Correlation between apolipoprotein B and severity of coronary artery stenosis in individuals aged 45 years and above

doi:10.3877/cma.j.issn.1674-0785.2026.03.006

Abstract

Abstract:

Objective

To explore the association between apolipoprotein B (ApoB) levels and the severity of coronary artery stenosis, as measured by the Gensini score, in middle-aged and elderly populations.

Methods

This cross-sectional retrospective study included 818 patients aged 45 years and older who underwent coronary angiography at Changzhi People's Hospital between January and June 2022. Based on their Gensini scores, patients were classified into a mild stenosis group (Gensini score ＜36) and a moderate-to-severe stenosis group (Gensini score ≥36). Binary logistic regression analysis was used to assess the association between ApoB levels and the severity of coronary stenosis, adjusting for confounding factors such as age, sex, body mass index, hypertension, diabetes, and smoking history.

Results

Of the 818 patients included, 547 were assigned to the mild stenosis group and 271 to the moderate-to-severe stenosis group. Multivariate logistic regression analysis revealed a significant positive correlation between ApoB levels and moderate-to-severe coronary stenosis (OR=1.24, 95%CI: 1.15~1.34, P＜0.001). After adjusting for confounding factors, each 1 g/L increase in ApoB was associated with a 24% increase in the risk of moderate-to-severe coronary stenosis.

Conclusion

This study demonstrates a significant positive correlation between ApoB levels and the severity of coronary artery stenosis (Gensini score) in middle-aged and elderly populations. These findings suggest that ApoB may serve as a supplementary marker for assessing the burden of coronary atherosclerosis. However, the conclusions of this study are limited to demonstrating a correlation and do not imply a causal relationship.

Key words: Coronary artery disease, Gensini score, Middle-aged and elderly population, Atherosclerosis, Blood lipids

Mao Ye, Xiaolan Wang, He Huang, Suqi Lv, Chen Li, Yuewei Li, Dingchao Lv. Correlation between apolipoprotein B and severity of coronary artery stenosis in individuals aged 45 years and above[J]. Chinese Journal of Clinicians(Electronic Edition), 2026, 20(03): 202-209.

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Figures/Tables 8

变量	Gensini score＜36 n=547	Gensini score≥36 n=271	P值
年龄（岁， $x ¯$ ±s）	60.0±8.8	62.5±8.8	＜0.001
BMI（kg/m²， $x ¯$ ±s）	22.6±3.0	22.8±4.3	0.187
性别[例（%）]			＜0.001
男性	293（53.7）	200（73.8）
女性	253（46.3）	71（26.2）
他汀治疗史[例（%）]			＜0.001
是	142（26.2）	39（14.5）
否	401（73.8）	230（85.5）
糖尿病病史[例（%）]			＜0.001
是	73（13.4）	70（26.0）
否	470（86.6）	199（74.0）
高血压病史[例（%）]			0.348
是	294（54.1）	155（57.6）
否	249（45.9）	114（42.4）
心血管疾病史[例（%）]			0.840
是	98（18.0）	47（17.5）
否	445（82.0）	222（82.5）
高脂血症史[例（%）]			0.282
是	116（28.7）	52（24.6）
否	288（71.3）	159（75.4）
吸烟史[例（%）]			＜0.001
是	184（33.9）	134（49.8）
否	359（66.1）	135（50.2）
家族史[例（%）]			0.903
是	69（12.7）	35（13.0）
否	474（87.3）	234（87.0）
TC（mmol/L， $x ¯$ ±s）	4.0±3.3	4.0±2.6	0.620
TG（mmol/L， $x ¯$ ±s）	1.6±1.0	1.5±0.9	0.654
HDL-c（mmol/L， $x ¯$ ±s）	1.1±0.3	1.0±0.3	＜0.001
LDL-C（mmol/L， $x ¯$ ±s）	2.4±0.8	2.5±0.9	0.009
UREA（mmol/L， $x ¯$ ±s）	5.0±1.8	5.5±2.4	＜0.001
UA（μmol/L， $x ¯$ ±s）	295.1±94.1	309.0±101.4	0.124
Cr（μmol/L， $x ¯$ ±s）	68.1±33.5	72.6±28.7	＜0.001
ApoA（g/L， $x ¯$ ±s）	1.3±0.3	1.1±0.2	＜0.001
ApoB（g/L， $x ¯$ ±s）	0.9±0.3	1.0±0.3	＜0.001
Gensini Score	5.0（2.0，12.0）	68.0（48.0，96.0）	＜0.001

变量	Gensini score＜36 n=547	Gensini score≥36 n=271	P值
年龄（岁， $x ¯$ ±s）	60.0±8.8	62.5±8.8	＜0.001
BMI（kg/m²， $x ¯$ ±s）	22.6±3.0	22.8±4.3	0.187
性别[例（%）]			＜0.001
男性	293（53.7）	200（73.8）
女性	253（46.3）	71（26.2）
他汀治疗史[例（%）]			＜0.001
是	142（26.2）	39（14.5）
否	401（73.8）	230（85.5）
糖尿病病史[例（%）]			＜0.001
是	73（13.4）	70（26.0）
否	470（86.6）	199（74.0）
高血压病史[例（%）]			0.348
是	294（54.1）	155（57.6）
否	249（45.9）	114（42.4）
心血管疾病史[例（%）]			0.840
是	98（18.0）	47（17.5）
否	445（82.0）	222（82.5）
高脂血症史[例（%）]			0.282
是	116（28.7）	52（24.6）
否	288（71.3）	159（75.4）
吸烟史[例（%）]			＜0.001
是	184（33.9）	134（49.8）
否	359（66.1）	135（50.2）
家族史[例（%）]			0.903
是	69（12.7）	35（13.0）
否	474（87.3）	234（87.0）
TC（mmol/L， $x ¯$ ±s）	4.0±3.3	4.0±2.6	0.620
TG（mmol/L， $x ¯$ ±s）	1.6±1.0	1.5±0.9	0.654
HDL-c（mmol/L， $x ¯$ ±s）	1.1±0.3	1.0±0.3	＜0.001
LDL-C（mmol/L， $x ¯$ ±s）	2.4±0.8	2.5±0.9	0.009
UREA（mmol/L， $x ¯$ ±s）	5.0±1.8	5.5±2.4	＜0.001
UA（μmol/L， $x ¯$ ±s）	295.1±94.1	309.0±101.4	0.124
Cr（μmol/L， $x ¯$ ±s）	68.1±33.5	72.6±28.7	＜0.001
ApoA（g/L， $x ¯$ ±s）	1.3±0.3	1.1±0.2	＜0.001
ApoB（g/L， $x ¯$ ±s）	0.9±0.3	1.0±0.3	＜0.001
Gensini Score	5.0（2.0，12.0）	68.0（48.0，96.0）	＜0.001

变量	模型1		模型2		模型3
变量	OR（95%CI）	P值	OR（95%CI）	P值	OR（95%CI）	P值
ApoB	1.89（1.52~2.35）	＜0.001	1.76（1.41~2.20）	＜0.001	1.24（1.15~1.34）	＜0.001

变量	n值	OR（95%CI）	P值	交互作用P值
年龄				0.234
＜60岁	356	1.31（1.16~1.48）	＜0.001
≥60岁	462	1.19（1.08~1.31）	＜0.001
性别				0.512
男性	524	1.22（1.11~1.34）	＜0.001
女性	294	1.48（1.12~1.46）	＜0.001
糖尿病病史				0.789
是	560	1.25（1.14~1.37）	＜0.001
否	258	1.21（1.06~1.38）	0.005
高血压病史				0.421
是	449	1.21（1.09~1.34）	＜0.001
否	363	1.26（1.13~1.40）	＜0.001
高脂血症史				0.563
是	168	1.20（1.02~1.41）	0.028
否	447	1.27（1.14~1.41）	＜0.001
他汀治疗史				0.097
是	181	1.12（0.95~1.32）	0.172
否	631	1.30（1.18~1.43）	＜0.001
吸烟史				0.318
是	318	1.19（1.05~1.35）	0.006
否	494	1.27（1.15~1.41）	＜0.001
家族史				0.623
是	104	1.29（1.05~1.58）	0.015
否	714	1.23（1.13~1.34）	＜0.001

分组	总例数（n）	缺失例数（n）	组内缺失率（%）	占全部缺失的比例（%）
轻度狭窄组（Gensini <36）	547	143	26.1	70.4
中重度狭窄组（Gensini ≥36）	271	60	22.1	29.6
合计	818	203	24.8	100

变量	模型1		模型2		模型3
变量	OR（95%CI）	P值	OR（95%CI）	P值	OR（95%CI）	P值
ApoB	1.89（1.52~2.35）	＜0.001	1.76（1.41~2.20）	＜0.001	1.23（1.14~1.33）	＜0.001

阈值	轻度组（例）	中重度组（例）	OR值	95%CI	P值
≥20	245	573	1.31	1.19~1.44	<0.001
≥40	468	350	1.26	1.17~1.36	<0.001
≥60	589	229	1.33	1.21~1.46	<0.001

评估指标	点估计值	95%CI
OR值	1.24	1.15~1.34
E-value	1.79	1.57~2.02

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