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Abstract：
BACKGROUND: Serum lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) in the general population, its association with ASCVD incidence in Chinese maintenance hemodialysis (MHD) patients remains unclear. We aimed to evaluate the relationship between Lp(a) levels and ASCVD incidence among MHD patients in Beijing, China.
METHODS: This retrospective, observational cohort study included MHD patients at Beijing Tongren Hospital from January 1, 2013 to December 1, 2020, and followed until December 1,2023. The primary outcome was ASCVD occurrence. Kaplan-Meier survival analysis was used to evaluate ASCVD-free survival in MHD patients, with stratification based on Lp(a) levels. Cox regression analyses were conducted to assess the association between Lp(a) levels and the occurrence of ASCVD.
RESULTS: A total of 265 patients were enrolled in the study. The median follow-up period were 71 months.78 (29.4%) participants experienced ASCVD events, and 118 (47%) patients died, with 58 (49.1%) deaths attributed to ASCVD. Spearman rank correlation analyses revealed positive correlations between serum Lp(a) levels and LDL-c levels, and negative correlations with hemoglobin, triglyceride, serum iron, serum creatinine, and albumin levels. Multivariate Cox regression analysis showed that Lp(a) levels ≥ 30 mg/L, increased age, decreased serum albumin levels, and a history of diabetes mellitus were significantly associated with ASCVD incidence.
CONCLUSIONS: This study demonstrated an independent and positive association between serum Lp(a) levels and the risk of ASCVD in MHD patients, suggesting that serum Lp(a) could potentially serve as a clinical biomarker for estimating ASCVD risk in this population.
METHODS: This retrospective, observational cohort study included MHD patients at Beijing Tongren Hospital from January 1, 2013 to December 1, 2020, and followed until December 1,2023. The primary outcome was ASCVD occurrence. Kaplan-Meier survival analysis was used to evaluate ASCVD-free survival in MHD patients, with stratification based on Lp(a) levels. Cox regression analyses were conducted to assess the association between Lp(a) levels and the occurrence of ASCVD.
RESULTS: A total of 265 patients were enrolled in the study. The median follow-up period were 71 months.78 (29.4%) participants experienced ASCVD events, and 118 (47%) patients died, with 58 (49.1%) deaths attributed to ASCVD. Spearman rank correlation analyses revealed positive correlations between serum Lp(a) levels and LDL-c levels, and negative correlations with hemoglobin, triglyceride, serum iron, serum creatinine, and albumin levels. Multivariate Cox regression analysis showed that Lp(a) levels ≥ 30 mg/L, increased age, decreased serum albumin levels, and a history of diabetes mellitus were significantly associated with ASCVD incidence.
CONCLUSIONS: This study demonstrated an independent and positive association between serum Lp(a) levels and the risk of ASCVD in MHD patients, suggesting that serum Lp(a) could potentially serve as a clinical biomarker for estimating ASCVD risk in this population.
摘要：
背景：血清脂蛋白（a）[Lp（a）]是普通人群中动脉粥样硬化性心血管疾病（ASCVD）的独立危险因素，在中国维持性血液透析(MHD)患者中,其与ASCVD发病率的相关性尚不清楚.我们旨在评估Lp（a）水平与北京MHD患者ASCVD发病率之间的关系。中国。
方法：本回顾性研究，观察性队列研究纳入2013年1月1日至2020年12月1日在北京同仁医院就诊的MHD患者,随访至2023年12月1日.主要结果是ASCVD发生。Kaplan-Meier生存分析用于评估MHD患者的无ASCVD生存。基于Lp(a)水平进行分层。进行Cox回归分析以评估Lp（a）水平与ASCVD发生之间的关联。
结果：本研究共纳入265例患者。中位随访期为71个月。78（29.4%）参与者经历了ASCVD事件，118名（47%）患者死亡，58（49.1%）死亡归因于ASCVD。Spearman等级相关分析显示血清Lp(a)水平与LDL-c水平呈正相关,与血红蛋白呈负相关，甘油三酯，血清铁,血清肌酐,和白蛋白水平。多因素Cox回归分析显示Lp(a)水平≥30mg/L,年龄增长,血清白蛋白水平降低，糖尿病病史与ASCVD发病率显著相关。
结论：本研究表明MHD患者血清Lp(a)水平与ASCVD风险之间存在独立的正相关，提示血清Lp(a)可能作为评估该人群ASCVD风险的临床生物标志物.
方法：本回顾性研究，观察性队列研究纳入2013年1月1日至2020年12月1日在北京同仁医院就诊的MHD患者,随访至2023年12月1日.主要结果是ASCVD发生。Kaplan-Meier生存分析用于评估MHD患者的无ASCVD生存。基于Lp(a)水平进行分层。进行Cox回归分析以评估Lp（a）水平与ASCVD发生之间的关联。
结果：本研究共纳入265例患者。中位随访期为71个月。78（29.4%）参与者经历了ASCVD事件，118名（47%）患者死亡，58（49.1%）死亡归因于ASCVD。Spearman等级相关分析显示血清Lp(a)水平与LDL-c水平呈正相关,与血红蛋白呈负相关，甘油三酯，血清铁,血清肌酐,和白蛋白水平。多因素Cox回归分析显示Lp(a)水平≥30mg/L,年龄增长,血清白蛋白水平降低，糖尿病病史与ASCVD发病率显著相关。
结论：本研究表明MHD患者血清Lp(a)水平与ASCVD风险之间存在独立的正相关，提示血清Lp(a)可能作为评估该人群ASCVD风险的临床生物标志物.
