Table 2.
Multivariable-adjusted associations of baseline Lp(a) levels with study variables
| Study variable | Per SD of ln Lp(a) | Lp(a) ≥30 mg/dL | Lp(a) ≥50 mg/dL | |||
|---|---|---|---|---|---|---|
| B / OR (95% CI) | p-value | B / OR (95% CI) | p-value | B / OR (95% CI) | p-value | |
| Dyslipidemia | ||||||
| Total cholesterol (mg/dL) | 7.39 (6.51, 8.27) | <0.001* | 11.38 (9.56, 13.20) | <0.001* | 13.72 (11.61, 15.83) | <0.001* |
| LDL cholesterol (mg/dL) | 7.20 (6.35, 8.05) | <0.001* | 11.33 (9.53, 13.13) | <0.001* | 13.59 (11.54, 15.65) | <0.001* |
| HDL cholesterol (mg/dL) | 0.37 (0.03, 0.72) | 0.03 | 0.64 (−0.08, 1.34) | 0.08 | 1.31 (0.45, 2.17) | 0.003* |
| Triglycerides (mg/dL)a | −0.028 (−0.040, −0.016) | <0.001* | −0.040 (−0.068, −0.017) | 0.001* | −0.042 (−0.071, −0.013) | 0.005* |
| Lp-PLA2 mass (ng/mL) | 1.91 (0.71, 3.12) | 0.002* | 2.32 (−0.41, 5.07) | 0.10 | 3.50 (0.45, 6.55) | 0.02 |
| Lp-PLA2 activity (nmol/min/mL) | −0.24 (−1.09, 0.61) | 0.58 | −0.29 (−2.06, 1.49) | 0.75 | 0.20 (−1.86, 2.27) | 0.85 |
| Diabetes and insulin resistance | ||||||
| Fasting glucose (mg/dL)a | −0.006 (−0.011, −0.002) | 0.01* | −0.012 (−0.022, −0.002) | 0.02 | −0.010 (−0.021, 0.001) | 0.08 |
| Fasting insulin (mU/L)a | −0.030 (−0.042, −0.017) | <0.001* | −0.044 (−0.070, −0.002) | <0.001* | −0.044 (−0.075, −0.014) | 0.004* |
| HOMA-IRa | −0.032 (−0.045, −0.020) | <0.001* | −0.053 (−0.078, −0.028) | <0.001* | −0.050 (−0.079, −0.020) | <0.001* |
| Diabetes | 1.01 (0.91, 1.13) | 0.79 | 1.21 (0.99, 1.49) | 0.06 | 1.33 (1.06, 1.67) | 0.01* |
| Hypertension | ||||||
| SBP (mm Hg) | −0.25 (−0.78, 0.28) | 0.35 | 0.24 (−0.89, 1.37 | 0.68 | 0.01 (−1.32, 1.34) | 0.99 |
| DBP (mm Hg) | −0.06 (−0.33, 0.21) | 0.67 | 0.12 (−0.45, 0.70) | 0.67 | −0.08 (−0.74, 0.58) | 0.82 |
| Hypertension | 1.00 (0.93, 1.07) | 0.93 | 1.02 (0.89, 1.18) | 0.73 | 1.02 (0.87, 1.19) | 0.84 |
| Inflammation | ||||||
| CRP (mg/L)a | 0.045 (0.015, 0.075) | 0.003* | 0.066 (0.005, 0.127) | 0.04 | 0.045 (−0.025, 0.116) | 0.21 |
| IL-2 sRα (ng/mL)a | −0.001 (−0.016, 0.013) | 0.85 | −0.008 (−0.040, 0.023) | 0.61 | −0.020 (−0.057, 0.017) | 0.28 |
| IL-6 (pg/mL)a | 0.017 (0.000, 0.034) | 0.05 | 0.032 (−0.004, 0.068) | 0.08 | 0.040 (−0.001, 0.082) | 0.06 |
| IL-10 (pg/mL)a | 0.019 (−0.012, 0.049) | 0.23 | 0.061 (−0.004, 0.125) | 0.07 | 0.061 (−0.013, 0.135) | 0.10 |
| sICAM (ng/mL) | −0.50 (−3.97, 2.98) | 0.78 | −4.83 (−12.85, 3.19) | 0.24 | 1.92 (−6.97, 10.81) | 0.67 |
| Homocysteine (μmol/L)a | −0.007 (−0.015, 0.000) | 0.07 | −0.016 (−0.032, −0.001) | 0.04 | −0.010 (−0.028, 0.007) | 0.25 |
| sTNF-R1 (ng/mL)a | 0.004 (−0.005, 0.013) | 0.39 | 0.007 (−0.012, 0.026) | 0.46 | −0.002 (−0.025, 0.020) | 0.84 |
| Coagulation | ||||||
| Fibrinogen (mg/dL) | 8.06 (6.13, 9.98) | <0.001* | 13.50 (9.42, 17.59) | <0.001* | 10.54 (5.89, 15.18) | <0.001 |
| Factor VIII (%) | 0.266 (−0.766, 1.299) | 0.61 | 1.795 (−0.365, 3.957) | 0.10 | 1.308 (−1.250, 3.865) | 0.32 |
| D-dimer (μg/ml)a | 0.041 (0.016, 0.066) | 0.001* | 0.037 (−0.016, 0.089) | 0.17 | 0.045 (−0.016, 0.106) | 0.15 |
| PAP (nM)a | 0.015 (0.005, 0.025) | 0.003* | 0.033 (0.012, 0.055) | 0.002* | 0.024 (−0.001, 0.049) | 0.06 |
Among 5975 participants, 1958 participants had Lp(a) ≥30 mg/dL and 1181 participants had Lp(a) ≥50 mg/dL.
Lp(a) was modeled as a continuous variable (per SD increase [1.144] in ln-transformed values) and by clinical cutoff values, 30 and 50 mg/dL.
Data are shown as odds ratio for diabetes and hypertension, and regression coefficient (B) (i.e. absolute change) for other parameters.
All data were adjusted for age, sex, race/ethnicity, education, smoking, pack-years of smoking, current alcohol use, physical activity, BMI, ln-transformed fasting glucose (except for analysis of HOMA-IR and diabetes), SBP (except for analysis of blood pressure and hypertension), HDL cholesterol, LDL cholesterol (except for analysis of total cholesterol), ln-transformed triglycerides, use of lipid-lowering medication, use of hypertensive medication (except for analysis of hypertension), use of glucose lowering medication (except for analysis of diabetes), family history of heart attack, and eGFR.
Abbreviations: BMI, body mass index; CRP, C-reactive protein; DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; HDL, high-density lipoprotein; HOMA-IR, homeostasis model assessment index of insulin resistance; IL, interleukin; IL-2 sRα, interleukin-2 soluble receptor α; LDL, low-density lipoprotein; Lp(a), lipoprotein(a); Lp-PLA2, lipoprotein-associated phospholipase A2; PAP, plasmin-antiplasmin complex; SBP, systolic blood pressure; SD, standard deviation; sICAM-1, soluble intercellular adhesion molecule-1; sTNF-R1, soluble tumor necrosis factor receptor 1.
Data were ln-transformed before analysis.
P values that remained significant after multiple testing correction of 24 study variables.