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- Borgquist, Signe, et al.
(författare)
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Apo-lipoproteins, lipids and risk of cancer.
- 2016
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136. ; 138:11, s. 2648-2656
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Tidskriftsartikel (refereegranskat)abstract
- The epidemiological evidence for an obesity-cancer association is solid, whereas the association between obesity-associated lipoprotein levels and cancer is less evident. We investigated circulating levels of Apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB), LDL-cholesterol (LDL-C) and HDL-cholesterol (HDL-C) and association to risk of overall cancer and common cancer forms. The Malmö Diet and Cancer Study, a population-based prospective cohort study, enrolled 17,035 women and 11,063 men (1991-1996). Incident cancer cases were ascertained by record linkage with the Swedish Cancer Registry until end of follow-up, Jan 1(st) 2012. Baseline serum levels of ApoA1 and ApoB were analyzed for the entire cohort, and HDL-C and LDL-C levels in 5,281 participants. Hazard ratios, with 95% confidence interval, were calculated using Cox's proportional hazards analysis. In the entire cohort, none of the exposures were related to overall cancer risk (HRadj ApoA1=0.98, 95%CI: 0.95,1.01; HRadj ApoB=1.01, 95%CI: 0.98-1.04). Among men, ApoB was positively associated with cancer risk (HRadj ApoB=1.06, 95%CI: 1.01,1.10). Female breast cancer risk was inversely associated with ApoB (HRadj =0.92, 95%CI: 0.86,0.99). Among both genders, ApoA1 was inversely associated with lung cancer risk (HRadj =0.88, 95%CI: 0.80,0.97), whereas high ApoB increased lung cancer risk (HRadj =1.08, 95%CI: 0.99,1.18). Colorectal cancer risk was increased with high ApoB (HRadj =1.08, 95%CI: 1.01,1.16) among both genders. Apolipoprotein levels were not associated with prostate cancer incidence. Circulating levels of apolipoproteins are associated with overall cancer risk in men and across both genders with breast, lung, and colorectal cancer risk. Validation of these findings may facilitate future primary prevention strategies for cancer. This article is protected by copyright. All rights reserved.
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| 2. |
- Fritz, Josef, et al.
(författare)
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Metabolic Mediators of the Effects of Family History and Genetic Risk Score on Coronary Heart Disease-Findings from the Malmö Diet and Cancer Study
- 2017
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Ingår i: Journal of the American Heart Association. - 2047-9980. ; 6:3
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Tidskriftsartikel (refereegranskat)abstract
- Background--Family history of coronary heart disease (CHD) as well as genetic predisposition to CHD assessed by a genetic risk score (GRS) are predictors of CHD risk. It is, however, uncertain to what extent these risk predictors are mediated by major metabolic pathways. Methods and Results--Total effects of self-reported family history and a 50-variant GRS (GRS50), as well as effects mediated by apolipoprotein B and A-I (apoB, apoA-I), blood pressure, and diabetes mellitus, on incidence of CHD were estimated in 23 595 participants of the Malmö Diet and Cancer study (a prospective, population-based study). During a median follow-up of 14.4 years, 2213 participants experienced a first CHD event. Family history of CHD and GRS50 (highest versus other quintiles) were associated with incident CHD, with hazard ratios of 1.52 (95% CI: 1.39-1.65) and 1.53 (95% CI: 1.39-1.68), respectively, after adjusting for age, sex, and smoking status. Small proportions of the family history effect were mediated by metabolic risk factors: 8.3% (95% CI: 5.8-11.7%) by the apoB pathway, 1.7% (95% CI: 0.2-3.4%) by apoA-I, 8.5% (95% CI: 5.9-12.0%) by blood pressure, and 1.5% (95% CI: 0.8% to 3.8%) by diabetes mellitus. Similarly, small proportions of GRS50 were mediated: 8.1% (95% CI: 5.5-11.8%) by apoB, 1.2% (95% CI: 0.5-3.0%) by apoA-I, 4.2% (95% CI: 1.3-7.5%) by blood pressure, and 0.9% (95% CI: 3.7% to 1.6%) by diabetes mellitus. Conclusions--A fraction of the CHD risk associated with family history or with GRS50 is mediated through elevated blood lipids and hypertension, but not through diabetes mellitus. However, a major part (≥80%) of the genetic effect operates independently of established metabolic risk factor pathways.
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| 3. |
- Louie, Judy Z., et al.
(författare)
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Insulin resistance probability score and incident cardiovascular disease
- 2023
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Ingår i: Journal of Internal Medicine. - 0954-6820. ; 294:4, s. 531-535
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Tidskriftsartikel (refereegranskat)abstract
- Background: Insulin resistance (IR) is associated with cardiovascular disease (CVD). However, insulin immunoassay variability and scarce research of the elderly have hindered the adoption of IR assessment for CVD prevention. We asked whether the probability of having IR [p(IR)]—derived from insulin and C-peptide mass-spectrometry assays—was associated with CVD in the elderly. Methods: A random cohort was drawn from MPP, a population-based study of the elderly. After excluding those with missing data, CVD, or diabetes, 3645 participants (median age = 68) remained. Results: During follow-up (13.3 years), 794 incident CVD events were observed. p(IR) > 80% (n = 152) compared with p(IR) ≤ 80% was associated with incident CVD (HR = 1.51, 95% CI 1.12–2.05, p = 0.007) and CVD or all-cause mortality (HR = 1.43, 95% CI 1.16–1.77, p = 0.0009) after adjusting for age, sex, hypertension, smoking, HDL-cholesterol, total cholesterol, triglycerides, BMI, and prediabetes. Conclusion: High p(IR) was associated with >50% greater risk of incident CVD. IR assessment in the elderly may be warranted.
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| 5. |
- Rowland, Charles M., et al.
(författare)
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Association of cardiovascular events and lipoprotein particle size : Development of a risk score based on functional data analysis
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:3
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Tidskriftsartikel (refereegranskat)abstract
- Background Functional data is data represented by functions (curves or surfaces of a low-dimensional index). Functional data often arise when measurements are collected over time or across locations. In the field of medicine, plasma lipoprotein particles can be quantified according to particle diameter by ion mobility. Goal We wanted to evaluate the utility of functional analysis for assessing the association of plasma lipoprotein size distribution with cardiovascular disease after adjustment for established risk factors including standard lipids. Methods We developed a model to predict risk of cardiovascular disease among participants in a case-cohort study of the Malmö Prevention Project. We used a linear model with 311 coefficients, corresponding to measures of lipoprotein mass at each of 311 diameters, and assumed these coefficients varied smoothly along the diameter index. The smooth function was represented as an expansion of natural cubic splines where the smoothness parameter was chosen by assessment of a series of nested splines. Cox proportional hazards models of time to a first cardiovascular disease event were used to estimate the smooth coefficient function among a training set consisting of one half of the participants. The resulting model was used to calculate a functional risk score for the remaining half of the participants (test set) and its association with events was assessed in Cox models that adjusted for traditional cardiovascular risk factors. Results In the test set, participants with a functional risk score in the highest quartile were found to be at increased risk of cardiovascular events compared with the lowest quartile (Hazard ratio = 1.34; 95% Confidence Interval: 1.05 to 1.70) after adjustment for established risk factors. Conclusion In an independent test set of Malmö Prevention Project participants, the functional risk score was found to be associated with cardiovascular events after adjustment for traditional risk factors including standard lipids.
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| 7. |
- Shiffman, Dov, et al.
(författare)
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LDL subfractions are associated with incident cardiovascular disease in the Malmö Prevention Project Study
- 2017
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Ingår i: Atherosclerosis. - : Elsevier BV. - 0021-9150. ; 263, s. 287-292
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims After assessing the risk for cardiovascular disease (CVD) based on traditional risk factors, decisions concerning lipid lowering therapy might remain uncertain. To investigate whether lipoprotein subfraction levels could aid these decisions, we assessed the association between lipoprotein subfractions and CVD, after adjustment for traditional risk factors including standard lipids. Methods Using a case-cohort design, participants were randomly drawn from the Malmö Prevention Project (MPP), a population-based prospective study of 18,240 participants, and supplemented with additional incident CVD events (5764 participants, 1784 CVD events). Results Low density lipoprotein particle number (LDL-P) and individual subfractions ranging in size from very-small to large were associated with CVD (continuous p value (pcont) < 0.001) while adjusting for age, sex, hypertension, smoking, and diabetes. After further adjustment for LDL-C, HDL-C, and triglycerides, very small LDL subfraction (b) (LDL-VS (b)) remained associated with CVD (HR = 1.23, 95% CI, 1.06 to 1.43 for top vs. bottom quartile, pcont = 0.03). Among participants with low/intermediate risk [without diabetes and with LDL-C <3.36 mmol/L (<130 mg/dL)], the fully adjusted HR for LDL-small (top vs. bottom quartile) was 1.48 (95% CI 1.02 to 2.17, pcont = 0.03). Among those with very-high risk (>20% 10-year risk of CVD), LDL-VS(a) and LDL-VS(b) were associated with CVD in fully adjusted models (HR = 1.37, 95% CI 1.12 to 1.67 and HR = 1.28, 95% CI 1.07 to 1.53, respectively, pcont≤0.03). Conclusions Smaller LDL particles are associated with incident CVD independently of traditional risk factors, including standard lipids, in participants with low/intermediate and very-high risk, who might benefit from improved risk assessment.
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