Serum apolipoproteins (apoA-1, apoB, and apoB/apoA-1 ratio) for early identification of dyslipidemia in children with CKD

• Published in: Pediatric nephrology (Berlin, West) West), 2024-03, Vol.39 (3), p.849-856
• Main Authors: M., Akshay Kumar, Mantan, Mukta, Mahajan, Bhawna
• Format: Article
• Language: English
• 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
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-023-06144-0

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,