title: Comparison of the Predictive Value of GlycA and Other Biomarkers of Inflammation for Total Death, Incident Cardiovascular Events, Noncardiovascular and Noncancer Inflammatory-Related Events, and Total Cancer Events.
abstract: BACKGROUND
  GlycA is a biomarker that reflects integrated concentrations and glycosylation states of several acute-phase proteins. We studied the association of GlycA and inflammatory biomarkers with future death and disease.
  
  
  METHODS
  A total of 6523 men and women in the Multi-Ethnic Study of Atherosclerosis who were free of overt cardiovascular disease (CVD) and in generally good health had a baseline blood sample taken. We assayed high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and d-dimer. A spectral deconvolution algorithm was used to quantify GlycA signal amplitudes from automated nuclear magnetic resonance (NMR) LipoProfile® test spectra. Median follow-up was 12.1 years. Among 4 primary outcomes, CVD events were adjudicated, death was by death certificate, and chronic inflammatory-related severe hospitalization and death (ChrIRD) and total cancer were classified using International Classification of Diseases (ICD) codes. We used Poisson regression to study baseline GlycA, hsCRP, IL-6, and d-dimer in relation to total death, CVD, ChrIRD, and total cancer.
  
  
  RESULTS
  Relative risk per SD of GlycA, IL-6, and d-dimer for total death (n = 915); for total CVD (n = 922); and for ChrIRD (n = 1324) ranged from 1.05 to 1.20, independently of covariates. In contrast, prediction from hsCRP was statistically explained by adjustment for other inflammatory variables. Only GlycA was predictive for total cancer (n = 663). Women had 7% higher values of all inflammatory biomarkers than men and had a significantly lower GlycA prediction coefficient than men in predicting total cancer.
  
  
  CONCLUSIONS
  The composite biomarker GlycA derived from NMR is associated with risk for total death, CVD, ChrIRD, and total cancer after adjustment for hsCRP, IL-6, and d-dimer. IL-6 and d-dimer contribute information independently of GlycA.
authors.affiliation: Cardiovascular Division, School of Medicine, University of Minnesota, Minneapolis, MN; dupre007@umn.edu.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Duprez
authors.affiliation: LabCorp, Raleigh, NC;
authors.forename: James
authors.initials: J
authors.lastname: Otvos
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, University of Minnesota, Minneapolis, MN;
authors.forename: Otto A
authors.initials: OA
authors.lastname: Sanchez
authors.affiliation: University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA;
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Mackey
authors.affiliation: Department of Pathology & Laboratory Medicine, and Biochemistry, University of Vermont College of Medicine, Colchester, VT;
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D050197:Atherosclerosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003644:Death Certificates; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood*; D011237:Predictive Value of Tests
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers