Apolipoprotein B attenuates albuminuria-associated cardiovascular disease in
prevention of renal and vascular endstage disease (PREVEND) participants
#MMPMID24854276
Corsetti JP
; Gansevoort RT
; Bakker SJ
; Sparks CE
; Vart P
; Dullaart RP
J Am Soc Nephrol
2014[Dec]; 25
(12
): 2906-15
PMID24854276
show ga
Whether urinary albumin excretion relates to higher levels of atherogenic
apolipoprotein B fractions in the nondiabetic population is uncertain. Such a
relationship could explain, in part, the association of elevated urinary albumin
excretion with cardiovascular disease risk. We assessed the relationship of
urinary albumin excretion with apolipoprotein B fractions and determined whether
the association of elevated urinary albumin excretion with incident
cardiovascular events is modified by high apolipoprotein B fraction levels. We
performed a prospective study on 8286 nondiabetic participants (580 participants
with cardiovascular disease; 4.9 years median follow-up time) with fasting
lipids, apolipoprotein B, and urinary albumin excretion determined at baseline.
With adjustment for sex and age, micro- and macroalbuminuria were associated with
increased apolipoprotein B fractions (non-HDL cholesterol, LDL cholesterol,
triglycerides, and apolipoprotein B). All four apolipoprotein B fractions
modified associations of urinary albumin excretion with incident cardiovascular
disease (hazard ratios for interaction terms ranged from 0.89 to 0.94 with 95%
confidence intervals ranging from 0.84 to 0.99 and P values ranging from 0.001 to
0.02 by Cox proportional hazards modeling). These interactions remained present
after additional adjustment for conventional risk factors, eGFR, cardiovascular
history, and lipid-lowering and antihypertensive drug treatments. Such
modification was also observed when urinary albumin excretion was stratified into
normo-, micro-, and macroalbuminuria. We conclude that there is an association
between elevated urinary albumin excretion and apolipoprotein B fraction levels
and a negative interaction between these variables in their associations with
incident cardiovascular events. Elevated urinary albumin excretion may share
common causal pathways with high apolipoprotein B fractions in the pathogenesis
of cardiovascular disease.
free
free
free
