Serum apolipoproteins (apoA-1, apoB, and apoB/apoA-1 ratio) for early identification of dyslipidemia in children with CKD
Background Dyslipidemia in children with chronic kidney disease (CKD) is identified based on lipid profile parameters; however, changes in lipoprotein quality precede quantitative changes. Methods A cross-sectional study was done from January to October 2021; overweight, obese children, known cases...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2024-03, Vol.39 (3), p.849-856 |
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| description | Background
Dyslipidemia in children with chronic kidney disease (CKD) is identified based on lipid profile parameters; however, changes in lipoprotein quality precede quantitative changes.
Methods
A cross-sectional study was done from January to October 2021; overweight, obese children, known cases of diabetes mellitus, hypothyroidism or on steroid therapy, or lipid lowering drugs were excluded. Clinical details were elicited and examinations done. Besides hemogram, kidney function tests, liver function tests, total cholesterol, low density lipoproteins (LDL), triglycerides, high density lipoproteins (HDL), and apolipoproteins A-1 and B were estimated to identify dyslipidemia. Relevant tests of significance were applied, and ROC curves were drawn for apoA-1, apoB, and apoB/apoA-1 ratios.
Results
A total of 76 (61 M:15 F) children with median (IQR) age 7 (3.25–11) years were enrolled; cause of CKD was CAKUT in 82.3% patients. Dyslipidemia (alteration of 1 or more lipid parameters) was seen in 78.9% with a prevalence of 71.7% in early and 95.7% in later stages of CKD (
P
= 0.02); most had elevated serum triglyceride levels. The median (IQR) values of apoB, apoA-1, and apoB/apoA-1 ratio were 78 (58–110) mg/dl, 80 (63–96.75) mg/dl, and 0.88 (0.68–1.41), respectively; apoB, apoA-1, and apoB/apoA-1 ratio had a sensitivity of 26.67%, 86.67%, and 70%, respectively, and specificity of 87.5%, 62.5%, and 62.5%, respectively, for diagnosis of dyslipidemia. The ROC for apoB, apoA-1, and apoB/apoA-1 ratio showed AUC of 0.66, 0.68, and 0.74 (
P
= 0.4, 0.02, |
| doi_str_mv | 10.1007/s00467-023-06144-0 |
| format | Article |
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Dyslipidemia in children with chronic kidney disease (CKD) is identified based on lipid profile parameters; however, changes in lipoprotein quality precede quantitative changes.
Methods
A cross-sectional study was done from January to October 2021; overweight, obese children, known cases of diabetes mellitus, hypothyroidism or on steroid therapy, or lipid lowering drugs were excluded. Clinical details were elicited and examinations done. Besides hemogram, kidney function tests, liver function tests, total cholesterol, low density lipoproteins (LDL), triglycerides, high density lipoproteins (HDL), and apolipoproteins A-1 and B were estimated to identify dyslipidemia. Relevant tests of significance were applied, and ROC curves were drawn for apoA-1, apoB, and apoB/apoA-1 ratios.
Results
A total of 76 (61 M:15 F) children with median (IQR) age 7 (3.25–11) years were enrolled; cause of CKD was CAKUT in 82.3% patients. Dyslipidemia (alteration of 1 or more lipid parameters) was seen in 78.9% with a prevalence of 71.7% in early and 95.7% in later stages of CKD (
P
= 0.02); most had elevated serum triglyceride levels. The median (IQR) values of apoB, apoA-1, and apoB/apoA-1 ratio were 78 (58–110) mg/dl, 80 (63–96.75) mg/dl, and 0.88 (0.68–1.41), respectively; apoB, apoA-1, and apoB/apoA-1 ratio had a sensitivity of 26.67%, 86.67%, and 70%, respectively, and specificity of 87.5%, 62.5%, and 62.5%, respectively, for diagnosis of dyslipidemia. The ROC for apoB, apoA-1, and apoB/apoA-1 ratio showed AUC of 0.66, 0.68, and 0.74 (
P
= 0.4, 0.02, < 0.01), respectively.
Conclusions
The prevalence (78.9%) of dyslipidemia was high in patients with CKD especially in those with later stages. The ratio of apoB/apoA-1 was altered early and appears to be promising for early detection.
Graphical Abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-023-06144-0</identifier><identifier>PMID: 37752382</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Apolipoprotein A-I ; Apolipoproteins ; Apolipoproteins B ; Child ; Children ; Cholesterol ; Cross-Sectional Studies ; Diabetes mellitus ; Dyslipidemia ; Dyslipidemias - diagnosis ; Dyslipidemias - epidemiology ; Dyslipidemias - etiology ; High density lipoprotein ; Humans ; Hypothyroidism ; Kidney diseases ; Lipids ; Lipoproteins ; Low density lipoprotein ; Medicine ; Medicine & Public Health ; Metabolic disorders ; Nephrology ; Original Article ; Pediatric Obesity ; Pediatrics ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - diagnosis ; Triglycerides ; Urology ; What’s New in Chronic Kidney Disease</subject><ispartof>Pediatric nephrology (Berlin, West), 2024-03, Vol.39 (3), p.849-856</ispartof><rights>The Author(s), under exclusive licence to International Pediatric Nephrology Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-401db4237ada71dca8012492ce3e10acaf0a6fc7692f9fbb6c676b7d6841573a3</cites><orcidid>0000-0002-6922-6548</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-023-06144-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-023-06144-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37752382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>M., Akshay Kumar</creatorcontrib><creatorcontrib>Mantan, Mukta</creatorcontrib><creatorcontrib>Mahajan, Bhawna</creatorcontrib><title>Serum apolipoproteins (apoA-1, apoB, and apoB/apoA-1 ratio) for early identification of dyslipidemia in children with CKD</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
Dyslipidemia in children with chronic kidney disease (CKD) is identified based on lipid profile parameters; however, changes in lipoprotein quality precede quantitative changes.
Methods
A cross-sectional study was done from January to October 2021; overweight, obese children, known cases of diabetes mellitus, hypothyroidism or on steroid therapy, or lipid lowering drugs were excluded. Clinical details were elicited and examinations done. Besides hemogram, kidney function tests, liver function tests, total cholesterol, low density lipoproteins (LDL), triglycerides, high density lipoproteins (HDL), and apolipoproteins A-1 and B were estimated to identify dyslipidemia. Relevant tests of significance were applied, and ROC curves were drawn for apoA-1, apoB, and apoB/apoA-1 ratios.
Results
A total of 76 (61 M:15 F) children with median (IQR) age 7 (3.25–11) years were enrolled; cause of CKD was CAKUT in 82.3% patients. Dyslipidemia (alteration of 1 or more lipid parameters) was seen in 78.9% with a prevalence of 71.7% in early and 95.7% in later stages of CKD (
P
= 0.02); most had elevated serum triglyceride levels. The median (IQR) values of apoB, apoA-1, and apoB/apoA-1 ratio were 78 (58–110) mg/dl, 80 (63–96.75) mg/dl, and 0.88 (0.68–1.41), respectively; apoB, apoA-1, and apoB/apoA-1 ratio had a sensitivity of 26.67%, 86.67%, and 70%, respectively, and specificity of 87.5%, 62.5%, and 62.5%, respectively, for diagnosis of dyslipidemia. The ROC for apoB, apoA-1, and apoB/apoA-1 ratio showed AUC of 0.66, 0.68, and 0.74 (
P
= 0.4, 0.02, < 0.01), respectively.
Conclusions
The prevalence (78.9%) of dyslipidemia was high in patients with CKD especially in those with later stages. The ratio of apoB/apoA-1 was altered early and appears to be promising for early detection.
Graphical Abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information</description><subject>Apolipoprotein A-I</subject><subject>Apolipoproteins</subject><subject>Apolipoproteins B</subject><subject>Child</subject><subject>Children</subject><subject>Cholesterol</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes mellitus</subject><subject>Dyslipidemia</subject><subject>Dyslipidemias - diagnosis</subject><subject>Dyslipidemias - epidemiology</subject><subject>Dyslipidemias - etiology</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Hypothyroidism</subject><subject>Kidney diseases</subject><subject>Lipids</subject><subject>Lipoproteins</subject><subject>Low density lipoprotein</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic disorders</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Pediatric Obesity</subject><subject>Pediatrics</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Triglycerides</subject><subject>Urology</subject><subject>What’s New in Chronic Kidney Disease</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UctuFDEQtBCIbBZ-gAOyxCWRcNJ-rO05huWpROIASLlZHo-HOJqxF3tGaP8ebyYkEgcubququtruQugVhTMKoM4LgJCKAOMEJBWCwBO0ooIzQht9_RStoOGUgKDXR-i4lFsA0Bstn6MjrtSGcc1WaP_N53nEdpeGsEu7nCYfYsEnFbgg9O2BeFfP2N3dzhcYZzuFdIr7lLG3edjj0Pk4hT64AxFx6nG3L9Wx4mOwOETsbsLQZR_x7zDd4O3l-xfoWW-H4l_e1zX68fHD9-1ncvX105ftxRVxnMmJCKBdKxhXtrOKds5qoEw0zHnuKVhne7Cyd0o2rG_6tpVOKtmqTmpBN4pbvkYni2_93K_Zl8mMoTg_DDb6NBfDtGwkpaoua43e_CO9TXOO9XWGNVQrqRnIqmKLyuVUSva92eUw2rw3FMwhGLMEY2ow5i4YA7Xp9b313I6-e2j5m0QV8EVQKhV_-vw4-z-2fwA5ZJfY</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>M., Akshay Kumar</creator><creator>Mantan, Mukta</creator><creator>Mahajan, Bhawna</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6922-6548</orcidid></search><sort><creationdate>20240301</creationdate><title>Serum apolipoproteins (apoA-1, apoB, and apoB/apoA-1 ratio) for early identification of dyslipidemia in children with CKD</title><author>M., Akshay Kumar ; Mantan, Mukta ; Mahajan, Bhawna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-401db4237ada71dca8012492ce3e10acaf0a6fc7692f9fbb6c676b7d6841573a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Apolipoprotein A-I</topic><topic>Apolipoproteins</topic><topic>Apolipoproteins B</topic><topic>Child</topic><topic>Children</topic><topic>Cholesterol</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes mellitus</topic><topic>Dyslipidemia</topic><topic>Dyslipidemias - diagnosis</topic><topic>Dyslipidemias - epidemiology</topic><topic>Dyslipidemias - etiology</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>Hypothyroidism</topic><topic>Kidney diseases</topic><topic>Lipids</topic><topic>Lipoproteins</topic><topic>Low density lipoprotein</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic disorders</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Pediatric Obesity</topic><topic>Pediatrics</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Triglycerides</topic><topic>Urology</topic><topic>What’s New in Chronic Kidney Disease</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>M., Akshay Kumar</creatorcontrib><creatorcontrib>Mantan, Mukta</creatorcontrib><creatorcontrib>Mahajan, Bhawna</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>M., Akshay Kumar</au><au>Mantan, Mukta</au><au>Mahajan, Bhawna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum apolipoproteins (apoA-1, apoB, and apoB/apoA-1 ratio) for early identification of dyslipidemia in children with CKD</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>39</volume><issue>3</issue><spage>849</spage><epage>856</epage><pages>849-856</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background
Dyslipidemia in children with chronic kidney disease (CKD) is identified based on lipid profile parameters; however, changes in lipoprotein quality precede quantitative changes.
Methods
A cross-sectional study was done from January to October 2021; overweight, obese children, known cases of diabetes mellitus, hypothyroidism or on steroid therapy, or lipid lowering drugs were excluded. Clinical details were elicited and examinations done. Besides hemogram, kidney function tests, liver function tests, total cholesterol, low density lipoproteins (LDL), triglycerides, high density lipoproteins (HDL), and apolipoproteins A-1 and B were estimated to identify dyslipidemia. Relevant tests of significance were applied, and ROC curves were drawn for apoA-1, apoB, and apoB/apoA-1 ratios.
Results
A total of 76 (61 M:15 F) children with median (IQR) age 7 (3.25–11) years were enrolled; cause of CKD was CAKUT in 82.3% patients. Dyslipidemia (alteration of 1 or more lipid parameters) was seen in 78.9% with a prevalence of 71.7% in early and 95.7% in later stages of CKD (
P
= 0.02); most had elevated serum triglyceride levels. The median (IQR) values of apoB, apoA-1, and apoB/apoA-1 ratio were 78 (58–110) mg/dl, 80 (63–96.75) mg/dl, and 0.88 (0.68–1.41), respectively; apoB, apoA-1, and apoB/apoA-1 ratio had a sensitivity of 26.67%, 86.67%, and 70%, respectively, and specificity of 87.5%, 62.5%, and 62.5%, respectively, for diagnosis of dyslipidemia. The ROC for apoB, apoA-1, and apoB/apoA-1 ratio showed AUC of 0.66, 0.68, and 0.74 (
P
= 0.4, 0.02, < 0.01), respectively.
Conclusions
The prevalence (78.9%) of dyslipidemia was high in patients with CKD especially in those with later stages. The ratio of apoB/apoA-1 was altered early and appears to be promising for early detection.
Graphical Abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37752382</pmid><doi>10.1007/s00467-023-06144-0</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6922-6548</orcidid></addata></record> |
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| subjects | Apolipoprotein A-I Apolipoproteins Apolipoproteins B Child Children Cholesterol Cross-Sectional Studies Diabetes mellitus Dyslipidemia Dyslipidemias - diagnosis Dyslipidemias - epidemiology Dyslipidemias - etiology High density lipoprotein Humans Hypothyroidism Kidney diseases Lipids Lipoproteins Low density lipoprotein Medicine Medicine & Public Health Metabolic disorders Nephrology Original Article Pediatric Obesity Pediatrics Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - diagnosis Triglycerides Urology What’s New in Chronic Kidney Disease |
| title | Serum apolipoproteins (apoA-1, apoB, and apoB/apoA-1 ratio) for early identification of dyslipidemia in children with CKD |
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