title: Butyrylcholinesterase activity, cardiovascular risk factors, and mortality in middle-aged and elderly men and women in Jerusalem.
abstract: BACKGROUND
  The association of butyrylcholinesterase (BuChE) with Alzheimer disease and the association of this disease with cardiovascular risk factors raise interest in the association of BuChE activity with cardiovascular risk factors and mortality.
  
  
  METHODS
  A baseline cross-sectional study was conducted between 1985 and 1987, encompassing residents > or =50 years of age living in a Jewish neighborhood in western Jerusalem. Interviews were followed by examinations and nonfasting blood sampling (available for 1807 participants). Follow-up data to April 1996 on mortality and causes of death were obtained through record linkage with the Israeli Population Registry.
  
  
  RESULTS
  BuChE activity was inversely related to age and was positively associated with serum concentrations of albumin (r = 0.35; P <0.001), cholesterol (r = 0.31; P <0.001), and triglycerides (r = 0.30; P <0.001). Enzyme activity was associated with measures of overweight, obesity, and body fat distribution (e.g., body mass index, r = 0.20; P <0.001). In multivariate analysis, the associations of enzyme activity with serum cholesterol, triglycerides, and albumin persisted strongly. After adjustment by Cox proportional hazards regression for other predictors of mortality in this population, individuals in the lowest quintile of BuChE activity had significantly higher mortality than those in the highest quintile [hazard ratios (95% confidence intervals): all-cause mortality, 1.62 (1.15-2.30); cardiovascular deaths, 1.79 (1.05-3.05)]. The association was attenuated by introduction of serum albumin into the models.
  
  
  CONCLUSIONS
  This is the first study to report on the association between BuChE and mortality. The relatively strong association of BuChE with serum lipid and albumin concentrations requires elucidation. Our results suggest that low BuChE activity may be a nonspecific risk factor for mortality in the elderly.
authors.affiliation: Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Jerusalem, Israel. ronitc@md.huji.ac.il
authors.forename: Ronit
authors.initials: R
authors.lastname: Calderon-Margalit
authors.forename: Bella
authors.initials: B
authors.lastname: Adler
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Abramson
authors.forename: Jaime
authors.initials: J
authors.lastname: Gofin
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Kark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D001837:Body Weights and Measures; D002091:Butyrylcholinesterase / Q000097:blood*; D003327:Coronary Disease / Q000175:diagnosis* / Q000401:mortality; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D001786:Blood Glucose; D008055:Lipids; D006710:Homocysteine; D002091:Butyrylcholinesterase