Serum Apolipoprotein B/Apolipoprotein A1 Ratio In Relation To Intervertebral Disc Herniation: A Cross-Sectional Frequency-Matched Case-Control Study

Abstract Study Design:A cross-sectional frequency-matched case-control studyObjective: In 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 intervertebral disc herniation (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.Method: A 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. The patients in the control group were collected randomly from patients who were matched with the baseline levels of the aforementioned lipid molecular.Results: 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).Conclusion:The 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.