A New Prediction Model Integrated Serum Lipid Profile for Patients with Multiple Myeloma

Abstract This study aimed to explore a predictive risk-stratification model combing clinical characteristics and lipid profiles in multiple myeloma (MM) patients. The data of 275 patients in Sun Yat-Sen University Cancer Center were retrospectively analyzed and randomly divided into the training (n = 138) and validation (n = 137) cohorts. Triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), lactate dehydrogenase (LDH), Apolipoprotein B (Apo B) and Apo B / Apolipoprotein A1 (Apo A1) ratio were the prognostic factors identified through univariate and multivariate Cox analysis. A 6-prognostic factor model was constructed based on Lasso regression. Patients were divided into low- and high-risk groups and the former group showed longer overall survival (OS) time (p<0.05). The area under the curve (AUC) of the risk score model for 5-and 10-year OS were 0.756 [95% CI: 0.661-0.850] and 0.940 [95% CI: 0.883-0.997], which exhibited better accuracy than International Staging System (ISS) and Durie and Salmon (DS) stage. The nomogram integrating ISS stage and risk score increased the prediction accuracy. The model can be used to help monitor the metabolic state and to establish primary prevention strategies to identify new therapeutic targets.

Download Full-text

Identification of High Serum Apolipoprotein A1 As a Favorable Prognostic Indicator in Patients with Multiple Myeloma

Blood ◽

10.1182/blood-2018-99-110919 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 5589-5589

Author(s):

Peng Liu ◽

Lifan Liang ◽

Jing Li

Keyword(s):

Multiple Myeloma ◽

Multivariate Analysis ◽

Serum Lipid ◽

Cox Regression ◽

Prognostic Significance ◽

Density Lipoprotein ◽

Prognostic Indicator ◽

Lipid Profiles ◽

Apolipoprotein A1 ◽

Apo B

Abstract Purpose To explore the prognostic significance of serum lipid profiles in patients with multiple myeloma (MM). Patients and methods The study retrospectively enrolled 307 MM patients in Zhongshan Hospital, Shanghai, China, from 2007 to 2016. We evaluated the prognostic significance of the prediagnostic serum lipid profile [cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), Apolipoprotein A1 (Apo A1) and Apolipoprotein B (Apo B)]. Prognostic factors identified through univariate and multivariate analysis were used to construct a new model based on Lasso Cox regression. Results In our cohort, lipid levels showed significant difference between ISS stages (P<0.001 in cholesterol, P<0.001 in LDL, P=0.002 in HDL, P<0.001 in Apo A1, P<0.001 in Apo B). However, only Apo A1 showed statistically significance in overall survival (OS), progression free survival (PFS) and cause specific survival (CSS) (P=0.038, P=0.028, P=0.011) in univariate Cox regression. Patients with higher Apo A1 displayed longer OS (median OS, 67 months vs. 30 months; P<0.001). Also, Apo A1 was revealed to be independent prognostic parameters through multivariate analysis. Combining the Apo A1 level, a Zhongshan Score model was constructed with Lasso regression for prognosis prediction. This model exhibited higher accuracy than International Staging System (ISS) and Durie and Salmon (DS) system. Conclusion Among all the serum lipid profiles, serum Apo A1 is a powerful prognostic indicator for patients with MM. Disclosures No relevant conflicts of interest to declare.

Download Full-text

A Systematic Review and Meta-Analysis of Therapeutic Efficacy and Safety of Alirocumab and Evolocumab on Familial Hypercholesterolemia

BioMed Research International ◽

10.1155/2021/8032978 ◽

2021 ◽

Vol 2021 ◽

pp. 1-16

Author(s):

Xiaoyue Ge ◽

Tiantian Zhu ◽

Hao Zeng ◽

Xin Yu ◽

Juan Li ◽

...

Keyword(s):

Clinical Trials ◽

Adverse Events ◽

Familial Hypercholesterolemia ◽

Meta Analysis ◽

Density Lipoprotein ◽

Apolipoprotein A1 ◽

Cochrane Library ◽

Efficacy And Safety ◽

Apo B ◽

Significant Difference

Objectives. The aim of this study was to provide the first study to systematically analyze the efficacy and safety of PCSK9-mAbs in the treatment of familial hypercholesterolemia (FH). Methods. A computer was used to search the electronic Cochrane Library, PubMed/MEDLINE, and Embase databases for clinical trials using the following search terms: “AMG 145”, “evolocumab”, “SAR236553/REGN727”, “alirocumab”, “RG7652”, “LY3015014”, “RN316/bococizumab”, “PCSK9”, and “familial hypercholesterolemia” up to November 2020. Study quality was assessed with the Cochrane Collaboration’s tool, and publication bias was evaluated by a contour-enhanced funnel plot and the Harbord modification of the Egger test. After obtaining the data, a meta-analysis was performed using R software, version 4.0.3. Results. A meta-analysis was performed on 7 clinical trials (926 total patients). The results showed that PCSK9-mAbs reduced the LDL-C level by the greatest margin, WMD −49.14%, 95% CI: −55.81 to −42.47%, on FH versus control groups. PCSK9-mAbs also significantly reduced lipoprotein (a) (Lp (a)), total cholesterol (TC), triglycerides (TG), apolipoprotein-B (Apo-B), and non-high-density lipoprotein cholesterol (non-HDL-C) levels and increased HDL-C and apolipoprotein-A1 (Apo-A1) levels of beneficial lipoproteins. Moreover, no significant difference was found between PCSK9-mAbs treatment and placebo in common adverse events, serious events, and laboratory adverse events. Conclusion. PCSK9-mAbs significantly decreased LDL-C and other lipid levels with satisfactory safety and tolerability in FH treatment.

Download Full-text

A Prognostic Scoring System for Patients with Multiple Myeloma Who Were Classified Stage II By Revised International Staging System

Blood ◽

10.1182/blood.v128.22.3284.3284 ◽

2016 ◽

Vol 128 (22) ◽

pp. 3284-3284

Author(s):

Sung-Hoon Jung ◽

Kihyun Kim ◽

Jin Seok Kim ◽

Seok Jin Kim ◽

June-Won Cheong ◽

...

Keyword(s):

Multiple Myeloma ◽

Risk Score ◽

Scoring System ◽

Prognostic Model ◽

Staging System ◽

Stage Ii ◽

Survival Outcomes ◽

Prognostic Tool ◽

International Staging System ◽

Novel Agent

Abstract Background: Revised International Staging System (R-ISS) is recently proposed risk stratification algorism based on ISS, cytogenetic risk, and lactate dehydrogenase in multiple myeloma (MM). Although R-ISS had an improved prognostic power compared to ISS, there is a problem that patients with stage II increase to 1.7 times. In this study, we evaluated survival outcomes and a new prognostic tool for MM patients classified as R-ISS II. Methods: Retrospective data from 441 patients who were initially treated with a novel agent-containing regimens were analyzed. Results: R-ISS staging system could discriminate survival outcome more clearly compared to ISS in patients treated with novel-agents [median overall survival (OS) times of R-ISS I vs. II. Vs. III was 76.3 vs. 51.3 vs. 30.3 months, P < 0.001]. By applying R-ISS, 6.2% of patients with ISS I, and 24.3% with ISS III were reclassified into R-ISS II. Overall, 290 patients (66%) was classified into R-ISS II and had wide range of survival outcomes (0.7-114.5 months). In multivariate analysis, poor performance status (PS) (HR 1.657, 95% CI 1.159-2.370, P =0.006), del (17p13) (HR 2.227, 95% CI 1.174-4.223), P = 0.014), and thrombocytopenia (HR 1.533, 95% CI 1.033-2.276, P = 0.034) were significantly associated with OS in patients with R-ISS II. Based on this analysis, we constructed a new prognostic model consisted of poor PS (1 point), del(17p13) (2 point), and thrombocytopenia (1point). Among the 290 patients, 152 patients (52.4%) were classified as low-risk (score 0), 109 (37.5%) as intermediate risk (score 1), and 29 (10%) as high risk (scores 2 or more). The median OS times for the corresponding risk groups was 57.5 months (95% CI 40.4-74.5), 30.2 months (95% CI 20.7-39.7), and 20.9 months (95% CI 6.4-35.3) (P <0.001). Conclusion: R-ISS is an excellent prognostic tool in MM in the novel-agent era, but there is a limitation that most of patients were classified into R-ISS II. A new prognostic model for patients with R-ISS II is needed, and prognostic scoring system based on poor PS, del(17p13), and thrombocytopenia may be useful to distinguishing survival outcomes of patients with R-ISS II. Figure Figure. Disclosures No relevant conflicts of interest to declare.

Download Full-text

Risk Factors to Predict Ocular Metastasis in Older Adult Patients With Gastric Cancer:LDL, ApoA1, and CA724

Technology in Cancer Research & Treatment ◽

10.1177/15330338211065876 ◽

2022 ◽

Vol 21 ◽

pp. 153303382110658

Author(s):

Wen-Qing Shi ◽

Shi-Nan Wu ◽

Tie Sun ◽

Hui-Ye Shu ◽

Qi-Chen Yang ◽

...

Keyword(s):

Risk Factors ◽

Roc Curve ◽

Area Under The Curve ◽

Density Lipoprotein ◽

Demographic Characteristics ◽

Curve Analysis ◽

Apolipoprotein A1 ◽

Roc Curve Analysis ◽

Significant Difference ◽

Ocular Metastasis

Objective: The purpose of this study was to explore the risk factors for Ocular metastasis (OM) of Gastric cancer (GC). Methods: This is a retrospective cohort study. A total of 1165 patients with GC were enrolled in this study and divided into OM and non-ocular metastasis (NOM) groups. Chi-square and independent samples t tests were used to determine whether differences in demographic characteristics and serological indicators (SI) between the two groups were significant. In addition, binary logistic regression was used to analyze the value of various SI as risk factors for OM in patients with GC. The statistical threshold was set as P < .05. Finally, receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic value of various SI in differentiating the occurrence of OM in patients with GC. Results: The incidence of OM in older adults with GC was 1.1%. Adenocarcinoma was the most common type of GC in both groups, and there was no significant difference in demographic characteristics between the groups. Low-density lipoprotein (LDL), carbohydrate antigen-724 (CA724), and carcinoembryonic antigen levels were significantly higher in the OM group than the NOM group, while those of apolipoprotein A1 (ApoA1) were significantly lower in the OM than the NOM group. Binary logistic analysis showed that LDL, ApoA1, and CA724 were independent risk factors for OM in patients with GC ( P < .001, P = .033, and P = .008, respectively). ROC curve analysis generated area under the curve (AUC) values of 0.881, 0.576, and 0.906 for LDL, ApoA1, and CA724, respectively. In addition, combined analysis of LDL, ApoA1, and CA724 generated the highest AUC value of 0.924 ( P < .001). Conclusion: Among SI, LDL, ApoA1, and CA724 have predictive value for the occurrence of OM in GC, with the three factors combined having the highest value.

Download Full-text

Serum Apolipoprotein B/apolipoprotein A1 Ratio in Relation to Intervertebral Disc Herniation : A Cross-sectional Frequency-Matched Case-Control Study

10.21203/rs.3.rs-113468/v1 ◽

2020 ◽

Author(s):

Fei Chen ◽

Tongde Wu ◽

Song Guo ◽

Junwen Huang ◽

Qiang Fu ◽

...

Keyword(s):

Apolipoprotein B ◽

Serum Lipid ◽

Density Lipoprotein ◽

Apolipoprotein A1 ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Lipid Levels ◽

Apo B ◽

Serum Lipid Levels ◽

Apo Ai

Abstract BackgroundIn recent decades, the serum lipid profile of apolipoprotein(a) (Lp(a)) level and apolipoprotein B/apolipoprotein A1 ratio (Apo B/ApoA1) ratio were found more representative for serum lipid level and were recognized as the independent risk factors for various diseases. Although the serum lipid levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were found associated with symptomatic IDH, no studies have been conducted to date for the evaluation of the association of Apo AI, Apo B, Lp(a) and Apo B/Apo AI levels with symptomatic IDH.MaterialsA total of 1,839 Chinese patients were recruited in the present study. 918 patients were diagnosed as IDH cases and were enrolled in the experimental group. A control group of 921 patients underwent a physical examination during the same period. The serum lipid levels of TC, TG, LDL-C, HDL-C, Lp(a), Apo B and Apo B/Apo AI were examined and analyzed.ResultsThe patients in the control group were collected randomly from patients who were matched with the baseline levels of the aforementioned lipid molecular. The patients with IDH exhibited significantly higher TC, TG, LDL, Apo B and Lp(a) levels compared with the control subjects. The percentage of high-TC, high-TG, high-LDL, high-Apo B and high-Lp(a) were significantly higher in the IDH group. However, hyperlipidaemia was not associated with the degenerated segment of the IDH (P=0.201). The odds ratios (OR) for the incidence of IDH with an elevated LDL-C, TC, TG, Lp(a), Apo B and Apo B/Apo AI were 1.583, 1.74, 1.62, 1.58, 1.49 and 1.39, respectively. The correlation analysis revealed the correlation between elevated LDL-C, TC, TG, Apo B, Lp(a) and incidence of IDH was significant (R2LDL=0.017; R2TC=0.004; R2TG=0.015; R2Apo B=0.004; R2LP(a)=0.021) (P<0.05). ConclusionsThe present study suggests that elevated levels of serum TC, TG, LDL, Apo B, Lp(a) and Apo B/Apo AI are associated with a higher risk for IDH.

Download Full-text

A validated gene expression model of high-risk multiple myeloma is defined by deregulated expression of genes mapping to chromosome 1

Blood ◽

10.1182/blood-2006-07-038430 ◽

2006 ◽

Vol 109 (6) ◽

pp. 2276-2284 ◽

Cited By ~ 582

Author(s):

John D. Shaughnessy ◽

Fenghuang Zhan ◽

Bart E. Burington ◽

Yongsheng Huang ◽

Simona Colla ◽

...

Keyword(s):

Multiple Myeloma ◽

High Risk ◽

Risk Score ◽

Staging System ◽

Therapeutic Interventions ◽

Chromosome 1 ◽

Chromosome 1P ◽

Chromosome 1Q ◽

Expression Of Genes ◽

High Risk Disease

Abstract To molecularly define high-risk disease, we performed microarray analysis on tumor cells from 532 newly diagnosed patients with multiple myeloma (MM) treated on 2 separate protocols. Using log-rank tests of expression quartiles, 70 genes, 30% mapping to chromosome 1 (P < .001), were linked to early disease-related death. Importantly, most up-regulated genes mapped to chromosome 1q, and down-regulated genes mapped to chromosome 1p. The ratio of mean expression levels of up-regulated to down-regulated genes defined a high-risk score present in 13% of patients with shorter durations of complete remission, event-free survival, and overall survival (training set: hazard ratio [HR], 5.16; P < .001; test cohort: HR, 4.75; P < .001). The high-risk score also was an independent predictor of outcome endpoints in multivariate analysis (P < .001) that included the International Staging System and high-risk translocations. In a comparison of paired baseline and relapse samples, the high-risk score frequency rose to 76% at relapse and predicted short postrelapse survival (P < .05). Multivariate discriminant analysis revealed that a 17-gene subset could predict outcome as well as the 70-gene model. Our data suggest that altered transcriptional regulation of genes mapping to chromosome 1 may contribute to disease progression, and that expression profiling can be used to identify high-risk disease and guide therapeutic interventions.

Download Full-text

Development of a Predictive Model of Difficult Hemostasis following Endobronchial Biopsy in Lung Cancer Patients

BioMed Research International ◽

10.1155/2019/1656890 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Saibin Wang

Keyword(s):

Lung Cancer ◽

Predictive Model ◽

Cancer Patients ◽

Primary Lung Cancer ◽

Area Under The Curve ◽

Density Lipoprotein ◽

Curve Analysis ◽

Lasso Regression ◽

Internal Validation ◽

Lung Cancer Patients

Endobronchial biopsy (EBB)-induced bleeding is fairly common; however, it can be potentially life-threatening due to difficult hemostasis following EBB. The aim of this study was to develop a predictive model of difficult hemostasis post-EBB. A total of 620 consecutive patients with primary lung cancer who had undergone EBB between 2014 and 2018 in a large tertiary hospital were enrolled in this retrospective single-center cohort study. Patients were classified into the difficult hemostasis group and the nondifficult hemostasis group according to hemostatic measures used following EBB. The LASSO regression method was used to select predictors and multivariate logistic regression was applied to develop the predictive model. The area under the curve (AUC) of the model was calculated. Bootstrapping method was applied for internal validation. Calibration curve analysis and decision curve analysis (DCA) were also performed. A nomogram was constructed to display the model. The incidence of difficult hemostasis post-EBB was 11.9% (74/620). Eight variables were selected by the LASSO regression analysis and seven (histological type of cancer, lesion location, neutrophil percentage, activated partial thromboplastin time, low density lipoprotein cholesterol, apolipoprotein-E, and pulmonary infection) of them were finally included in the predictive model. The AUC of the model was 0.822 (95% CI, 0.777-0.868), and it was 0.808 (95% CI, 0.761-0.856) in the internal validation. The predictive model was well calibrated and DCA indicated its potential clinical usefulness, which suggests that the model has great potential to predict lung cancer patients with a more difficult post-EBB hemostasis.

Download Full-text

Serum apolipoprotein B/apolipoprotein A1 ratio in relation to intervertebral disk herniation: a cross-sectional frequency-matched case–control study

Lipids in Health and Disease ◽

10.1186/s12944-021-01502-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Fei Chen ◽

Tongde Wu ◽

Chong Bai ◽

Song Guo ◽

Wenjun Huang ◽

...

Keyword(s):

Serum Lipid ◽

Density Lipoprotein ◽

Intervertebral Disk ◽

Apolipoprotein A1 ◽

Control Group ◽

Lipid Levels ◽

Cross Sectional ◽

Apo B ◽

Intervertebral Disk Herniation ◽

Apo Ai

Abstract Study design This was a cross-sectional frequency-matched case–control study. Background and aim The serum lipid profile of lipoprotein(a) [Lp(a)] level and apolipoprotein B/apolipoprotein A1 ratio (Apo B/Apo A1) ratio were found to be more representative for serum lipid level and were recognized as the independent risk factors for various diseases. Although the blood levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were found to be associated with symptomatic intervertebral disk herniation (IDH), no studies to date have evaluated the association of Apo AI, Apo B, Lp(a), and Apo B/Apo AI levels with symptomatic IDH. This study aimed to assess the link between blood lipid levels and symptomatic IDH. Method The study included 1839 Chinese patients. Of these, 918 patients were diagnosed with IDH and enrolled in the experimental group. A control group of 921 patients underwent a physical examination during the same period. The serum lipid levels of TC, TG, LDL-C, HDL-C, Lp(a), Apo B, and Apo B/Apo AI were examined and analyzed. The control group comprised randomly selected patients who met the baseline levels of the aforementioned lipid molecules. Results Patients with IDH exhibited significantly higher TC, TG, LDL, Apo B, and Lp(a) levels than controls. The percentage of high TC, high TG, high LDL, high Apo B, and high Lp(a) were obviously higher in the IDH group than in the control group. However, hyperlipidemia had no relationship with the degenerated segment of the IDH (P = 0.201). The odds ratio (OR) for the incidence of IDH with elevated levels of LDL-C, TC, TG, Lp(a), Apo B, and Apo B/Apo AI was 1.583, 1.74, 1.62, 1.58, 1.49, and 1.39, respectively. The correlation analysis revealed the correlation between elevated LDL-C, TC, TG, Apo B, Lp(a), and incidence of IDH was significant (R2LDL = 0.017; R2TC = 0.004; R2TG = 0.015; R2Apo B = 0.004; R2Lp(a) = 0.021) (P < 0.05). Conclusion This study suggested that elevated levels of serum TC, TG, LDL, Apo B, Lp(a), and Apo B/Apo AI were associated with a higher risk of IDH. This study provided useful information to identify a population that might be at risk of developing IDH based on elevated lipid levels.

Download Full-text

LDL/Apo B ratio and Lp (a) Each Predict Coronary Artery Disease in Type2 Diabetes Independent of ASCVD Risk Score: A Case-Cohort Study

10.1101/2020.09.16.20195990 ◽

2020 ◽

Author(s):

Soghra Rabizadeh ◽

Armin Rajab ◽

Jeffrey Mechanick ◽

Fatemeh Moosaie ◽

Yekta Rahimi ◽

...

Keyword(s):

Coronary Heart Disease ◽

Cohort Study ◽

Heart Disease ◽

Risk Score ◽

Density Lipoprotein ◽

Atherogenic Index ◽

Apo B ◽

Atherogenic Index Of Plasma ◽

Type2 Diabetes ◽

Ascvd Risk

Aim: To evaluate the predictive value of the LDL/ApoB ratio for coronary heart disease (CHD) in patients with type2 diabetes (T2D). Methods: In this case-cohort study, (apo)lipoproteins and glycemic indices were measured in 1058 individuals with T2D from February 2002 to March 2019, with a median duration of follow up of 10 years. Results: Of 1058 patients with T2D, coronary heart disease occurred in 242 patients. Increased waist circumference, waist to hip ratio, and hemoglobin A1c, low-density lipoprotein cholesterol (LDL)/Apolipoprotein B (ApoB) ratio, presence of hypertension and metabolic syndrome, and insulin and statin use were more prevalent among patients with CHD (P<0.001). Logistic regression analysis showed that an LDL/ApoB ratio equal or lower than 1.2, as well as a Lp(a) cutoff level more than 25.45 mg/dl could each predict CHD independent of ASCVD risk score [adjusted OR:1.841, CI:1.257 to 2.698, P<0.001 and adjusted OR: 1.433, CI:1.014 to 2.026, P=0.041) respectively ] when adjusted for multiple confounders.The atherogenic index of plasma (AIP) did not predict CHD. Conclusion: This study showed that LDL/ApoB ratio and Lp(a) each, but not the atherogenic index of plasma, may be considered as an indicator of CHD independent of ASCVD risk score in patients with T2D. This finding merits further clarification to optimize preventive strategies for CHD.

Download Full-text

Effect of Ramadan Fasting on Serum Glucose and Lipid Profile Among Algerian Type 2 Diabetes Patients

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.1515/rjdnmd-2015-0045 ◽

2015 ◽

Vol 22 (4) ◽

pp. 385-392 ◽

Cited By ~ 1

Author(s):

Ghania Tiboura ◽

Boumediene Meghit Khaled ◽

Mustapha Diaf ◽

Sarah Semeria ◽

Ghizlane Bouanani

Keyword(s):

Type 2 Diabetes ◽

Lipid Profile ◽

Total Duration ◽

Density Lipoprotein ◽

Apolipoprotein A1 ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Apo B ◽

Ramadan Fasting

Abstract Background and aims: We designed this study to assess the effect of Ramadan fasting on serum lipid profile among type 2 diabetic patients. Material and Methods: The study was carried out in July 2014 (Ramadan 1421). The total duration of fasting was 17 hours a day. The investigation involved 80 patients. The mean age of the patients was 56± 8 years. The dietary survey lasting three days was recorded. The anthropometric and the biochemical parameters were measured in all subjects before (T1) and during (T2) the fasting month of Ramadan and results were compared using student t-test. Results: There was a significant decrease in high density lipoprotein cholesterol (HDL-c) levels during T2 (0.35±0,08 g/L) compared to T1 (0.38±0,11 g/L). Apolipoprotein A1 (Apo A1) decreased significantly during fasting compared to pre-fasting days while apo B increased during T2 (p˂0.05). The dietary fat consumption increased during Ramadan; especially for the saturated one (p<0.05). Conclusion: The present study suggests that fasting month of Ramadan could be beneficial for some patients with type 2 diabetes who are well controlled and balanced. However, some of them may be at risk of cardiovascular complications in which dyslipidemia can be the leading cause.

Download Full-text