1. Apolipoprotein C-III Levels and Incident Coronary Artery Disease Risk: The EPIC-Norfolk Prospective Population Study
- Author
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Sotirios Tsimikas, Erick S.G. Stroes, Julian C. van Capelleveen, S. Matthijs Boekholdt, Aeilko H. Zwinderman, Sophie J. Bernelot Moens, Xiaohong Yang, Nicholas J. Wareham, G. Kees Hovingh, John J.P. Kastelein, Joseph L. Witztum, Kay-Tee Khaw, Wareham, Nicholas [0000-0003-1422-2993], Khaw, Kay-Tee [0000-0002-8802-2903], Apollo - University of Cambridge Repository, Vascular Medicine, Amsterdam Cardiovascular Sciences, APH - Methodology, Epidemiology and Data Science, Cardiology, ACS - Atherosclerosis & ischemic syndromes, ACS - Pulmonary hypertension & thrombosis, and ACS - Heart failure & arrhythmias
- Subjects
Male ,Time Factors ,Coronary Artery Disease Risk ,030204 cardiovascular system & hematology ,EPIC ,Coronary artery disease ,0302 clinical medicine ,Risk Factors ,Odds Ratio ,Medicine ,030212 general & internal medicine ,Prospective Studies ,triglycerides ,biology ,Incidence ,Middle Aged ,Prognosis ,Up-Regulation ,Lipoproteins, LDL ,England ,Cardiology ,Population study ,Female ,lipids (amino acids, peptides, and proteins) ,Inflammation Mediators ,Cardiology and Cardiovascular Medicine ,coronary artery disease ,medicine.medical_specialty ,Risk Assessment ,C-reactive protein ,03 medical and health sciences ,Internal medicine ,Humans ,Particle Size ,Nuclear Magnetic Resonance, Biomolecular ,Aged ,Apolipoprotein C-III ,business.industry ,apolipoprotein CIII ,medicine.disease ,lipoproteins ,Logistic Models ,Case-Control Studies ,Multivariate Analysis ,biology.protein ,Apolipoprotein CIII ,business ,Biomarkers - Abstract
Objective— Apolipoprotein C-III (apoC-III) is a key regulator of triglyceride metabolism. Elevated triglyceride-rich lipoproteins and apoC-III levels are causally linked to coronary artery disease (CAD) risk. The mechanism(s) through which apoC-III increases CAD risk remains largely unknown. The aim was to confirm the association between apoC-III plasma levels and CAD risk and to explore which lipoprotein subfractions contribute to this relationship between apoC-III and CAD risk. Approach and Results— Plasma apoC-III levels were measured in baseline samples from a nested case–control study in the European Prospective Investigation of Cancer (EPIC)-Norfolk study. The study comprised 2711 apparently healthy study participants, of whom 832 subsequently developed CAD. We studied the association of baseline apoC-III levels with incident CAD risk, lipoprotein subfractions measured by nuclear magnetic resonance spectroscopy and inflammatory biomarkers. ApoC-III levels were significantly associated with CAD risk (odds ratio, 1.91; 95% confidence interval, 1.48–2.48 for highest compared with lowest quintile), retaining significance after adjustment for traditional CAD risk factors (odds ratio, 1.47; 95% confidence interval, 1.11–1.94). ApoC-III levels were positively correlated with triglyceride levels, ( r =0.39), particle numbers of very-low-density lipoprotein ( r =0.25), intermediate-density lipoprotein ( r =0.23), small dense low-density lipoprotein ( r =0.26), and high-sensitivity C-reactive protein ( r =0.15), whereas an inverse correlation was observed with large low-density lipoprotein particle number ( r =−0.11), P Conclusions— ApoC-III levels are significantly associated with incident CAD risk. Elevated levels of remnant lipoproteins, small dense low-density lipoprotein, and low-grade inflammation may explain this association.
- Published
- 2017
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