The following is a summary of “Blood lipid profiles as a prognostic biomarker in idiopathic pulmonary fibrosis,” published in the July 2024 issue of Pulmonology by Oh et al.

Dysregulation of lipid metabolism has been implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF), yet the precise relationship between blood lipid profiles and IPF prognosis remains underexplored. 

This study aimed to elucidate the impact of lipid profiles on the prognosis of patients with IPF.

Methods involved a retrospective analysis of clinical data from 371 patients with IPF, divided into derivation (n=145) and validation (n=226) cohorts. The study assessed serum lipid profiles including total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I (Apo A-I), and apolipoprotein B. The primary outcome measure was mortality, analyzed using the Cox proportional hazards model.

In the derivation cohort, the mean age was 67.5 years, with 86.2% being male, and 30.3% of patients died during the median follow-up period of 18.0 months. Non-survivors exhibited significantly lower lung function and higher gender-age-physiology scores compared to survivors. Among the lipid measures, triglycerides and Apo A-I levels were notably lower in non-survivors. Multivariate Cox regression analysis revealed that low Apo A-I levels (<140 mg/dL) independently predicted increased mortality risk, with a hazard ratio of 3.910 (95% CI: 1.170–13.069; P=0.027), after adjusting for factors such as smoking history, body mass index, GAP score, and use of antifibrotic agents. Kaplan–Meier survival analysis showed that patients with low Apo A-I levels had significantly poorer survival outcomes compared to those with higher levels. Specifically, (median survival: [derivation] 34.0 months vs. not reached, P= 0.003; [validation] 40.0 vs. 53.0 months, P= 0.027).

In conclusion, the findings suggested that low serum Apo A-I levels are a significant independent predictor of mortality in patients with IPF. This highlights the potential of serum Apo A-I as a valuable prognostic biomarker for predicting outcomes and guiding management strategies in IPF.

Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02905-z