载脂蛋白B/载脂蛋白A1的临床研究进展
Clinical Research Progress of Apolipoprotein B/Apolipoprotein A1
DOI: 10.12677/acm.2025.153611, PDF,    科研立项经费支持
作者: 李小红, 赵秋燕, 董 榆*：大理大学第一附属医院，心血管内科，云南 大理
关键词: 载脂蛋白；冠心病；高血压；心力衰竭；糖尿病；Apolipoprotein； Coronary Heart Disease； Hypertension； Heart Failure； Diabetes
摘要: 载脂蛋白(Apolipoprotein)是与脂质结合，形成脂蛋白的蛋白质分子，它主要负责脂质的运输和代谢，根据其功能和结构特性，载脂蛋白可分为A类、B类、C类、E类以及脂蛋白(a)，其主要的载脂蛋白如ApoA1、ApoB和ApoE各自承担着独特的职能，影响着人体的脂质代谢和心血管健康。既往研究表明，Apolipoprotein异常表达与多种疾病的发生和发展密切相关，本文将从载脂蛋白A1 (ApoA1)、载脂蛋白B (ApoB)及两者比值(ApoB/ApoA1)的研究进展入手进行概述。
Abstract: Apolipoproteins are protein molecules that bind with lipids to form lipoproteins. It is mainly responsible for the transportation and metabolism of lipids. They can be classified into various classes based on their functional and structural characteristics, including apolipoprotein A, B, C, E, and lipoprotein (a). Key proteins, such as ApoA1, ApoB, and ApoE each have unique functions that impact lipid metabolism and cardiovascular health in the human body. Research conducted in the past indicates that unusual levels of apolipoproteins are strongly linked to the onset and progression of multiple diseases. This article will summarize the research progress of apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and their ratio (ApoB/ApoA1).
文章引用：李小红, 赵秋燕, 董榆. 载脂蛋白B/载脂蛋白A1的临床研究进展[J]. 临床医学进展, 2025, 15(3): 253-261. https://doi.org/10.12677/acm.2025.153611

参考文献

[1] Beisiegel, U. (1998) Lipoprotein Metabolism. European Heart Journal, 19, A20-A23.
[2] Behbodikhah, J., Ahmed, S., Elyasi, A., Kasselman, L.J., De Leon, J., Glass, A.D., et al. (2021) Apolipoprotein B and Cardiovascular Disease: Biomarker and Potential Therapeutic Target. Metabolites, 11, Article 690. [Google Scholar] [CrossRef] [PubMed]
[3] Linton, M.F., Yancey, P.G., Davies, S.S., et al. (2019) The Role of Lipids and Lipoproteins in Atherosclerosis. Endotext.
[4] Borén, J. and Williams, K.J. (2016) The Central Role of Arterial Retention of Cholesterol-Rich Apolipoprotein-B-Containing Lipoproteins in the Pathogenesis of Atherosclerosis: A Triumph of Simplicity. Current Opinion in Lipidology, 27, 473-483. [Google Scholar] [CrossRef] [PubMed]
[5] Frank, P.G. and Marcel, Y.L. (2000) Apolipoprotein A-I: Structure-Function Relationships. Journal of Lipid Research, 41, 853-872. [Google Scholar] [CrossRef] 
[6] Cochran, B.J., Ong, K., Manandhar, B. and Rye, K. (2021) ApoA1: A Protein with Multiple Therapeutic Functions. Current Atherosclerosis Reports, 23, Article No. 11. [Google Scholar] [CrossRef] [PubMed]
[7] Chistiakov, D.A., Orekhov, A.N. and Bobryshev, Y.V. (2016) ApoA1 and ApoA1-Specific Self-Antibodies in Cardiovascular Disease. Laboratory Investigation, 96, 708-718. [Google Scholar] [CrossRef] [PubMed]
[8] Button, E.B., Boyce, G.K., Wilkinson, A., Stukas, S., Hayat, A., Fan, J., et al. (2019) ApoA-I Deficiency Increases Cortical Amyloid Deposition, Cerebral Amyloid Angiopathy, Cortical and Hippocampal Astrogliosis, and Amyloid-Associated Astrocyte Reactivity in APP/PS1 Mice. Alzheimer’s Research & Therapy, 11, Article No. 44. [Google Scholar] [CrossRef] [PubMed]
[9] Wang, X., Gong, Y., Deng, T., Zhang, L., Liao, X., Han, C., et al. (2019) Diagnostic and Prognostic Significance of mRNA Expressions of Apolipoprotein A and C Family Genes in Hepatitis B Virus-Related Hepatocellular Carcinoma. Journal of Cellular Biochemistry, 120, 18246-18265. [Google Scholar] [CrossRef] [PubMed]
[10] Hughes, T.A., Calderon, R.M., Diaz, S., Mendez, A.J. and Goldberg, R.B. (2016) Lipoprotein Composition in Patients with Type 1 Diabetes Mellitus: Impact of Lipases and Adipokines. Journal of Diabetes and Its Complications, 30, 657-668. [Google Scholar] [CrossRef] [PubMed]
[11] Tian, M., Li, R., Shan, Z., Wang, D.W., Jiang, J. and Cui, G. (2019) Comparison of Apolipoprotein B/A1 Ratio, Framingham Risk Score and TC/HDL-C for Predicting Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention. Lipids in Health and Disease, 18, Article No. 202. [Google Scholar] [CrossRef] [PubMed]
[12] Ljungberg, J., Holmgren, A., Bergdahl, I.A., Hultdin, J., Norberg, M., Näslund, U., et al. (2017) Lipoprotein(a) and the Apolipoprotein B/A1 Ratio Independently Associate with Surgery for Aortic Stenosis Only in Patients with Concomitant Coronary Artery Disease. Journal of the American Heart Association, 6, e007160. [Google Scholar] [CrossRef] [PubMed]
[13] Tani, S., Nagao, K., Anazawa, T., Kawamata, H., Furuya, S., Takahashi, H., et al. (2010) Relation of Change in Apolipoprotein B/Apolipoprotein A-I Ratio to Coronary Plaque Regression after Pravastatin Treatment in Patients with Coronary Artery Disease. The American Journal of Cardiology, 105, 144-148. [Google Scholar] [CrossRef] [PubMed]
[14] Kim, J.H., Jeong, M.H., Hong, Y.J., Lee, K.H., Kim, I.S., Choi, Y.H., et al. (2012) Low Density Lipoprotein-Cholesterol/High Density Lipoprotein-Cholesterol Ratio Predicts Plaque Vulnerability in Patients with Stable Angina. Korean Circulation Journal, 42, 246-251. [Google Scholar] [CrossRef] [PubMed]
[15] Hua, R., Li, Y., Li, W., Wei, Z., Yuan, Z. and Zhou, J. (2021) Apolipoprotein B/A1 Ratio Is Associated with Severity of Coronary Artery Stenosis in CAD Patients but Not in Non-Cad Patients Undergoing Percutaneous Coronary Intervention. Disease Markers, 2021, 1-10. [Google Scholar] [CrossRef] [PubMed]
[16] Fu, C., Liu, D., Liu, Q., Wang, X., Ma, X., Pan, H., et al. (2024) Revisiting an Old Relationship: The Causal Associations of the ApoB/ApoA1 Ratio with Cardiometabolic Diseases and Relative Risk Factors—A Mendelian Randomization Analysis. Cardiovascular Diabetology, 23, Article No. 51. [Google Scholar] [CrossRef] [PubMed]
[17] Pencina, M.J., D’Agostino, R.B., Zdrojewski, T., Williams, K., Thanassoulis, G., Furberg, C.D., et al. (2015) Apolipoprotein B Improves Risk Assessment of Future Coronary Heart Disease in the Framingham Heart Study Beyond LDL-C and Non-HDL-C. European Journal of Preventive Cardiology, 22, 1321-1327. [Google Scholar] [CrossRef] [PubMed]
[18] Sniderman, A.D., Islam, S., McQueen, M., Pencina, M., Furberg, C.D., Thanassoulis, G., et al. (2016) Age and Cardiovascular Risk Attributable to Apolipoprotein B, Low-Density Lipoprotein Cholesterol or Non-High-Density Lipoprotein Cholesterol. Journal of the American Heart Association, 5, e003665. [Google Scholar] [CrossRef] [PubMed]
[19] Thanassoulis, G., Williams, K., Ye, K., Brook, R., Couture, P., Lawler, P.R., et al. (2014) Relations of Change in Plasma Levels of LDL-C, Non-HDL-C and ApoB with Risk Reduction from Statin Therapy: A Meta-Analysis of Randomized Trials. Journal of the American Heart Association, 3, e000759. [Google Scholar] [CrossRef] [PubMed]
[20] Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., et al. (2004) Effect of Potentially Modifiable Risk Factors Associated with Myocardial Infarction in 52 Countries (the INTERHEART Study): Case-Control Study. The Lancet, 364, 937-952. [Google Scholar] [CrossRef] [PubMed]
[21] Bodde, M.C., Hermans, M.P.J., Jukema, J.W., Schalij, M.J., Lijfering, W.M., Rosendaal, F.R., et al. (2018) Apolipoproteins A1, B, and ApoB/ApoA1 Ratio Are Associated with First St-Segment Elevation Myocardial Infarction but Not with Recurrent Events during Long-Term Follow-Up. Clinical Research in Cardiology, 108, 520-538. [Google Scholar] [CrossRef] [PubMed]
[22] McQueen, M.J., Hawken, S., Wang, X., Ounpuu, S., Sniderman, A., Probstfield, J., et al. (2008) Lipids, Lipoproteins, and Apolipoproteins as Risk Markers of Myocardial Infarction in 52 Countries (The Interheart Study): A Case-Control Study. The Lancet, 372, 224-233. [Google Scholar] [CrossRef] [PubMed]
[23] Galal, H., Samir, A. and Shehata, M. (2020) Assessment of Apolipoprotein B/Apolipoprotein A-I Ratio in Non-ST Segment Elevation Acute Coronary Syndrome Patients. The Egyptian Heart Journal, 72, Article No. 27. [Google Scholar] [CrossRef] [PubMed]
[24] Liu, Y., Jia, S., Yuan, D., Xu, N., Jiang, L., Gao, Z., et al. (2020) Apolipoprotein B/A-I Ratio Predicts Lesion Severity and Clinical Outcomes in Diabetic Patients with Acute Coronary Syndrome. Circulation Journal, 84, 1132-1139. [Google Scholar] [CrossRef] [PubMed]
[25] Florvall, G., Basu, S. and Larsson, A. (2006) Apolipoprotein A1 Is a Stronger Prognostic Marker than Are HDL and LDL Cholesterol for Cardiovascular Disease and Mortality in Elderly Men. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61, 1262-1266. [Google Scholar] [CrossRef] [PubMed]
[26] Walldius, G., Jungner, I., Aastveit, A.H., Holme, I., Furberg, C.D. and Sniderman, A.D. (2004) The ApoB/ApoA-I Ratio Is Better than the Cholesterol Ratios to Estimate the Balance between Plasma Proatherogenic and Antiatherogenic Lipoproteins and to Predict Coronary Risk. Clinical Chemistry and Laboratory Medicine (CCLM), 42, 1355-1363. [Google Scholar] [CrossRef] [PubMed]
[27] Canouï-Poitrine, F., Luc, G., Bard, J., Ferrieres, J., Yarnell, J., Arveiler, D., et al. (2010) Relative Contribution of Lipids and Apolipoproteins to Incident Coronary Heart Disease and Ischemic Stroke: The PRIME Study. Cerebrovascular Diseases, 30, 252-259. [Google Scholar] [CrossRef] [PubMed]
[28] Han, S.J., Fujimoto, W.Y., Kahn, S.E., Leonetti, D.L. and Boyko, E.J. (2020) Apolipoprotein B Levels Predict Future Development of Hypertension Independent of Visceral Adiposity and Insulin Sensitivity. Endocrinology and Metabolism, 35, 351-358. [Google Scholar] [CrossRef] [PubMed]
[29] Pietri, P., Vlachopoulos, C., Vyssoulis, G., Ioakeimidis, N., Terentes-Printzios, D., Skoumas, J., et al. (2016) [OP.1B.08] Association of ApoB/ApoA 1 Ratio with Target Organ Damage in Hypertensive Patients. Journal of Hypertension, 34, e7. [Google Scholar] [CrossRef] 
[30] He, H., Feng, J., Zhang, S., Wang, Y., Li, J., Gao, J., et al. (2022) The Apolipoprotein B/A1 Ratio Is Associated with Metabolic Syndrome Components, Insulin Resistance, Androgen Hormones, and Liver Enzymes in Women with Polycystic Ovary Syndrome. Frontiers in Endocrinology, 12, Article 773781. [Google Scholar] [CrossRef] [PubMed]
[31] Sun, Q., Jiang, S., Wang, X., Zhang, J., Li, Y., Tian, J., et al. (2022) A Prediction Model for Major Adverse Cardiovascular Events in Patients with Heart Failure Based on High-Throughput Echocardiographic Data. Frontiers in Cardiovascular Medicine, 9, Article 1022658. [Google Scholar] [CrossRef] [PubMed]
[32] Smadja, D.M. (2022) Stem Cell Therapy, Artificial Heart or Xenotransplantation: What Will Be New “Regenerative” Strategies in Heart Failure during the Next Decade? Stem Cell Reviews and Reports, 19, 694-699. [Google Scholar] [CrossRef] [PubMed]
[33] Li, S., Xie, X., Zeng, X., Wang, S. and Lan, J. (2023) Serum Apolipoprotein B to Apolipoprotein A-I Ratio Predicts Mortality in Patients with Heart Failure. ESC Heart Failure, 11, 99-111. [Google Scholar] [CrossRef] [PubMed]
[34] Holme, I., Aastveit, A.H., Hammar, N., Jungner, I. and Walldius, G. (2009) Lipoprotein Components and Risk of Congestive Heart Failure in 84 740 Men and Women in the Apolipoprotein Mortality Risk Study (AMORIS). European Journal of Heart Failure, 11, 1036-1042. [Google Scholar] [CrossRef] [PubMed]
[35] Zhou, Y., Liu, H., Yang, H., Zhao, X. and Jiao, Y. (2023) The Value of the Apolipoprotein B/Apolipoprotein A1 Ratio in Predicting the Rapid Progression of Non-Culprit Coronary Lesions in Acute Coronary Syndrome in Patients with Diabetes Mellitus after Percutaneous Coronary Intervention. International Heart Journal, 64, 562-569. [Google Scholar] [CrossRef] [PubMed]
[36] American Diabetes Association (2013) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 37, S81-S90. [Google Scholar] [CrossRef] [PubMed]
[37] Gao, L., Zhang, Y., Wang, X. and Dong, H. (2021) Association of Apolipoproteins A1 and B with Type 2 Diabetes and Fasting Blood Glucose: A Cross-Sectional Study. BMC Endocrine Disorders, 21, Article No. 59. [Google Scholar] [CrossRef] [PubMed]
[38] Zheng, S., Han, T., Xu, H., Zhou, H., Ren, X., Wu, P., et al. (2017) Associations of Apolipoprotein B/Apolipoprotein A-I Ratio with Pre-Diabetes and Diabetes Risks: A Cross-Sectional Study in Chinese Adults. BMJ Open, 7, e014038. [Google Scholar] [CrossRef] [PubMed]
[39] Mao, Y., Xu, Y. and Lu, L. (2017) The Nonlinear Association between Apolipoprotein B to Apolipoprotein A1 Ratio and Type 2 Diabetes. Medicine, 96, e5834. [Google Scholar] [CrossRef] [PubMed]
[40] Lim, H.H. and Kim, O.Y. (2016) Association of Serum Apolipoprotein B with the Increased Risk of Diabetes in Korean Men. Clinical Nutrition Research, 5, 204-212. [Google Scholar] [CrossRef] [PubMed]
[41] Malyala, R., Rapi, L., Nash, M.M. and Prasad, G.V.R. (2019) Serum Apolipoprotein B and A1 Concentrations Predict Late-Onset Posttransplant Diabetes Mellitus in Prevalent Adult Kidney Transplant Recipients. Canadian Journal of Kidney Health and Disease, 6, Article 2054358119850536. [Google Scholar] [CrossRef] [PubMed]
[42] Han, S.K., Baik, S.K. and Kim, M.Y. (2023) Non-Alcoholic Fatty Liver Disease: Definition and Subtypes. Clinical and Molecular Hepatology, 29, S5-S16. [Google Scholar] [CrossRef] [PubMed]
[43] Choe, Y.G., Jin, W., Cho, Y.K., Chung, W.G., Kim, H.J., Jeon, W.K., et al. (2013) Apolipoprotein B/AI Ratio Is Independently Associated with Non-Alcoholic Fatty Liver Disease in Nondiabetic Subjects. Journal of Gastroenterology and Hepatology, 28, 678-683. [Google Scholar] [CrossRef] [PubMed]
[44] Zhao, Y. (2022) Association between Apolipoprotein B/A1 and the Risk of Metabolic Dysfunction Associated Fatty Liver Disease According to Different Lipid Profiles in a Chinese Population: A Cross-Sectional Study. Clinica Chimica Acta, 534, 138-145. [Google Scholar] [CrossRef] [PubMed]
[45] Huh, J.H., Jung, S., Cho, S.K., Lee, K.J. and Kim, J.W. (2018) Predictive Value of Apolipoprotein B and A-I Ratio in Severe Acute Pancreatitis. Journal of Gastroenterology and Hepatology, 33, 548-553. [Google Scholar] [CrossRef] [PubMed]
[46] 钟瑞, 徐欢, 彭燕, 等. 血清载脂蛋白A1和载脂蛋白B/A1比值对重型急性胰腺炎的预测价值[J]. 临床肝胆病杂志, 2020, 36(3): 631-635.
[47] Wu, J., Wang, Y., Li, H., Tan, W., Chen, X. and Ye, S. (2019) Serum Apolipoprotein B-to-Apolipoprotein A1 Ratio Is Independently Associated with Disease Severity in Patients with Acute Pancreatitis. Scientific Reports, 9, Article No. 7764. [Google Scholar] [CrossRef] [PubMed]
[48] Fan, S., Lai, E.C.S., Mok, F.P.T., Lo, C., Zheng, S. and Wong, J. (1993) Prediction of the Severity of Acute Pancreatitis. The American Journal of Surgery, 166, 262-269. [Google Scholar] [CrossRef] [PubMed]
[49] Woodruff, T.M., Thundyil, J., Tang, S., Sobey, C.G., Taylor, S.M. and Arumugam, T.V. (2011) Pathophysiology, Treatment, and Animal and Cellular Models of Human Ischemic Stroke. Molecular Neurodegeneration, 6, Article No. 11. [Google Scholar] [CrossRef] [PubMed]
[50] Hahm, C. and Hong, K. (2012) Apolipoprotein B/A1 Ratio as Risk Factor for Cerebral Ischemic Stroke. The Ewha Medical Journal, 35, 21-25. [Google Scholar] [CrossRef] 
[51] Lin, J., Si, Z. and Wang, A. (2024) Predictive Value of ApoB/ApoA-I for Recurrence within 1 Year after First Incident Stroke. Frontiers in Neurology, 14, Article 1308442. [Google Scholar] [CrossRef] [PubMed]
[52] Kalani, R., Krishnamoorthy, S., Deepa, D., Gopala, S., Prabhakaran, D., Tirschwell, D., et al. (2020) Apolipoproteins B and A1 in Ischemic Stroke Subtypes. Journal of Stroke and Cerebrovascular Diseases, 29, Article 104670. [Google Scholar] [CrossRef] [PubMed]
[53] Lee, M., Lim, J., Kim, Y., Park, S.H., Lee, S., Kim, C., et al. (2023) High ApoB/ApoA-I Ratio Predicts Post-Stroke Cognitive Impairment in Acute Ischemic Stroke Patients with Large Artery Atherosclerosis. Nutrients, 15, Article 4670. [Google Scholar] [CrossRef] [PubMed]
[54] Fahmy, E.M., El Awady, M.A.E.S., Sharaf, S.A., Selim, N.M., Abdo, H.E.S. and Mohammed, S.S. (2020) Apolipoproteins A1 and B and Their Ratio in Acute Ischemic Stroke Patients with Intracranial and Extracranial Arterial Stenosis: An Egyptian Study. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 56, Article No. 115. [Google Scholar] [CrossRef] 
[55] Eldeeb, M.A., Zaki, A.S., Ashour, S., Abdel Nasser, A., El Bassiouny, A. and Abdulghani, K.O. (2019) Serum Apolipoprotein A1: A Predictor and Prognostic Biomarker in Acute Ischemic Stroke. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 56, Article No. 3. [Google Scholar] [CrossRef] 
[56] Kostapanos, M.S., Christogiannis, L.G., Bika, E., Bairaktari, E.T., Goudevenos, J.A., Elisaf, M.S., et al. (2010) Apolipoprotein B-to-A1 Ratio as a Predictor of Acute Ischemic Nonembolic Stroke in Elderly Subjects. Journal of Stroke and Cerebrovascular Diseases, 19, 497-502. [Google Scholar] [CrossRef] [PubMed]
[57] Daneshpajouhnejad, P., Kopp, J.B., Winkler, C.A. and Rosenberg, A.Z. (2022) The Evolving Story of Apolipoprotein L1 Nephropathy: The End of the Beginning. Nature Reviews Nephrology, 18, 307-320. [Google Scholar] [CrossRef] [PubMed]
[58] Pan, X. (2022) The Roles of Fatty Acids and Apolipoproteins in the Kidneys. Metabolites, 12, Article 462. [Google Scholar] [CrossRef] [PubMed]
[59] Sniderman, A.D. and Kiss, R.S. (2007) The Strengths and Limitations of the ApoB/ApoA-I Ratio to Predict the Risk of Vascular Disease: A Hegelian Analysis. Current Atherosclerosis Reports, 9, 261-265. [Google Scholar] [CrossRef] [PubMed]
[60] Nurtazina, A., Kozhakhmetova, D., Dautov, D., Shakhanova, A. and Chattu, V.K. (2020) Apolipoprotein B/A1 Ratio as a Diagnostic Alternative to Triglycerides and HDL-Cholesterol for the Prediction of Metabolic Syndrome among Hypertensives in Kazakhstan. Diagnostics, 10, Article 510. [Google Scholar] [CrossRef] [PubMed]

为你推荐