Association of apolipoprotein levels with peripheral arterial disease: a meta-analysis of literature studies.

ABSTRACT

AIMS: Lower limb peripheral artery disease (PAD) is a leading cause of atherosclerotic cardiovascular disease (ASCVD). Discordant data are available on the association between apolipoprotein and PAD. We performed a meta-analyses on the association between apolipoprotein (apo)B, apoA-I, and apoB/apoA-I ratio with PAD. METHODS AND RESULTS: PubMed, Web of Science, Scopus databases were systematically searched. Studies providing data about apoB, apoA-I, apoB/apoA-I ratio in PAD subjects and non-PAD controls were included. Differences between PAD and non-PAD subjects were expressed as mean difference (MD) with pertinent 95% confidence intervals (95%CI). Twenty-two studies were included. Peripheral artery disease subjects showed higher apoB (MD 12.5 mg/dL, 95%CI 2.14, 22.87) and lower apoA-I levels (MD -7.11 mg/dL, 95%CI -11.94, -2.28) than non-PAD controls. Accordingly, ApoB/ApoA-I ratio resulted higher in PAD subjects than non-PAD controls (MD 0.11, 95% CI 0.00, 0.21). Non-HDL-C showed a direct association with the difference in apoB (z-value 4.72, P < 0.001) and an inverse association with the difference of apoA-I (z-value -2.43, P = 0.015) between PAD subjects and non-PAD controls. An increasing BMI was associated with an increasing difference in apoA-I values between PAD subjects and non-PAD controls (z-value 1.98, P = 0.047). CONCLUSIONS: Our meta-analysis suggests that PAD subjects exhibit increased apoB and reduced apoA-I levels, accompanied by an increased apoB/apoA-I ratio as compared with non-PAD controls.