Expression of Apolipoprotein A1 and Apolipoprotein B Genes in Iraqi Patients with Chronic Kidney Disease: A Clinical and Laboratory Correlation

Abstract

Background: Chronic kidney disease (CKD) is associated with dyslipidemia and cardiovascular complications, where apolipoproteins A1 (ApoA1) and B (ApoB) play critical roles in lipid metabolism and disease progression. Evaluating their gene expression can provide insights into the pathophysiological mechanisms linking lipid abnormalities to CKD. Objective: This study aims to analyze the expression levels of the ApoA1 and ApoB genes in CKD patients and correlate them with biochemical markers to assess their role in disease progression. Methods: A case-control study was conducted on 100 CKD patients and 50 healthy controls. Gene expression levels of ApoA1 and ApoB were measured using quantitative real-time polymerase chain reaction (qRT-PCR). Laboratory investigations included serum lipid profile (total cholesterol, LDL, HDL, triglycerides), kidney function tests (creatinine, eGFR, blood urea nitrogen), and inflammatory markers (CRP, IL-6). Statistical analysis assessed the correlation between gene expression and biochemical parameters. Results: ApoA1 expression was significantly downregulated in CKD patients compared to controls (p < 0.01), correlating with reduced HDL levels and increased inflammatory markers. In contrast, ApoB expression was significantly upregulated (p < 0.05), associated with elevated LDL and triglyceride levels, indicating a higher cardiovascular risk in CKD patients. A significant inverse correlation was observed between ApoA1 expression and serum creatinine levels (r = -0.48, p < 0.001), while ApoB expression positively correlated with disease severity (r = 0.52, p < 0.001). Conclusion: Altered expression of ApoA1 and ApoB genes in CKD patients suggests a key role in dyslipidemia and cardiovascular complications. The study underscores the potential of ApoA1 and ApoB gene expression as biomarkers for monitoring disease progression and guiding therapeutic interventions in CKD patients.