Next Article in Journal
Characterization of Patients with Pulmonary Arterial Hypertension: Data from the Polish Registry of Pulmonary Hypertension (BNP-PL)
Previous Article in Journal
Oncolytic Virotherapy with Myxoma Virus
Open AccessArticle

Apolipoprotein B/Apolipoprotein A-I Ratio Is a Better Predictor of Cancer Mortality Compared with C-Reactive Protein: Results from Two Multi-Ethnic US Populations

by Mohsen Mazidi 1,*, Niki Katsiki 2, Dimitri P. Mikhailidis 3, Dina Radenkovic 4, Daniel Pella 5 and Maciej Banach 6,7,8,*,† on behalf of the International Lipid Expert Panel (ILEP)
1
Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital, Strand, London SE1 7EH, UK
2
First Department of Internal Medicine, Center for Diabetes, Metabolism and Endocrinology, AHEPA University Hospital, 546 36 Thessaloniki, Greece
3
Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London NW3 2QG, UK
4
Guy’s & St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
5
2nd Cardiology Clinic East Slovak Institute for CV Disease and Faculty of Medicine PJ Safarik University, 04011 Kosice, Slovakia
6
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, 93-338 Lodz, Poland
7
Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93-338 Lodz, Poland
8
Cardiovascular Research Centre, University of Zielona Gora, 65-046 Zielona Gora, Poland
*
Authors to whom correspondence should be addressed.
Membership of the International Lipid Expert Panel (ILEP) is provided in the Acknowledgments.
J. Clin. Med. 2020, 9(1), 170; https://doi.org/10.3390/jcm9010170
Received: 23 December 2019 / Accepted: 3 January 2020 / Published: 8 January 2020
(This article belongs to the Section Cardiology)
Background: There is a lack of evidence regarding the link between apolipoproteins and cancer mortality. By using two nationally representative samples of US adults, we prospectively evaluated the associations between apolipoprotein B (apoB) levels and apoB/apoA-I ratio with cancer mortality. We also examined the role of C-reactive protein (CRP) in these associations. Materials and Methods: Adults aged ≥20 years, enrolled in the 3rd National Health and Nutrition Examination Survey (NHANES III, 1988–1994) and continuous NHANES (2005–2010), and followed up to 31 December 2011, were included in the analysis. Multiple Cox regressions were applied to evaluate the associations between the variables of interest and cancer mortality. Results: Overall, 7695 participants were included (mean age: 49.2 years; 50.4% men, median follow-up: 19.1 years). In the fully adjusted model, participants in the highest quartile (Q4) of apoB/apoA-I had a significantly greater risk for cancer mortality (hazard ratio (HR): 1.40; 95% confidence interval (CI): 1.25–1.93) compared with those in the first quartile (Q1). In the same model, a positive and significant association between apoB levels and cancer mortality was observed for individuals in Q3 (HR: 1.12; 95% CI: 1.09–1.16) and Q4 (HR: 1.17; 95% CI: 1.09–1.25) compared with those in Q1. When CRP levels were added in the analysis, the apoB/apoA-I ratio, but not apoB levels, remained significantly related to cancer mortality (Q4 = HR: 1.17; 95% CI: 1.09–1.25). In contrast, CRP levels were not able to predict cancer death after correction for apoB/apoA-I ratio. Conclusions: In a large representative sample of the US adult population, the apoB/apoA-I ratio and apoB levels significantly predicted cancer mortality, independently of several cardiometabolic risk factors. The predictive value of apoB/apoA-I, but not apoB levels, remained significant after taking into account CRP, whereas CRP was not associated with cancer mortality after adjustment for apoB/apoA-I ratio. If further evidence supports our findings, apoA-I and apoB measurements could be considered in general healthcare policies.
Keywords: apolipoprotein B; apolipoprotein A-I; C-reactive protein; cancer mortality; NHANES apolipoprotein B; apolipoprotein A-I; C-reactive protein; cancer mortality; NHANES
MDPI and ACS Style

Mazidi, M.; Katsiki, N.; Mikhailidis, D.P.; Radenkovic, D.; Pella, D.; Banach, M., on behalf of the International Lipid Expert Panel (ILEP); Apolipoprotein B/Apolipoprotein A-I Ratio Is a Better Predictor of Cancer Mortality Compared with C-Reactive Protein: Results from Two Multi-Ethnic US Populations. J. Clin. Med. 2020, 9, 170.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop