Case-Control Study to Investigate the Association Between Serum Apolipoprotein B/A1 Ratio and Atrial Fibrillation by Sex in 920 Patients from China

Overview

Journal Med Sci Monit

Specialties General Medicine
Pathology

Date 2022 May 14

PMID 35567295

Authors

Xia Zhong

Huachen Jiao

Dongsheng Zhao

Jing Teng

Mengqi Yang

Affiliations

Soon will be listed here.

Abstract

BACKGROUND The serum apolipoprotein B/A1 ratio (APOB/APOA1) has been shown to predict cardiovascular events, whereas the effect of the APOB/APOA1 ratio on atrial fibrillation (AF) is less known. We investigated the association between the APOB/APOA1 ratio and AF by sex in 920 patients from China. MATERIAL AND METHODS We reviewed clinical data on 1840 hospitalized patients, including 920 patients with AF (male/female: 460/460, age: 68.62±10.36 years) and 920 age- and sex-matched patients without AF with sinus rhythm in China between January 2019 and September 2021. Pearson correlation analysis was performed to investigate the correlation between APOB/APOA1 ratio and AF-related metabolic factors. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Low serum APOB/APOA1 ratios in male and female patients were significantly associated with AF after adjusting for confounding factors (OR 0.159, 95% CI 0.058-0.432, P<0.05). Serum APOB/APOA1 ratio was positively correlated with triglyceride (TG) (r=0.146, P<0.05) and total cholesterol (TC) (r=0.227, P<0.05) and was negatively correlated with albumin (ALB) (r=-0.128, P<0.05) and prealbumin (PAB) (r=-0.107, P<0.05). There was no significant difference of APOB/APOA1 ratio in different subtypes, complications, and statin use in patients with AF (P>0.05). CONCLUSIONS A low serum APOB/APOA1 ratio in male and female patients from China was significantly related to AF. This finding implies that a low serum APOB/APOA1 ratio may be associated with the causes of AF. Further studies are needed to determine causalities.

Citing Articles

Association between serum uric acid levels and atrial fibrillation in different fasting glucose patterns: A case-control study.

Zhong X, Jiao H, Zhao D, Yang M, Teng J Front Endocrinol (Lausanne). 2023; 14:1021267.

PMID: 36755929 PMC: 9899926. DOI: 10.3389/fendo.2023.1021267.

References

Guo Y, Lip G, Apostolakis S . Inflammation in atrial fibrillation. J Am Coll Cardiol. 2012; 60(22):2263-70. DOI: 10.1016/j.jacc.2012.04.063. View

Wong C, Brooks A, Leong D, Roberts-Thomson K, Sanders P . The increasing burden of atrial fibrillation compared with heart failure and myocardial infarction: a 15-year study of all hospitalizations in Australia. Arch Intern Med. 2012; 172(9):739-41. DOI: 10.1001/archinternmed.2012.878. View

Walldius G, Jungner I, Aastveit A, Holme I, Furberg C, Sniderman A . The apoB/apoA-I ratio is better than the cholesterol ratios to estimate the balance between plasma proatherogenic and antiatherogenic lipoproteins and to predict coronary risk. Clin Chem Lab Med. 2004; 42(12):1355-63. DOI: 10.1515/CCLM.2004.254. View

Walldius G, Jungner I . The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy--a review of the evidence. J Intern Med. 2006; 259(5):493-519. DOI: 10.1111/j.1365-2796.2006.01643.x. View

Lu M, Lu Q, Zhang Y, Tian G . ApoB/apoA1 is an effective predictor of coronary heart disease risk in overweight and obesity. J Biomed Res. 2013; 25(4):266-73. PMC: 3597070. DOI: 10.1016/S1674-8301(11)60036-5. View

Xu W, Li R, Zhang S, Gong L, Wang Z, Ren W . The relationship between high-sensitivity C-reactive protein and ApoB, ApoB/ApoA1 ratio in general population of China. Endocrine. 2012; 42(1):132-8. DOI: 10.1007/s12020-012-9599-x. View

Korantzopoulos P, Letsas K, Tse G, Fragakis N, Goudis C, Liu T . Inflammation and atrial fibrillation: A comprehensive review. J Arrhythm. 2018; 34(4):394-401. PMC: 6111477. DOI: 10.1002/joa3.12077. View

Link M, Haissaguerre M, Natale A . Ablation of Atrial Fibrillation: Patient Selection, Periprocedural Anticoagulation, Techniques, and Preventive Measures After Ablation. Circulation. 2016; 134(4):339-52. DOI: 10.1161/CIRCULATIONAHA.116.021727. View

Simsek B, Altay S, Ozbilgin N, Onat A . Autoimmune activation as a determinant of atrial fibrillation among Turks: A prospective evaluation. Medicine (Baltimore). 2018; 97(31):e11779. PMC: 6081191. DOI: 10.1097/MD.0000000000011779. View

10.

Kaneva A, Potolitsyna N, Bojko E, Odland J . The apolipoprotein B/apolipoprotein A-I ratio as a potential marker of plasma atherogenicity. Dis Markers. 2015; 2015:591454. PMC: 4380097. DOI: 10.1155/2015/591454. View

11.

Santhanakrishnan R, Wang N, Larson M, Magnani J, McManus D, Lubitz S . Atrial Fibrillation Begets Heart Failure and Vice Versa: Temporal Associations and Differences in Preserved Versus Reduced Ejection Fraction. Circulation. 2016; 133(5):484-92. PMC: 4738087. DOI: 10.1161/CIRCULATIONAHA.115.018614. View

12.

Reis Geovanini G, Libby P . Atherosclerosis and inflammation: overview and updates. Clin Sci (Lond). 2018; 132(12):1243-1252. DOI: 10.1042/CS20180306. View

13.

Hamedi-Kalajahi F, Zarezadeh M, Mojtahedi S, Shabbidar S, Fahimi D, Imani H . Effect of L-carnitine supplementation on lipid profile and apolipoproteins in children on hemodialysis: a randomized placebo-controlled clinical trial. Pediatr Nephrol. 2021; 36(11):3741-3747. DOI: 10.1007/s00467-021-05080-1. View

14.

Van Linthout S, Spillmann F, Riad A, Trimpert C, Lievens J, Meloni M . Human apolipoprotein A-I gene transfer reduces the development of experimental diabetic cardiomyopathy. Circulation. 2008; 117(12):1563-73. DOI: 10.1161/CIRCULATIONAHA.107.710830. View

15.

Tousoulis D . Biomarkers in Atrial Fibrillation; From Pathophysiology to Diagnosis and Treatment. Curr Med Chem. 2019; 26(5):762-764. DOI: 10.2174/092986732605190422092911. View

16.

Holme I, Aastveit A, Hammar N, Jungner I, Walldius G . Inflammatory markers, lipoprotein components and risk of major cardiovascular events in 65,005 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). Atherosclerosis. 2010; 213(1):299-305. DOI: 10.1016/j.atherosclerosis.2010.08.049. View

17.

ELOVSON J, Chatterton J, Bell G, Schumaker V, Reuben M, Puppione D . Plasma very low density lipoproteins contain a single molecule of apolipoprotein B. J Lipid Res. 1988; 29(11):1461-73. View

18.

Lu X, Chen D, Endresz V, Xia M, Faludi I, Burian K . Immunization with a combination of ApoB and HSP60 epitopes significantly reduces early atherosclerotic lesion in Apobtm2SgyLdlrtm1Her/J mice. Atherosclerosis. 2010; 212(2):472-80. DOI: 10.1016/j.atherosclerosis.2010.06.007. View

19.

Wallenfeldt K, Bokemark L, Wikstrand J, Hulthe J, Fagerberg B . Apolipoprotein B/apolipoprotein A-I in relation to the metabolic syndrome and change in carotid artery intima-media thickness during 3 years in middle-aged men. Stroke. 2004; 35(10):2248-52. DOI: 10.1161/01.STR.0000140629.65145.3c. View

20.

Ivert T, Hammar N, Talback M, Malmstrom H, Leander K, Walldius G . Elevated Apolipoprotein B/A-1 Ratio is Associated With an Increased Risk of Aortic Stenosis: Experience From the AMORIS Cohort. Heart Lung Circ. 2021; 30(7):1050-1057. DOI: 10.1016/j.hlc.2020.12.005. View