Lipoprotein(a), Inflammation, and Peripheral Arterial Disease in a Community-Based Sample of Older Men and Women (the InCHIANTI Study)
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- 作者：Stefano Volpato ; Giovanni B. Vigna ; Mary M. McDermott ; Margherita Cavalieri ; Cinzia Maraldi ; Fulvio Lauretani ; Stefania B ; inelli ; Giovanni Zuliani ; Jack M. Guralnik ; Renato Fellin ; Luigi Ferrucci
- 刊名：The American Journal of Cardiology
- 出版年：2010
- 出版时间：15 June 2010
- 年：2010
- 卷：105
- 期：12
- 页码：1825-1830
- 全文大小：269 K
文摘
Lipoprotein(a) (Lp[a]) may represent an independent risk factor for peripheral arterial disease of the lower limbs (LL-PAD), but prospective data are scant. We estimated the association between baseline Lp(a) with prevalent and incident LL-PAD in older subjects from the InCHIANTI Study. LL-PAD, defined as an ankle–brachial index <0.90, was assessed at baseline and over a 6-year follow-up in a sample of 1,002 Italian subjects 60 to 96 years of age. Plasma Lp(a) and potential traditional and novel cardiovascular risk factors (including a score based on relevant inflammatory markers) were entered in multivariable models to assess their association with prevalent and incident LL-PAD. At baseline, Lp(a) concentration was directly related to the number of increased inflammatory markers (p <0.05). There were 125 (12.5 % ) prevalent cases of LL-PAD and 57 (8.3 % ) incident cases. After adjustment for potential confounders, participants in the highest quartile of the Lp(a) distribution (≥32.9 mg/dl) were more likely to have LL-PAD compared to those in the lowest quartile (odds ratio [OR] 1.83, 95 % confidence interval [CI] 1.01 to 3.33). The association was stronger (OR 3.80, 95 % CI 1.50 to 9.61) if LL-PAD was defined by harder criteria, namely an ankle–brachial index <0.70. Compared to subjects in the lowest Lp(a) quartile, those in the highest quartile showed a somewhat increased risk of incident LL-PAD (lowest quartile 7.7 % , highest quartile 10.8 % ), but the association was not statistically significant (OR 1.52, 95 % CI 0.71 to 3.22). In conclusion, Lp(a) is an independent LL-PAD correlate in the cross-sectional evaluation, but further prospective studies in larger populations, with longer follow-up and more definite LL-PAD ranking, might be needed to establish a longitudinal association.