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Race and gender differences in the association of Lp(a) with carotid artery wall thickness. The Atherosclerosis Risk in Communities (ARIC) Study.

TitleRace and gender differences in the association of Lp(a) with carotid artery wall thickness. The Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication1996
AuthorsSchreiner PJ, Heiss G, Tyroler HA, Morrisett JD, Davis CE, Smith R
JournalArterioscler Thromb Vasc Biol
Volume16
Issue3
Pagination471-8
Date Published1996 Mar
ISSN1079-5642
KeywordsAfrican Continental Ancestry Group, Age Factors, Aged, Arteriosclerosis, Carotid Arteries, Cholesterol, LDL, European Continental Ancestry Group, Female, Humans, Lipoprotein(a), Male, Middle Aged, Risk Factors, Sex Factors
Abstract

The association of lipoprotein(a) [Lp(a)] with preclinical atherosclerotic disease is not well established in any race group, particularly African Americans. This report examined the association of Lp(a) with preclinical extracranial carotid atherosclerosis in middle-aged black and white participants in the Atherosclerosis Risk in Communities (ARIC) Study. Study participants (15 124: 2417 black women, 1522 black men, 5907 white women, and 5278 white men) who were 45 to 64 years old at baseline were examined during the period 1987 to 1989. Carotid intimal-medial far-wall thickness was determined by B-mode ultrasonography and expressed as the overall wall thickness mean at six sites to approximate atherosclerosis in the carotid system. Lp(a) was measured as its total protein component, Lp(a) protein, by a double-antibody ELISA for apolipoprotein(a) detection. Mean Lp(a) protein levels were higher in blacks than whites (169.1 and 147.0 microgram/mL in black women and black men, respectively, compared with 86.6 and 75.1 micrograms/mL in white women and white men). Mean carotid wall thickness (in millimeters) varied by race and gender: 0.798 in white men, 0.779 in black men, 0.718 in black women and 0.695 in white women. Multivariable-adjusted Lp(a) protein was independently associated with wall thickness (in millimeters) in white men and black men; among women, however, this association appeared to be stronger when smoking and diabetes were present. A 100-microgram/mL difference in Lp(a) protein was associated with 0.049- and 0.043-mm higher wall thickness values in black men and white men, respectively. Among white women who smoked, the difference in wall thickness was 0.051 mm compared with 0.032 mm for former/never smokers and 0.21 mm in black female diabetics compared with 0.031 mm in black female nondiabetics. These results suggest that Lp(a) is associated with preclinical carotid atherosclerosis in both blacks and whites, but that this association may be affected by the presence of other cardiovascular risk factors, particularly in women.

DOI10.1161/01.atv.16.3.471
Alternate JournalArterioscler Thromb Vasc Biol
PubMed ID8630675
Grant ListN01-HC-55018 / HC / NHLBI NIH HHS / United States