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Review paper

High-density lipoprotein cholesterol, apolipoprotein E and atherogenic index of plasma are associated with risk of chronic kidney disease

By
Jasmina Smajić Orcid logo ,
Jasmina Smajić
Contact Jasmina Smajić

Clinical Chemistry and Biochemistry, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Sabaheta Hasić ,
Sabaheta Hasić
Contact Sabaheta Hasić

Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Senija Rašić
Senija Rašić

Clinic for Nephrology, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Abstract

Aim
To investigate the association of parameters of lipid profile and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m 2 calculated by the Modification of Diet in Renal Disease (MDRD) in non-dialysis kidney patients.
Methods
The observational, case-control study enrolled patients (n=117) recruited from the Nephrological Counselling Centre of the University Clinical Centre Sarajevo and divided into two groups: group 1 eGFR (15-59 mL/min/1.73 m 2), and group 2 (control) eGFR ≥ 60 mL/min/1.73 m 2. Concentration of lipids, lipoproteins and apolipoproteins was measured, and atherogenic index of plasma (AIP; log(TG/HDLc)) was calculated.
Results
High density lipoprotein cholesterol (HDLc) and apolipoprotein E (APOE) concentrations in serum were reduced [(1.02 (0.94-1.29) vs 1.15 (1.1-1.4) mmol/L; p=0.009 and 0.035 (0.026-0.04) vs 0.041 (0.034-0.05) g/L; p=0.002, respectively)], while AIP was higher in group 1 than in group 2 (0.19±0.03 vs 0.09±0.04; p=0.013). Values less than 1.09 mmol/L and 0.038 g/L for HDLc and APOE, or higher than 0.165 for AIP (p<0.05) were associated with the eGFR below 60 ml/min/1.73 m 2. The age [OR = 1.1; 95% CI (1.05-1.17)] and AIP [OR = 8.7; 95% CI (1.18-65.0)] were independent positive predictors, while APOE was a negative predictor of eGFR reduction rate (OR=0.01; 95% CI (0.001-0.033; p<0.001).
Conclusion
Changes in parameters such as HDLc, APOE and AIP are associated with CKD. The study results imply the need of the AIP calculation as routine laboratory work due to its role along with the age and APOE in the prediction of renal function decline.

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