title: CKD, plasma lipids, and common carotid intima-media thickness: results from the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  Altered levels of atherogenic lipoproteins have been shown to be common in mild kidney dysfunction. This study sought to determine the associations between plasma lipids (including LDL particle distribution) and subclinical atherosclerosis measured by the common carotid intima-media thickness (IMT) across levels of estimated GFR (eGFR) and to assess whether inflammation modifies these associations.
  
  
  METHODS
  Cross-sectional analyses of 6572 participants in the Multi-Ethnic Study of Atherosclerosis enrolled from 2000 to 2002 were performed.
  
  
  RESULTS
  CKD, defined as eGFR <60 ml/min per 1.73 m(2), was present in 853 individuals (13.0%). Associations of total cholesterol and LDL cholesterol (LDL-C) with IMT were J shaped, particularly among participants with CKD (P value for interaction, P=0.01). HDL cholesterol (HDL-C) and small-dense LDL-C were consistently and linearly associated with IMT across levels of eGFR. The results showed differences in IMT of -21.41 (95% confidence interval, -41.00, -1.57) in eGFR ≥60 and -58.49 (-126.61, 9.63) in eGFR <60 per unit difference in log-transformed HDL-C, and 4.83 (3.16, 6.50) in eGFR ≥60 and 7.48 (1.45, 13.50) in eGFR <60 per 100 nmol/L difference in small-dense LDL. Among participants with CKD, inflammation significantly modified the associations of total cholesterol and LDL-C with IMT (P values for interaction, P<0.01 and P<0.001, respectively).
  
  
  CONCLUSIONS
  Compared with total cholesterol and LDL-C, abnormalities in HDL-C and small-dense LDL-C are more strongly and consistently associated with subclinical atherosclerosis in CKD. Inflammation modifies the association between total cholesterol and LDL-C with IMT.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Lamprea-Montealegre
authors.forename: Brad C
authors.initials: BC
authors.lastname: Astor
authors.forename: Robin L
authors.initials: RL
authors.lastname: McClelland
authors.forename: Ian H
authors.initials: IH
authors.lastname: de Boer
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Sibley
authors.forename: Daniel
authors.initials: D
authors.lastname: O'Leary
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000473:pathology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D008078:Cholesterol, LDL; D008055:Lipids