title: Determinants and clinical significance of plasma oxidized LDLs in older individuals. A 9 years follow-up study.
abstract: Oxidized LDLs (ox.LDLs) uptake by macrophages inside the arterial wall is a crucial step in atherosclerotic disease, and some studies suggest that high ox.LDLs plasma levels might be associated with cardiovascular disease (CVD). However, whether high ox.LDLs continue to be a CVD risk factors in older persons is unknown. We investigated the clinical correlates of plasma ox.LDLs, and their role in predicting long-term CVD/cardiac mortality in 1025 older community dwelling individuals (mean age: 75.5 ± 7.4 years; females: 55%) from the InCHIANTI study. Kaplan-Meier curves were fitted to explore the relationship between tertiles of ox.LDLs (ox.LDL/LDL-C ratio) and time to CVD/cardiac death. Hazard Ratios (HR) were estimated by Cox regression analysis. At multivariate analysis, ox.LDLs were independently associated with LDL-C, triglycerides, and HDL-C (adjusted r(2): 0.42; P = 0.001). The ox.LDL/LDL-C ratio (the extent of LDLs oxidation) was independently correlated with HDL-C, triglycerides, and beta-carotene (adjusted r(2): 0.15, P = 0.001). Among 1025 individuals, 392 died after 9 years, 166 from CVD. The HR for CVD/cardiac mortality was not significantly different across tertiles of ox.LDLs or ox.LDL/LDL-C ratio, both in the whole sample and in individuals with prevalent CVD. We conclude that in an elderly population LDL-C, triglycerides, and HDL-C are the most important determinants of ox.LDLs levels, indirectly suggesting an association between small dense LDLs and LDLs oxidation. No association emerged between higher ox.LDLs levels and 9 years CVD/cardiac mortality, suggesting that in advanced age the prognostic information added by ox.LDLs on CVD/cardiac mortality might be negligible.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology, and Clinical Nutrition, University of Ferrara, Via Savonarola n°9, 44100 Ferrara, Italy. gzuliani@hotmail.com
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zuliani
authors.forename: Mario Luca
authors.initials: ML
authors.lastname: Morieri
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpato
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Vigna
authors.forename: Cristina
authors.initials: C
authors.lastname: Bosi
authors.forename: Marcello
authors.initials: M
authors.lastname: Maggio
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein