ApoA1, ApoB, ApoA1/B for Pathogenic Prediction of Chronic Obstructive Pulmonary Disease Complicated by Acute Lower Respiratory Tract Infection: A Cross-Sectional Study

Abstract

Purpose

To investigate the value of apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and ApoA1/B ratio in pathogenic diagnosis of chronic obstructive pulmonary disease (COPD) complicated by acute lower respiratory tract infection, assisting comprehensive disease assessment.

Patients and Methods

The study enrolled 171 COPD patients with acute lower respiratory tract infections, 35 COPD patients without acute lower respiratory tract infections, and 41 healthy controls. Correlation analysis and binary logistic regression were used to assess the roles of various factors in COPD with acute lower respiratory tract infections. Receiver operating characteristic (ROC) curves were plotted and area under curves (AUC) values were calculated to evaluate the predictive performance.

Results

Infections were the cause of alterations in ApoA1, ApoB and ApoA1/B index. In correlation analysis for pathogenic diagnosis of COPD complicated by acute lower respiratory infections, age, ApoA1, ApoA1/B ratio, lymphocyte count (LYMPH), neutrophil count (NEUT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and endotoxin were significantly correlated. For predicting COPD complicated by acute lower respiratory tract bacterial infection, ApoA1 had the highest area under the ROC curve (AUC: 0.889), with sensitivity and specificity of 82.9% and 83.9%, respectively. The combination of NEUT and ApoA1 improved the prediction efficacy (AUC: 0.909; sensitivity/specificity: 85.1%/85.7%).

Conclusion

ApoA1, ApoB, and ApoA1/B ratio are good indicators for predicting pathogens in COPD complicated by acute lower respiratory tract infection, especially ApoA1 which has high predictive value.

Keywords:

• ApoA1
• ApoB
• ApoA1/B
• COPD
• Acute lower respiratory tract infection
• pathogens

Ethics Approval and Consent to Participate

The study is in line with the Declaration of Helsinki. This study was approved and permitted by the Ethics Committee of The First Hospital of Nanchang City (No.KY2023044). It complies with ethical norms and laws and regulations to protect patients’ privacy and rights. The principle of strict confidentiality of data is adhered to, and there was no leakage of patients’ personal information during the research process. Due to the retrospective nature of the study, the requirement to obtain written informed consent was waived.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by Science and Technology Research Project of Education Department of Jiangxi Province (No.GJJ190021).