title: GlycA, a Pro-Inflammatory Glycoprotein Biomarker, and Incident Cardiovascular Disease: Relationship with C-Reactive Protein and Renal Function.
abstract: OBJECTIVE
  GlycA is a novel nuclear magnetic resonance spectroscopy-measured biomarker of systemic inflammation. We determined whether GlycA is associated with incident cardiovascular disease (CVD) in men and women, examined whether this association with CVD is modified by renal function, and compared this association with high sensitivity C-reactive protein (hsCRP).
  
  
  METHODS
  A prospective cohort study was performed among 4,759 subjects (PREVEND study) without a history of CVD and cancer. Incident CVD was defined as the combined endpoint of cardiovascular morbidity and mortality. Cox regression analyses were used to examine associations of baseline GlycA and hsCRP with CVD.
  
  
  RESULTS
  298 first CVD events occurred during a median follow-up of 8.5 years. After adjustment for clinical and lipid measures the hazard ratio (HR) for CVD risk in the highest GlycA quartile was 1.58 (95% CI, 1.05-2.37, P for trend = 0.004). This association was similar after further adjustment for renal function (estimated glomerular filtration rate and urinary albumin excretion). After additional adjustment for hsCRP, GlycA was still associated with incident CVD (HR: 1.16 per SD change (95% CI, 1.01-1.33), P = 0.04). Similar results were obtained for hsCRP (HR per SD change after adjustment for GlycA: 1.17 (95% CI 1.17 (95% CI, 1.01-3.60), P = 0.04). CVD risk was highest in subjects with simultaneously higher GlycA and hsCRP (fully adjusted HR: 1.79 (95% CI, 1.31-2.46), P<0.001).
  
  
  CONCLUSIONS
  GlycA is associated with CVD risk in men and women, independent of renal function. The association of GlycA with incident CVD is as strong as that of hsCRP.
authors.affiliation: Department of Nephrology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands; Department of Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Eke G
authors.initials: EG
authors.lastname: Gruppen
authors.affiliation: Department of Nephrology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Ineke J
authors.initials: IJ
authors.lastname: Riphagen
authors.affiliation: LabCorp, Raleigh, North Carolina, United States of America.
authors.forename: Margery A
authors.initials: MA
authors.lastname: Connelly
authors.affiliation: LabCorp, Raleigh, North Carolina, United States of America.
authors.forename: James D
authors.initials: JD
authors.lastname: Otvos
authors.affiliation: Department of Nephrology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
authors.affiliation: Department of Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Robin P F
authors.initials: RP
authors.lastname: Dullaart
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D005919:Glomerular Filtration Rate; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood; D007674:Kidney Diseases / Q000097:blood*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D006023:Glycoproteins; D002097:C-Reactive Protein