scholarly journals Lipoprotein-Associated Phospholipase A2 Predicts 5-Year Cardiac Mortality Independently of Established Risk Factors and Adds Prognostic Information in Patients with Low and Medium High-Sensitivity C-Reactive Protein (The Ludwigshafen Risk and Cardiovascular Health Study)

2007 ◽  
Vol 53 (8) ◽  
pp. 1440-1447 ◽  
Author(s):  
Karl Winkler ◽  
Michael M Hoffmann ◽  
Bernhard R Winkelmann ◽  
Isolde Friedrich ◽  
Günther Schäfer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Phospholipase A2 ◽  
Cardiac Death ◽  
High Sensitivity ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Cardiac Mortality ◽  
C Reactive Protein ◽  
Adjusted Risk ◽  
Reactive Protein

Abstract Background: Lipoprotein-associated phospholipase A2 (LpPLA2), also denoted as platelet-activating factor acetylhydrolase, is a lipoprotein-bound enzyme involved in inflammation and atherosclerosis. In this cohort study we investigated LpPLA2 activity to predict cardiac mortality in patients scheduled for coronary angiography. Methods: LpPLA2 activity was determined in 2513 patients with and in 719 patients without angiographically confirmed coronary artery disease (CAD). Results: During the median observation period of 5.5 years, 501 patients died. In patients with tertiles of LpPLA2 activity of 420–509 U/L or ≥510 U/L, unadjusted hazard ratios (HRs) for cardiac death were 1.7 (95% CI 1.3–2.4; P = 0.001), and 1.9 (95% CI 1.4–2.5; P <0.001), respectively, compared with patients with LpPLA2 activity ≤419 U/L. After we accounted for established risk factors and included angiographic CAD status, high-sensitivity C-reactive protein (hsCRP), and N-terminal pro-B-type natriuretic peptide, the 3rd tertile of LpPLA2 activity predicted cardiac 5-year mortality with an HR of 2.0 (95% CI 1.4–3.1; P = 0.001). LpPLA2 activity increased the adjusted risk for cardiac death by 2-fold in patients with hsCRP <3 mg/L in the 2nd (HR 2.4, 95% CI 1.4–4.2; P = 0.002) and 3rd (HR 2.1, 95% CI 1.1–4.0; P = 0.02) tertiles of LpPLA2 activity and in patients with hsCRP of 3–10 mg/L in the 3rd tertile (HR 1.9, 95% CI 1.0–3.6; P = 0.03) of LpPLA2 activity. Conclusions: LpPLA2 activity predicts risk for 5-year cardiac mortality independently from established risk factors and indicates risk for cardiac death in patients with low and medium-high hsCRP concentrations. Therefore, LpPLA2 activity may provide information for the identification and management of patients at risk beyond established risk stratification strategies.

Abstract P059: Prevalence And Correlates Of Co-occurring Metabolic Syndrome And Chronic Kidney Disease: Findings From The Hispanic Community Health Study/study Of Latinos (hchs/sol)

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Celestin Missikpode ◽  
Sylvia E Rosas ◽  
Ana Ricardo ◽  
James Lash ◽  
Unab I Khan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Chronic Kidney Disease ◽  
High Sensitivity ◽  
Health Study ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hispanic Community

Introduction: Metabolic syndrome (MetS) and chronic kidney disease (CKD) are highly prevalent among Hispanics/Latinos, yet data on co-occurring MetS and CKD are not available. Understanding the prevalence and correlates of MetS-CKD overlap may inform intervention programs for such subgroups. Methods: Data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Visit 1 (2008-2011) was used. MetS was defined as the presence of three or more of the following risk factors: abdominal obesity, high triglyceride, low high-density lipoprotein cholesterol level, elevated blood pressure, and elevated glucose level. CKD was defined as eGFR <60 mL/min per 1.73 m 2 or the presence of albuminuria (urine albumin-creatinine ratio ≥17 mg/g in men and ≥25 mg/g in women). Of 16,415 HCHS/SOL participants, data from 14,527 persons with complete information on kidney function measures and covariates were analyzed using logistic regression. Potential correlates included age, sex, Hispanic/Latino background, acculturation, education, income, physical activity, alcohol use, cigarette smoking, cardiovascular disease, hemoglobin, high-sensitivity C-reactive protein, and homeostasis model assessment of insulin resistance (HOMA-IR). Analyses accounted for complex sampling design. Results: Average age was 41 years, 52% were women, 33% had prevalent MetS, and 14% had prevalent CKD. MetS and CKD co-occurred in 7.8% of the study population, 8.5% in men and 7.2% in women. The prevalence of co-occurring MetS and CKD was 10.4% in Puerto Rican, 9.2% in Cuban, 7.2% in Central American, 7.2% in Mexican, 6.5% in Dominican, and 5.3% in South American. Factors independently related to those co-occurring conditions were age, sex, physical activity levels, cardiovascular disease, high-sensitivity C-reactive protein, and HOMA-IR ( Table ). Conclusions: Targeted prevention efforts that address key modifiable overlapping risk factors may be especially effective in reducing metabolic syndrome and improving kidney health.

scholarly journals Comparison of Lipoprotein-Associated Phospholipase A2 and High Sensitive C-Reactive Protein as Determinants of Metabolic Syndrome in Subjects without Coronary Heart Disease: In Search of the Best Predictor

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Mónica Acevedo ◽  
Paola Varleta ◽  
Verónica Kramer ◽  
Giovanna Valentino ◽  
Teresa Quiroga ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Phospholipase A2 ◽  
High Sensitivity ◽  
Roc Curves ◽  
Activity Levels ◽  
Pla2 Activity ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Cv Disease

High sensitivity C-reactive protein (hsCRP) is a marker of metabolic syndrome (MS) and cardiovascular (CV) disease. Lipoprotein-associated phospholipase A2 (Lp-PLA2) also predicts CV disease. There are no reports comparing these markers as predictors of MS.Methods. Cross-sectional study comparing Lp-PLA2 and hsCRP as predictors of MS in asymptomatic subjects was carried out; 152 subjects without known atherosclerosis participated. Data were collected on demographics, cardiovascular risk factors, anthropometric and biochemical measurements, and hsCRP and Lp-PLA2 activity levels. A logistic regression analysis was performed with each biomarker and receiver operating characteristic (ROC) curves were constructed for MS.Results. Mean age was 46 ± 11 years, and 38% of the subjects had MS. Mean Lp-PLA2 activity was 185 ± 48 nmol/mL/min, and mean hsCRP was 2.1 ± 2.2 mg/L. Subjects with MS had significantly higher levels of Lp-PLA2 (P=0.03) and hsCRP (P<0.0001) than those without MS. ROC curves showed that both markers predicted MS.Conclusion. Lp-PLA2 and hsCRP are elevated in subjects with MS. Both biomarkers were independent and significant predictors for MS, emphasizing the role of inflammation in MS. Further research is necessary to determine if inflammation predicts a higher risk for CV events in MS subjects.

scholarly journals Association of high-sensitivity C-reactive protein with cardiometabolic risk factors and micronutrient deficiencies in adults of Ouagadougou, Burkina Faso

2012 ◽  
Vol 109 (7) ◽  
pp. 1266-1275 ◽  
Author(s):  
Augustin N. Zeba ◽  
Hélène F. Delisle ◽  
Clémentine Rossier ◽  
Genevieve Renier
Keyword(s):  
Risk Factors ◽  
Burkina Faso ◽  
Cardiometabolic Risk ◽  
High Sensitivity ◽  
Sub Saharan Africa ◽  
Micronutrient Deficiencies ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sub Saharan ◽  
Hs Crp

Increasing evidence suggests that high-sensitivity C-reactive protein (hs-CRP) is associated with cardiometabolic risk factors (CMRF) while being also related to micronutrient deficiencies. As part of a project on the double burden of under- and overnutrition in sub-Saharan Africa, we assessed the relationship between hs-CRP and both CMRF and micronutrient deficiencies in a population-based cross-sectional study carried out in the Northern district of Ouagadougou, the capital city of Burkina Faso. We randomly selected 330 households stratified by income tertile. In each income stratum, 110 individuals aged 25–60 years and having lived in Ouagadougou for at least 6 months were randomly selected, and underwent anthropometric measurements and blood sample collection. The prevalence of high hs-CRP was 39·4 %, with no sex difference. Vitamin A-deficient subjects (12·7 %) exhibited significant risk of elevated hs-CRP (OR 2·5;P= 0·015). Serum ferritin was positively correlated with log hs-CRP (r0·194;P= 0·002). The risk of elevated hs-CRP was significant in subjects with BMI ≥ 25 kg/m2(OR 6·9; 95 % CI 3·6, 13·3), abdominal obesity (OR 4·6; 95 % CI 2·2, 7·3) and high body fat (OR 10·2; 95 % CI 5·1, 20·3) (P< 0·001, respectively). Independent predictors of hs-CRP in linear regression models were waist circumference (β = 0·306;P= 0·018) and serum TAG (β = 0·158;P= 0·027). In this sub-Saharan population, hs-CRP was consistently associated with adiposity. Assuming that plasma hs-CRP reflects future risk of cardiovascular events, intervention which reduces CRP, or chronic and acute nutrition conditions associated with it, could be effective in preventing their occurrence particularly in sub-Saharan Africa.

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