| Fasting compared with nonfasting lipids and apolipoproteins for predicting incident cardiovascular events. | |
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MedLine Citation:
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PMID: 18711012 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although guidelines recommend measuring fasting lipids for initial screening of adults without cardiovascular disease (CVD), recent studies suggest that nonfasting triglycerides may be superior to fasting. Whether fasting status alters associations of nontriglyceride lipids with CVD is unclear. METHODS AND RESULTS: In a prospective study of 26 330 healthy women (19 983 fasting; 6347 nonfasting), associations of baseline lipids with incident CVD (754 fasting; 207 nonfasting) were examined over an 11-year follow-up. Except for triglycerides, lipid concentrations differed minimally (<5%) for fasting versus nonfasting. However, stronger associations with CVD were noted for fasting total cholesterol (adjusted fasting hazard ratio [HR], 1.22 per 1-SD increment; 95% CI, 1.14 to 1.30; nonfasting HR, 1.07; 95% CI, 0.93 to 1.21), low-density lipoprotein (LDL) cholesterol (fasting HR, 1.21; 95% CI, 1.13 to 1.29; nonfasting HR, 1.00; 95% CI, 0.87 to 1.15), apolipoprotein B-100 (fasting HR, 1.36; 95% CI, 1.27 to 1.45; nonfasting HR, 1.20; 95% CI, 1.05 to 1.36), non-high-density lipoprotein (HDL) cholesterol (fasting HR, 1.29; 95% CI, 1.21 to 1.38; nonfasting HR, 1.15; 95% CI, 1.01 to 1.31), and apolipoprotein B-100/A-1 ratio (fasting HR, 1.39; 95% CI, 1.30 to 1.48; nonfasting HR, 1.18; 95% CI, 1.09 to 1.27). Compared with fasting levels, nonfasting HDL cholesterol, apolipoprotein A-1, and total/HDL cholesterol ratio had similar associations, and triglycerides had a stronger association, with CVD. Significant interactions were seen for LDL cholesterol and apolipoprotein B-100/A-1 ratio with fasting status (P for interaction=0.03 and <0.001, respectively). CONCLUSIONS: This study demonstrates that HDL cholesterol, triglycerides, total/HDL cholesterol ratio, and apolipoprotein A-1 predict CVD when measured nonfasting. By contrast, total, LDL, and non-HDL cholesterol, in addition to apolipoprotein B-100 and B-100/A-1 ratio, provide less useful CVD risk information when nonfasting, despite small changes in their concentrations. Guidelines for lipid screening may need to consider these differences. |
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Authors:
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Samia Mora; Nader Rifai; Julie E Buring; Paul M Ridker |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2008-08-18 |
Journal Detail:
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Title: Circulation Volume: 118 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-09-03 Completed Date: 2008-09-23 Revised Date: 2013-02-28 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 993-1001 Citation Subset: AIM; IM |
Affiliation:
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Donald W. Reynolds Center for Cardiovascular Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. smora@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Apolipoproteins
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blood* Cardiovascular Diseases / blood* Cholesterol, HDL / blood* Cholesterol, LDL / blood* Double-Blind Method Fasting / blood* Female Follow-Up Studies Guidelines as Topic Humans Middle Aged Predictive Value of Tests Prospective Studies Randomized Controlled Trials as Topic |
| Grant Support | |
ID/Acronym/Agency:
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CA-47988/CA/NCI NIH HHS; HL-43851/HL/NHLBI NIH HHS; R01 CA047988/CA/NCI NIH HHS; R01 CA047988-09/CA/NCI NIH HHS; R01 CA047988-10/CA/NCI NIH HHS; R01 CA047988-11/CA/NCI NIH HHS; R01 CA047988-12/CA/NCI NIH HHS; R01 CA047988-13/CA/NCI NIH HHS; R01 CA047988-14/CA/NCI NIH HHS; R01 CA047988-15/CA/NCI NIH HHS; R01 CA047988-16/CA/NCI NIH HHS; R01 CA047988-17/CA/NCI NIH HHS; R01 CA047988-18/CA/NCI NIH HHS; R01 HL043851/HL/NHLBI NIH HHS; R01 HL043851-09/HL/NHLBI NIH HHS; R01 HL043851-10/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Apolipoproteins; 0/Cholesterol, HDL; 0/Cholesterol, LDL |
| Comments/Corrections | |
Comment In:
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Circulation. 2009 Apr 7;119(13):e384; author reply e385
[PMID:
19349329
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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