| Malnutrition-inflammation modifies the relationship of cholesterol with cardiovascular disease. | |
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MedLine Citation:
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PMID: 20864686 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In moderate and severe CKD, the association of cholesterol with subsequent cardiovascular disease (CVD) is weak. We examined whether malnutrition or inflammation (M-I) modifies the risk relationship between cholesterol levels and CVD events in African Americans with hypertensive CKD and a GFR between 20 and 65 ml/min per 1.73 m². We stratified 990 participants by the presence or absence of M-I, defined as body mass index <23 kg/m² or C-reactive protein >10 mg/L at baseline. The primary composite outcome included cardiovascular death or first hospitalization for coronary artery disease, stroke, or congestive heart failure occurring during a median follow-up of 77 months. Baseline total cholesterol (212 ± 48 versus 212 ± 44 mg/dl) and overall incidence of the primary CVD outcome (19 versus 21%) were similar in participants with (n = 304) and without (n = 686) M-I. In adjusted analyses, the CVD composite outcome exhibited a significantly stronger relationship with total cholesterol for participants without M-I than for participants with M-I at baseline (P < 0.02). In the non-M-I group, the cholesterol-adjusted hazard ratio (HR) for CVD increased progressively across cholesterol levels: HR = 1.19 [95% CI; 0.77, 1.84] and 2.18 [1.43, 3.33] in participants with cholesterol 200 to 239 and ≥240 mg/dl, respectively (reference: cholesterol <200). In the M-I group, the corresponding HRs did not vary significantly by cholesterol level. In conclusion, the presence of M-I modifies the risk relationship between cholesterol level and CVD in African Americans with hypertensive CKD. |
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Authors:
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Gabriel Contreras; Bo Hu; Brad C Astor; Tom Greene; Thomas Erlinger; John W Kusek; Michael Lipkowitz; Julia A Lewis; Otelio S Randall; Lee Hebert; Jackson T Wright; Cynthia A Kendrick; Jennifer Gassman; George Bakris; Joel D Kopple; Lawrence J Appel; |
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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: 2010-09-23 |
Journal Detail:
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Title: Journal of the American Society of Nephrology : JASN Volume: 21 ISSN: 1533-3450 ISO Abbreviation: J. Am. Soc. Nephrol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-01 Completed Date: 2011-01-07 Revised Date: 2011-12-21 |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 2131-42 Citation Subset: IM |
Affiliation:
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Department of Medicine, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 360E, Miami, FL 33136, USA. gcontrer@med.miami.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult African Americans / statistics & numerical data Cardiovascular Diseases / blood, diagnosis, epidemiology* Causality Cholesterol / blood* Cohort Studies Comorbidity Female Glomerular Filtration Rate Humans Hypertension / diagnosis, epidemiology Incidence Inflammation / diagnosis, epidemiology* Kidney Failure, Chronic / diagnosis, epidemiology* Male Malnutrition / diagnosis, epidemiology* Middle Aged Prognosis Proportional Hazards Models Risk Assessment Severity of Illness Index Survival Analysis |
| Grant Support | |
ID/Acronym/Agency:
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2P20 RR11104/RR/NCRR NIH HHS; 5M01 RR-00071/RR/NCRR NIH HHS; DK 2818-02/DK/NIDDK NIH HHS; M01 RR-00080/RR/NCRR NIH HHS; M01 RR00052/RR/NCRR NIH HHS; M01 RR00827/RR/NCRR NIH HHS; M0100032//PHS HHS; P20-RR11145/RR/NCRR NIH HHS; U01 DK048652/DK/NIDDK NIH HHS; UL1 RR024989/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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57-88-5/Cholesterol |
| Investigator | |
Investigator/Affiliation:
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J Wright / ; R Haynie / ; C Mbanefo / ; M Rahman / ; M Smith / ; B Crenshaw / ; R Dancie / ; Y Hall / ; L Jaen / ; J Lea / ; A Chapman / ; L Dean / ; M Douglas / ; D Watkins / ; B Wilkening / ; L Williams / ; C Ross / ; J Kopple / ; L Miladinovich / ; P Oleskie / ; V Pogue / ; D Dowie / ; H Anderson / ; L Herbert / ; R Locko / ; H Nurse / ; J Cheng / ; G Darkwa / ; V Dowdy / ; B Nicholas / ; O Randall / ; G Ali / ; T Retta / ; S Xu / ; T Alexander / ; M Ketete / ; E Mathew / ; D Ordor / ; C Tilghman / ; L Appel / ; J Charleston / ; C Diggs / ; C Harris / ; P Miller / ; T Shields / ; M Sotomayer / ; K Norris / ; H Ward / ; D Martins / ; M Miller / ; H Howell / ; D Martins / ; D Cheek / ; C Gadegbeku / ; D Ploth / ; D Brooks / ; N Monestime / ; S Murner / ; S Thompson / ; M Faulkner / ; O Adeyele / ; K Phillips / ; G Sanford / ; C Weaver / ; W Cleveland / ; A Howard / ; K Chapman / ; S Plater / ; W Smith / ; R Phillips / ; M Lipkowitz / ; A Gabriel / ; A Travis / ; J Williams / ; L Hebert / ; M Falkenhain / ; S Ladson-Wofford / ; N Nahman / ; K Osei / ; L Hiremath / ; A Dodley / ; J Parks / ; D Veley / ; G Bakris / ; J Lash / ; L Fondren / ; L Bagnuolo / ; J Cohen / ; M Powell / ; A Smith / ; D White / ; G Henry / ; A Johnson / ; T Collins / ; S Koshy / ; E Afante / ; S Rostand / ; D Thornley-Brown / ; R Gay / ; C Johnson / ; B Key / ; D O'Connor / ; F Gabbai / ; R Parmer / ; F Rao / ; J Little / ; T Makrogiannis / ; J Mount / ; A Ogundipe / ; A Stephenson / ; C Tisher / ; D Allen / ; L Burgin / ; A Diaz / ; C Sarmiento / ; J Bourgoignie / ; G Contreras / ; D Florence-Green / ; A Doss / ; J Junco / ; D Merrill / ; J Vassallo / ; A de Velasco / ; K Jamerson / ; F Port / ; M Keshishian / ; A Ojo / ; S Steigerwalt / ; D Cornish-Zirker / ; T Graham / ; A Johnson / ; J Layne / ; S Nesbitt / ; K Manchester / ; W Bloembergen / ; S Massry / ; V Campese / ; M Smogorzewski / ; A Richardson / ; J Middleton / ; E Kuo / ; S Leach / ; R Toto / ; K Jones / ; K Hart / ; T Lightfoot / ; L Littmon / ; B McNeill / ; C Ying / ; J Lewis / ; G Schulman / ; S McLeroy / ; N Rogers / ; M Sika / ; L Y Agodoa / ; J P Briggs / ; J W Kusek / ; J Douglas / ; J Gassman / ; G Beck / ; V Dennis / ; T Greene / ; M Kutner / ; K Brittain / ; S Sherer / ; R Stewart / ; L Tuason / ; S-R Wang / ; W Zhang / ; F Van Lente / ; J Waletzky / ; C O'Laughlin / ; C Peck / ; P Hall / ; D Pexa / ; H Rolin / ; R Byington / ; P Greene / ; R Luke / ; V Chinchilli / ; C Cook / ; B Falkner / ; C Ford / ; R Glassock / ; T Karrison / ; T Kotchen / ; E Saunders / ; M Secundy / ; D Wesson / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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