期刊
ATHEROSCLEROSIS
卷 231, 期 2, 页码 246-251出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2013.08.036
关键词
High density lipoprotein; Inflammation; C-reactive protein; Coronary heart disease
资金
- NHLBI [HHSN268201200036C, N01-HC-85239, N01-HC-85079, N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, N01-HC-45133, HL080295]
- NIA [AG-023629, AG-15928, AG-20098, AG-027058]
Background: Inflammatory factors and low HDL-C relate to CHD risk, but whether inflammation attenuates any protective association of high HDL-C is unknown. Objective: Investigate inflammatory markers' individual and collective impact on the association of HDLC with incident coronary heart disease (CHD). Methods: In 3888 older adults without known cardiovascular disease (CVD), we examined if the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and lipoprotein-associated phospholipase A(2)(Lp-PLA(2)) modify the relation of HDL-C with CHD. HDL-C, CRP, IL-6, and Lp-PLA(2) values were grouped as using gender-specific tertiles. Also, an inflammation index of z-score sums for CRP, IL-6, and Lp-PLA(2) was categorized into tertiles. We calculated CHD incidence for each HDL-C/inflammation group and performed Cox regression, adjusted for standard CVD risk factors and triglycerides to examine the relationship of combined HDL-C-inflammation groups with incident events. Results: CHD incidence (per 1000 person years) was higher for higher levels of CRP, IL-6, and the index, and lower for higher levels of HDL-C. Compared to high HDL-C/low-inflammation categories (referent), adjusted HRs for incident CHD were increased for those with high HDL-C and high CRP (HR 1.50, p < 0.01) or highest IL-6 tertile (HR 1.40, p < 0.05), but not with highest Lp-PLA(2) tertile. Higher CHD incidence was similarly seen for those with intermediate or low HDL-C accompanied by high CRP, high IL-6, or a high inflammatory index. Conclusion: The protective relation of high HDL-C for incident CHD appears to be attenuated by greater inflammation. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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