Abstract
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 HDL-C 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 A2 (Lp-PLA2) modify the relation of HDL-C with CHD. HDL-C, CRP, IL-6, and Lp-PLA2 values were grouped as using gender-specific tertiles. Also, an inflammation index of z-score sums for CRP, IL-6, and Lp-PLA2 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-PLA2 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.
Original language | English (US) |
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Pages (from-to) | 246-251 |
Number of pages | 6 |
Journal | Atherosclerosis |
Volume | 231 |
Issue number | 2 |
DOIs | |
State | Published - Dec 2013 |
Funding
Presented in part at the National Lipid Association Scientific Sessions, Las Vegas, NV, May 2013. This research was supported by NHLBI contracts HHSN268201200036C, N01-HC-85239, N01-HC-85079 through N01-HC-85086; N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, N01-HC-45133 and NHLBI grant HL080295 , with additional contribution from NINDS . Additional support was provided through AG-023629 , AG-15928 , AG-20098 , and AG-027058 from the NIA . See also http://www.chs-nhlbi.org/pi.htm .
Keywords
- C-reactive protein
- Coronary heart disease
- High density lipoprotein
- Inflammation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine