Objective-Elevated urine albumin excretion is an established risk factor for cardiovascular disease. Increased cardiovascular risk may be partly mediated by abnormalities in lipoprotein metabolism. We examined cross-sectional associations of urine albumin-creatinine ratio (ACR) with standard lipid measurements and with lipoprotein particle concentrations measured by Nuclear Magnetic Resonance (NMR) in the Multi-Ethnic Study of Atherosclerosis.Methods and Results-Among 5633 participants who were not using lipid-lowering medications, greater ACR was associated with greater triglyceride concentration and lesser high density lipoprotein cholesterol concentration (women only), but not with low density lipoprotein Address correspondence to: Ian H. de Boer, MD MS, University of Washington, Division of Nephrology, Box 356521, BB-1265 Health Sciences Building, 1959 NE Pacific, Seattle, WA 98195. PHONE (206) FAX (206) 685-6881; EMAIL deboer@u.washington.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Author ManuscriptAtherosclerosis. Author manuscript; available in PMC 2009 March 1.
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript (LDL) cholesterol calculated using conventional methods. In contrast, unadjusted mean small LDL particle concentrations measured by NMR were 770, 827, and 935 nmol/L for women (p<0.001) and 996, 1030, and 1040 nmol/L for men (p=0.037) among participants with normal, high normal, and elevated ACR. Adjusting for age, race/ethnicity, diabetes, impaired fasting glucose, hypertension, smoking, medications, body mass index, and serum creatinine, each two-fold greater ACR was associated with an increase in small LDL particle concentration of 27 nmol/L for women (p<0.001) and 14 nmol/L for men (p=0.008). Greater ACR was also associated with greater intermediate density lipoprotein particle concentration and smaller mean LDL particle size.Conclusions-Mild elevations of urine ACR are associated with atherogenic lipoprotein abnormalities that are not directly observed with a standard lipid panel.
KeywordsAlbuminuria; kidney; lipids; lipoproteins; epidemiology Elevated urine albumin excretion (UAE) is an established risk factor for cardiovascular (CV) disease. 1-5 Greater levels of UAE have been associated with increased risk for cardiovascular events and an increased prevalence of subclinical CV disease even within the proposed normal range of UAE. 6-9The increased CV risk associated with elevated UAE may be mediated, in part, by abnormalities in lipoprotein metabolism. Conventional lipid measurements have...