Background and aims The role of serum lipoprotein(a) [Lp(a)] levels in atrial fibrillation (AF) is still uncertain, especially in the Chinese population. Here, we aimed to elucidate the potential relationship between Lp(a) quantiles and AF. Methods All data were collected through inpatients with electronic health records from the Second Affiliated Hospital of Nanchang University, Jiangxi Province, China. The propensity score matching (PSM) method was used to match control and case groups. Interactions between AF, Lp(a) quantiles, and other clinical indices were analyzed by logistic regression and stratified analysis. Statistical analyses were performed with IBM SPSS statistical software and R software. Results From 2017 to 2021, 4,511 patients with AF and 9,022 patients without AF were 1:2 matched by the propensity score matching method. A total of 46.9% of the study group was women, and the baseline mean age was 65 years. The AF group exhibited lower median Lp(a) than the non-AF group (15.95 vs. 16.90 mg/dL; P < 0.001). Based on the Lp(a) quantiles, the study population was divided into four groups: Q1 (≤ 8.71 mg/dL), Q2 (8.71–16.54 mg/dL), Q3 (16.54–32.42 mg/dL) and Q4 (> 32.42 mg/dL). The AF prevalence of each group decreased from 34.2% (Q1) to 30.9% (Q4) (P < 0.001). Lp(a) quantiles 1–3 significantly increased AF to 1.162-fold (1.049–1.286), 1.198-fold (1.083–1.327), and 1.111-fold (1.003–1.231) in the unadjusted logistic regression model, respectively. In the adjusted model, Lp(a) < 32.42 mg/dL still showed a significant inverse association with AF. In the stratified analysis, Lp(a) levels in female patients exhibited a significant negative correlation with AF (OR of Q1: 1.394[1.194–1.626], P = 0.001). Age and hypertension did not affect the adverse correlation. Conclusion Low circulating Lp(a) levels were associated with AF, especially in the female Han population, suggesting that Lp(a) may be useful for risk stratification of AF in female individuals.
Emerging evidence has suggested the unique and critical role of exosomes as signal molecules vector in various diseases. Numerous researchers have been trying to identify how these exosomes function in immune progression, as this could promote their use as biomarkers for the disease process and potential promising diagnostic tools. NOD-like receptor (NLR) family, pyrin domain containing 3 (NLRP3), a tripartite protein, contains three functional domains a central nucleotide-binding and oligomerization domain (NACHT), an N-terminal pyrin domain (PYD), and a leucine-rich repeat domain (LRR). Of note, existing studies have identified exosome as a novel mediator of the NLRP3 inflammasome, which is critical in diseases progression. However, the actual mechanisms and clinical treatment related to exosomes and NLRP3 are still not fully understood. Herein, we presented an up-to-date review of exosomes and NLRP3 in diseases, outlining what is known about the role of exosomes in the activation of NLRP3 inflammasome and also highlighting areas of this topic that warrant further study.
The original article has been updated.
BACKGROUND AND AIMS: The role of serum lipoprotein(a) [Lp(a)] levels in atrial fibrillation (AF) is still uncertain, especially in the Chinese population. Here we aimed to elucidate the potential relationship between Lp(a) quantiles and AF risk.METHODS: From 2017 to 2021, 4,511 patients with AF and 9,022 patients without AF were 1:2 matched by the propensity score matching method. Interactions between AF risk, Lp(a) quantiles, and other clinical indices were analyzed by logistics regression and stratified analysis.RESULTS: 46.9% of the study group were women, and the baseline mean age exhibited 65 years. The AF group exhibited lower median Lp(a) than the non-AF group (15.95 vs. 16.90 mg/dL; P<0.001). The AF risk decreased from 34.2% (Q1) to 30.9% (Q4) (P<0.001). Lp(a) quantiles 1-3 increased the AF risk 1.162 fold (1.049-1.286), 1.198 fold (1.083-1.327), and 1.111 fold (1.003-1.231) in the unadjusted logistics model, respectively. Lp(a) levels in female patients exhibited significantly negatively correlated with AF (OR of Q1: 1.394[1.194-1.626], P=0.001). Age and hypertension did not affect the adverse correlation.CONCLUSION: For female patients whose serum Lp(a) concentration was less than 16.54 mg/dL, there was a higher risk of suffering from AF. Thus, we recommend a pre-emptive screening for AF in women with low Lp(a) plasma levels.
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