title: The prevalence of nontraditional risk factors for coronary heart disease in patients with chronic kidney disease.
abstract: BACKGROUND
  Risk for coronary heart disease is high among patients with chronic kidney disease.
  
  
  OBJECTIVE
  To compare the prevalence of low apolipoprotein A1 levels and elevated apolipoprotein B, plasma fibrinogen, lipoprotein(a), homocysteine, and C-reactive protein levels by estimated glomerular filtration rate (GFR).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Third National Health and Nutrition Examination survey.
  
  
  METHODS
  12 547, 3180, and 744 persons with estimated GFRs of at least 90, 60 to 89, or less than 60 mL/min per 1.73 m2, respectively, who were at least 18 years of age.
  
  
  METHODS
  Chronic kidney disease was defined as an estimated GFR of less than 60 mL/min per 1.73 m2 based on the abbreviated Modification of Diet in Renal Disease formula.
  
  
  RESULTS
  After standardization for age, race or ethnicity, and sex, lower estimated GFR (> or =90, 60 to 89, or <60 mL/min per 1.73 m2) was associated with lower average levels of apolipoprotein A1 (1.44, 1.43, and 1.35 g/L) and higher levels of apolipoprotein B (1.03, 1.06, and 1.08 g/L), plasma fibrinogen (8.43, 8.44, and 9.53 micromol/L), homocysteine (8.5, 10.0, and 13.2 micromol/L), and C-reactive protein (3.0, 2.9, and 3.9 mg/L) (P < 0.05 for all values). The multivariate-adjusted odds ratios of an apolipoprotein A1 level of less than 1.2 g/L, a serum lipoprotein(a) level of at least 1.61 micromol/L (> or =45.3 mg/dL), a plasma fibrinogen level of at least 10.35 micromol/L, a serum homocysteine level of at least 15 micromol/L, and a C-reactive protein level of at least 10.0 mg/L for participants with chronic kidney disease compared with those with a GFR of at least 90 mL/min per 1.73 m2 or greater were 1.92 (95% CI, 1.02 to 3.63), 1.82 (CI, 1.06 to 3.13), 1.74 (CI, 1.35 to 2.24), 8.23 (CI, 5.00 to 13.6), and 1.93 (CI, 1.33 to 2.81), respectively.
  
  
  CONCLUSIONS
  Levels of apolipoprotein A1 are decreased and levels of homocysteine, lipoprotein(a), fibrinogen, and C-reactive protein are increased among patients with chronic kidney disease.
authors.affiliation: Tulane University, New Orleans, Louisiana, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: L Lee
authors.initials: LL
authors.lastname: Hamm
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.forename: Jiang
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D003327:Coronary Disease / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications*; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D017270:Lipoprotein(a); D006710:Homocysteine; D005340:Fibrinogen; D002097:C-Reactive Protein