculated as ordinal variables.
Advantageous effects
The invention shows that serum apoB as a marker shows better prediction value on the onset risk of MetS, and the research of the invention shows that the MetS of the population with normal body weight and BMI <25 is ill and the onset risk is higher compared with the overweight/obese population with the BMI more than or equal to 25. The results of the study suggest that normal weight populations with higher serum apoB levels should pay more attention to preventing the development of metabolic disease.
Serum apoB is an independent risk factor for MetS and is an effective predictor of future risk of MetS, this association being particularly evident in normal weight populations.
Drawings
FIG. 1 is a graph of the stratification of serum apoB for risk association with MetS based on BMI levels.
Detailed Description
The invention will be further illustrated with reference to the following specific examples. It should be understood that these examples are for illustrative purposes only and are not intended to limit the scope of the present invention. Further, it should be understood that various changes or modifications of the present invention may be made by those skilled in the art after reading the teaching of the present invention, and such equivalents may fall within the scope of the present invention as defined in the appended claims.
Example 1
1. Basic information of research object
At baseline, a total of 2,794 (27.02%) of 10,340 elderly population in the chinese community aged 40 and older had MetS. The mean age of the study population was 58.5 ± 9.7 years with a female proportion of 61.90%. As can be seen from the baseline information comparison, subjects tended to have greater age, higher BMI, SBP, DBP, TC, TG, HDL-c, LDL-c, FBG and fasting insulin levels (all trend P values <0.05) with increasing serum apoB pentad levels (table 1). In addition, the proportion of female subjects, the proportion of current smokers, and the proportion of subjects with family history of diabetes all increased with increasing serum apoB pentad levels (trend P values all < 0.05).
Table 1 shows the basic information for subjects grouped according to baseline serum apoB pentad level
Correlation analysis of serum apoB and metabolic syndrome illness and morbidity risk
Baseline profile data for the study subjects were expressed as mean ± standard deviation or median (interquartile range) of continuous variables, and number of instances (percentage) of categorical variables, respectively. One-way anova and χ 2 test were used for statistical comparisons between sets of continuous and categorical variables, respectively. Correlation of serum apoB with MetS risk was assessed using multivariate Logistic regression analysis to calculate Odds Ratio (OR) and 95% Confidence Interval (CI) for endpoint events. In the follow-up analysis, a relative risk regression model was used to assess the relationship between serum apoB and MetS risk of onset, with Risk Ratio (RR) and 95% CI as assessments of effector volume. In the multiple regression analysis model, potential confounding factors measured at baseline were corrected. Model 1 was corrected for age (continuous variable) and gender (male/female). Model 2 further corrected BMI (continuous variable), smoking and drinking status (past/present/never), educational status (high and above/below high), family history of diabetes (yes/no), and physical exercise status (moderate to severe exercise/below moderate exercise) on the basis of model 1. Model 3 further corrected Systolic Blood Pressure (SBP), TG and HDL-c on the basis of model 2. A two-sided P value <0.05 was considered statistically significant. Serum apoB levels were pentagraded in regression analysis and the trend P values for the pentagraded serum apoB were calculated as ordinal variables. All statistics used were performed using version SAS 9.4 (SAS Institute Inc, Cary, NC).
Multiple Logistic regression model analysis indicated that serum apoB was significantly associated with increased risk of MetS. After correction of a range of potential confounders (including age, sex, BMI, smoking and drinking status, education, physical exercise, family history of diabetes, HDL-c, TG and SBP), the results showed that the risk of MetS development was significantly increased in second, third, fourth and fifth deciders with quintile levels of apoB compared to subjects with serum apoB at the lowest decile, with OR values and 95% CI of 1.29(1.02-1.63), 1.47(1.18-1.84), 1.32(1.06-1.65) and 2.02(1.61-2.51) (trend P value <0.05) (as shown in Table 2).
Table 2 is an analysis of the correlation between serum apoB levels and MetS risk
When fasting insulin was included in the model, the results showed that serum apoB was still significantly elevated at risk of MetS in the second, third, fourth, and fifth quantiles, with OR values and 95% CI of [1.29(1.02-1.63), 1.46(1.17-1.82), 1.28(1.03-1.61), and 1.97(1.57-2.46) ], respectively, as compared to subjects with serum apoB in the first quantile. The above results remained significant after further correction of DBP, FBG, LDL-c and TC.
Follow-up analysis results showed that at baseline, 830 of 4627 without MetS (17.94% of all) had a MetS event during the mean 5.1 year follow-up period. Serum apoB levels were significantly associated with an increased risk of MetS development. After correction of a range of potential confounders (including age, sex, BMI, smoking and drinking status, education, physical exercise, family history of diabetes, HDL-c, TG and SBP), the risk of MetS onset was significantly increased in second, third, fourth and fifth quantiles with apoB levels in the fifth quantile compared to the study subject with serum apoB in the lowest quantile, and RR (95% CI) was 1.43(1.13-1.82), 1.57(1.25-1.98), 1.74(1.38-2.18) and 2.07(1.66-2.58), respectively (trend P value < 0.05). Subjects with serum apoB at the second, third, fourth, fifth cohort after correction of fasting insulin levels were still significantly increased in risk of MetS compared to the first cohort [ RR (95% CI) 1.43(1.09-1.88), 1.56(1.20-2.03), 1.72(1.33-2.23) and 2.06(1.60-2.65), respectively ]. After further correction of biochemical indicators such as DBP, FBG, LDL-c, TC, etc., the results remained significant. Furthermore, an increase in baseline serum apoB levels, whether in subjects with reduced or unchanged serum apoB during the mean 5.1 year follow-up period or in subjects with elevated serum apoB, was significantly correlated with an increased risk of MetS onset (as shown in table 3).
TABLE 3 analysis of the correlation of baseline serum apoB with MetS onset Risk in different populations with varying levels of serum apoB during follow-up
In which the a model corrects age, sex, BMI, smoking and drinking status, education, physical activity, family history of diabetes, HDL-c, triglycerides, systolic blood pressure.
Analysis of Risk correlation between serum apoB and various components of metabolic syndrome
At baseline, subjects in the third, fourth, and fifth quantiles had significantly increased risk of developing hypertension and impaired glucose metabolism, subjects in the fourth, fifth quantile had significantly increased prevalence of abdominal obesity, and subjects in the second, third, fourth, and fifth quantiles had significantly increased risk of developing hypertriglyceridemia, as compared to subjects in the first quantile for serum apoB. In the follow-up analysis, subjects in the second, third, fourth and fifth cohorts had significantly increased risk of hypertriglyceridemia and low HDL-c (trend P value <0.05) compared to subjects in the first cohort with serum apoB, and subjects in the fifth cohort had a higher risk of impaired glucose metabolism regulation (trend P value 0.14) (as shown in table 4).
Table 4 correlates of serum apoB levels with the risk of developing disease and morbidity of the MetS component
Model a corrects age, gender, BMI, smoking and drinking status, education, physical activity, family history of diabetes, HDL-c, triglycerides, systolic blood pressure.
Analysis of predicted effect of serum apoB on metabolic syndrome
The role of serum apoB and other lipids in predicting the risk of MetS development was compared. Wherein the basic models include age, gender, BMI, family history of diabetes, smoking and drinking status, educational level, physical activity status. The results show that addition of serum apoB to the conventional risk model significantly improved the predictive power compared to predictive models combining TC, non-HDL-C or LDL-C, respectively, with the basic factor model, including significant improvements in C-statistics, IDI and NRI (all P values <0.05 except for IDI for apoB compared to non-HDL-C) (Table 5)
Where the C-statistics calculation is used to measure the consistency between the model-based risk assessment and the new MetS observed. The Net Recessiveness Improvement (NRI) and the Integrated Discrimination Improvement (IDI) of serum apoB for the new MetS were calculated to measure the improvement effect of adding apoB to the existing prediction model.
Effect of obesity on the Risk-Association of serum apoB with Metabolic syndrome
The association of serum apoB with MetS risk in different weight populations was further analyzed by stratification of BMI levels. The results show that subjects in the fifth cohort were at a higher risk of developing MetS disease and disease than subjects in the first cohort, both in normal weight (BMI <25kg/m2) and overweight/obese (BMI > 25kg/m 2). Notably, the association between serum apoB and increased MetS risk was particularly significant and more trending in normal weight populations compared to overweight or obese people (as shown in figure 1).
The study of the invention shows that compared with overweight/obese people with BMI more than or equal to 25, the MetS of normal weight people with BMI less than 25 is ill and the disease risk is higher. The results of the study suggest that normal weight populations with higher serum apoB levels should pay more attention to preventing the development of metabolic disease.
Serum apoB is an independent risk factor for MetS and is an effective predictor of future risk of MetS, this association being particularly evident in normal weight populations. It is worth mentioning that the above correlation is independent of conventional risk factors and other lipid profiles, such as TG and HDL-c. The invention not only provides new evidence for the connection between serum apoB and MetS in Chinese population, but also highlights the importance of serum apoB in the management and prevention of MetS in clinical work, especially in population with normal weight.
Note that: abbreviations in this patent control: MetS, metabolic syndrome; BMI, body mass index; IDI, global discrimination index; NRI, net reclassification index; 95% CI, 95% confidence interval; apoB, apolipoprotein B; TG, triglycerides; TC, total cholesterol; LDL-c, low density lipoprotein cholesterol; HDL-c, high density lipoprotein; cholesterol; FPG, fasting plasma glucose; SBP, systolic blood pressure.
Claims (3)
1. An application of serum apoB as metabolic syndrome marker.
2. The use of claim 1, wherein the method for assessing the risk of serum apoB and MetS is as follows:
correlation of serum apoB with MetS risk was assessed using multiple Logistic regression analysis to calculate odds ratio OR and 95% confidence interval CI for endpoint events.
3. The use according to claim 2, wherein the statistical analysis using SAS 9.4 shows that a bilateral P value of <0.05 is statistically significant and a serum apoB value of no more than 0.76g/L is indicative of the absence of metabolic syndrome.
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Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102239412A (en) * | 2008-10-03 | 2011-11-09 | 国立健康与医学研究所 | Combination of spla2 activity and oxpl/apob cardiovascular risk factors for the diagnosis/prognosis of a cardiovascular disease/event |
| CN103077301A (en) * | 2012-12-24 | 2013-05-01 | 浙江大学医学院附属邵逸夫医院 | Method for predicting subclinical cardiovascular diseases by metabolic syndrome component accumulation |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102239412A (en) * | 2008-10-03 | 2011-11-09 | 国立健康与医学研究所 | Combination of spla2 activity and oxpl/apob cardiovascular risk factors for the diagnosis/prognosis of a cardiovascular disease/event |
| CN103077301A (en) * | 2012-12-24 | 2013-05-01 | 浙江大学医学院附属邵逸夫医院 | Method for predicting subclinical cardiovascular diseases by metabolic syndrome component accumulation |
Non-Patent Citations (1)
| Title |
|---|
| RUI DU等: "Serum apolipoprotein B is associated with increased risk of metabolic syndrome among middle-aged and elderly Chinese :A cross-sectional and prospective cohort study", 《JOURNAL OF DIABETES》 * |
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Application publication date: 20210504 |