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Major lipids, apoli...
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Di Angelantonio, Emanuele
(author)
Major lipids, apolipoproteins, and risk of vascular disease
- Article/chapterEnglish2009
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American Medical Association (AMA),2009
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LIBRIS-ID:oai:DiVA.org:uu-123104
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-123104URI
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https://doi.org/10.1001/jama.2009.1619DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Co-authors: Vilmantas Giedraitis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, Geriatrik Lars Lannfelt, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, Geriatrik Lars Lind, Uppsala universitet, Institutionen för medicinska vetenskaper Ingår i Emerging Risk Factors Collaboration.
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CONTEXT: Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified. OBJECTIVE: To assess major lipids and apolipoproteins in vascular risk. DESIGN, SETTING, AND PARTICIPANTS: Individual records were supplied on 302,430 people without initial vascular disease from 68 long-term prospective studies, mostly in Europe and North America. During 2.79 million person-years of follow-up, there were 8857 nonfatal myocardial infarctions, 3928 coronary heart disease [CHD] deaths, 2534 ischemic strokes, 513 hemorrhagic strokes, and 2536 unclassified strokes. MAIN OUTCOME MEASURES: Hazard ratios (HRs), adjusted for several conventional factors, were calculated for 1-SD higher values: 0.52 log(e) triglyceride, 15 mg/dL high-density lipoprotein cholesterol (HDL-C), 43 mg/dL non-HDL-C, 29 mg/dL apolipoprotein AI, 29 mg/dL apolipoprotein B, and 33 mg/dL directly measured low-density lipoprotein cholesterol (LDL-C). Within-study regression analyses were adjusted for within-person variation and combined using meta-analysis. RESULTS: The rates of CHD per 1000 person-years in the bottom and top thirds of baseline lipid distributions, respectively, were 2.6 and 6.2 with triglyceride, 6.4 and 2.4 with HDL-C, and 2.3 and 6.7 with non-HDL-C. Adjusted HRs for CHD were 0.99 (95% CI, 0.94-1.05) with triglyceride, 0.78 (95% CI, 0.74-0.82) with HDL-C, and 1.50 (95% CI, 1.39-1.61) with non-HDL-C. Hazard ratios were at least as strong in participants who did not fast as in those who did. The HR for CHD was 0.35 (95% CI, 0.30-0.42) with a combination of 80 mg/dL lower non-HDL-C and 15 mg/dL higher HDL-C. For the subset with apolipoproteins or directly measured LDL-C, HRs were 1.50 (95% CI, 1.38-1.62) with the ratio non-HDL-C/HDL-C, 1.49 (95% CI, 1.39-1.60) with the ratio apo B/apo AI, 1.42 (95% CI, 1.06-1.91) with non-HDL-C, and 1.38 (95% CI, 1.09-1.73) with directly measured LDL-C. Hazard ratios for ischemic stroke were 1.02 (95% CI, 0.94-1.11) with triglyceride, 0.93 (95% CI, 0.84-1.02) with HDL-C, and 1.12 (95% CI, 1.04-1.20) with non-HDL-C. CONCLUSION: Lipid assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride.
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Sarwar, Nadeem
(author)
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Perry, Philip
(author)
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Kaptoge, Stephen
(author)
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Ray, Kausik K
(author)
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Thompson, Alexander
(author)
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Wood, Angela M
(author)
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Lewington, Sarah
(author)
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Sattar, Naveed
(author)
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Packard, Chris J
(author)
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Collins, Rory
(author)
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Thompson, Simon G
(author)
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Danesh, John
(author)
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In:Journal of the American Medical Association (JAMA): American Medical Association (AMA)302:18, s. 1993-20000098-74841538-3598
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Di Angelantonio, ...
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Sarwar, Nadeem
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Perry, Philip
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Kaptoge, Stephen
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Ray, Kausik K
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Thompson, Alexan ...
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Wood, Angela M
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Lewington, Sarah
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Sattar, Naveed
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Packard, Chris J
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Collins, Rory
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Thompson, Simon ...
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Danesh, John
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