Chronic Kidney Disease, Plasma Lipoproteins, and Coronary Artery Calcium Incidence The Multi-Ethnic Study of Atherosclerosis
Chronic Kidney Disease, Plasma Lipoproteins, and Coronary Artery Calcium Incidence The Multi-Ethnic Study of Atherosclerosis
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DOI：
10.1161/atvbaha.112.300624
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发表时间：
2013-03-01
影响因子：
8.7
通讯作者：
Szklo, Moyses
中科院分区：
文献类型：
--
作者：
Lamprea-Montealegre, Julio A.;McClelland, Robyn L.;Szklo, Moyses
为了确定慢性肾脏疾病与冠状动脉钙化（CAC）发病率的关系，方法和结果--我们分析了2795名参与多种族动脉粥样硬化研究的无CAC患者的数据在2000年至2002年之间的首次多种族动脉粥样硬化研究访视时入组的基线（钙评分=0）。在2.4年的中位随访期间，随访时，12%、19%和27%的受试者出现了Cystatin-C估计的肾小球滤过率（钙评分>0）（mL/min/1.73 m）（2）≥ 90、60至89和30至59（差异P = 90），校正的CAC发生率风险比和95%置信区间（CI）如下：在估计肾小球滤过率为60 - 89和30 - 59的患者中，分别为1.26（95%CI，1.04-1.52）和1.56（95%CI，1.11-2.20; P趋势=0.014）。在调整了一个特征性的和强烈相关的脂质表型后，这些相关性减弱（主成分1），这在慢性肾脏疾病患者中更常见，其特征是富含甘油三酯的脂蛋白占优势：CAC发病风险比=1.21在校正主成分1后，估计肾小球滤过率为60 ~ 89和30 ~ 59的患者中，CAC的发生率分别为1.44（95%CI，1.00-1.46）和1.44（95%CI，1.02-2.04; P趋势=0.06）。这种关联的一部分是通过特征性脂质表型介导的，包括富含磷脂酰肌醇的脂蛋白的升高。（Arterioscler Thromb Vasc Biol.2013;33：652-658.）
Objective-To determine the association of chronic kidney disease and coronary artery calcium (CAC) incidence, and the distribution of lipoproteins across categories of kidney function and their association with CAC risk.Methods and Results-We analyzed data from 2795 participants in the Multi-Ethnic Study of Atherosclerosis with no CAC (calcium score=0) at baseline enrolled at the first Multi-Ethnic Study of Atherosclerosis visit between the years 2000 and 2002. During a median follow-up of 2.4 years, incident calcium (calcium score>0 at follow-up) developed in 12%, 19%, and 27% of participants with a cystatin-c estimated glomerular filtration rate (mL/min per 1.73 m)(2) of >= 90, 60 to 89, and 30 to 59 (P for difference = 90), adjusted CAC incidence risk ratios, and 95% confidence intervals (CIs) were as follows: 1.26 (95% CI, 1.04-1.52), and 1.56 (95% CI, 1.11-2.20; P-trend=0.014) in those with estimated glomerular filtration rate of 60 to 89 and 30 to 59, respectively. These associations were attenuated after adjusting for a characteristic and strongly interrelated lipid phenotype (principal component 1), which was more common in those with chronic kidney disease and characterized by a predominance of triglyceride-rich lipoproteins: CAC incidence risk ratios=1.21 (95% CI, 1.00-1.46) and 1.44 (95% CI, 1.02-2.04; P-trend=0.06) in those with estimated glomerular filtration rate 60 to 89 and 30 to 59, respectively, after adjusting for principal component 1.Conclusion-Chronic kidney disease is strongly associated with CAC incidence. Part of this association is mediated through a characteristic lipid phenotype comprising elevations in triglyceride-rich lipoproteins. (Arterioscler Thromb Vasc Biol. 2013;33:652-658.)