Plasma neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease: Findings from the PREVEND prospective cohort study

Setor K. Kunutsor; José L. Flores-Guerrero; Lyanne M. Kieneker; Tom Nilsen; Clara Hidden; Erling Sundrehagen; Samuel Seidu; Robin P.F. Dullaart; Stephan J.L. Bakker

doi:10.1016/j.cca.2018.07.034

Plasma neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease: Findings from the PREVEND prospective cohort study

Setor K. Kunutsor^*, José L. Flores-Guerrero, Lyanne M. Kieneker, Tom Nilsen, Clara Hidden, Erling Sundrehagen, Samuel Seidu, Robin P.F. Dullaart, Stephan J.L. Bakker

^*Corresponding author for this work

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Abstract

Background: Neutrophil gelatinase-associated lipocalin (NGAL), a novel biomarker of acute kidney injury, might play a role in the development of atherosclerotic cardiovascular disease (CVD). We aimed to assess the association of circulating NGAL with CVD risk.

Materials and methods: Plasma NGAL concentrations were measured at baseline in 5275 participants in the PREVEND prospective study. Hazard ratios (95% confidence intervals [CI]) for CVD were estimated.

Results: After a median follow-up of 8.3 years, 338 participants developed first CVD events. Plasma NGAL was weakly to moderately correlated with several CVD risk markers. There was a non-linear relationship between NGAL and CVD risk. In analyses adjusted for established risk factors, the hazard ratio (95% CI) for CVD in a comparison of the top quartile versus bottom quartiles 1–2 of NGAL values was 1.35 (1.05–1.75; P = 0.022), which was abrogated after additional adjustment for other potential confounders (mainly attributed to high sensitivity C-reactive protein) 1.20 (0.92–1.57; P = 0.176). The association was considerably attenuated following further adjustment for renal function 1.05 (0.79–1.40; P = 0.745). The association between NGAL and CVD risk did not vary importantly in relevant clinical subgroups.

Conclusion: Evidence suggests a non-linear association between NGAL and CVD risk, which is dependent on inflammation and renal function.

Original language	English
Pages (from-to)	66-75
Number of pages	10
Journal	Clinica Chimica Acta
Volume	486
Early online date	20 Jul 2018
DOIs	https://doi.org/10.1016/j.cca.2018.07.034
Publication status	Published - 1 Nov 2018

Keywords

Cardiovascular disease
Cohort study
Neutrophil gelatinase-associated lipocalin
Risk factor

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Kunutsor, S. K., Flores-Guerrero, J. L., Kieneker, L. M., Nilsen, T., Hidden, C., Sundrehagen, E., Seidu, S., Dullaart, R. P. F., & Bakker, S. J. L. (2018). Plasma neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease: Findings from the PREVEND prospective cohort study. Clinica Chimica Acta, 486, 66-75. https://doi.org/10.1016/j.cca.2018.07.034

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title = "Plasma neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease: Findings from the PREVEND prospective cohort study",

abstract = "Background: Neutrophil gelatinase-associated lipocalin (NGAL), a novel biomarker of acute kidney injury, might play a role in the development of atherosclerotic cardiovascular disease (CVD). We aimed to assess the association of circulating NGAL with CVD risk. Materials and methods: Plasma NGAL concentrations were measured at baseline in 5275 participants in the PREVEND prospective study. Hazard ratios (95% confidence intervals [CI]) for CVD were estimated. Results: After a median follow-up of 8.3 years, 338 participants developed first CVD events. Plasma NGAL was weakly to moderately correlated with several CVD risk markers. There was a non-linear relationship between NGAL and CVD risk. In analyses adjusted for established risk factors, the hazard ratio (95% CI) for CVD in a comparison of the top quartile versus bottom quartiles 1–2 of NGAL values was 1.35 (1.05–1.75; P = 0.022), which was abrogated after additional adjustment for other potential confounders (mainly attributed to high sensitivity C-reactive protein) 1.20 (0.92–1.57; P = 0.176). The association was considerably attenuated following further adjustment for renal function 1.05 (0.79–1.40; P = 0.745). The association between NGAL and CVD risk did not vary importantly in relevant clinical subgroups. Conclusion: Evidence suggests a non-linear association between NGAL and CVD risk, which is dependent on inflammation and renal function.",

keywords = "Cardiovascular disease, Cohort study, Neutrophil gelatinase-associated lipocalin, Risk factor",

author = "Kunutsor, {Setor K.} and Flores-Guerrero, {Jos{\'e} L.} and Kieneker, {Lyanne M.} and Tom Nilsen and Clara Hidden and Erling Sundrehagen and Samuel Seidu and Dullaart, {Robin P.F.} and Bakker, {Stephan J.L.}",

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doi = "10.1016/j.cca.2018.07.034",

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T1 - Plasma neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease

T2 - Findings from the PREVEND prospective cohort study

AU - Kunutsor, Setor K.

AU - Flores-Guerrero, José L.

AU - Kieneker, Lyanne M.

AU - Nilsen, Tom

AU - Hidden, Clara

AU - Sundrehagen, Erling

AU - Seidu, Samuel

AU - Dullaart, Robin P.F.

AU - Bakker, Stephan J.L.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Neutrophil gelatinase-associated lipocalin (NGAL), a novel biomarker of acute kidney injury, might play a role in the development of atherosclerotic cardiovascular disease (CVD). We aimed to assess the association of circulating NGAL with CVD risk. Materials and methods: Plasma NGAL concentrations were measured at baseline in 5275 participants in the PREVEND prospective study. Hazard ratios (95% confidence intervals [CI]) for CVD were estimated. Results: After a median follow-up of 8.3 years, 338 participants developed first CVD events. Plasma NGAL was weakly to moderately correlated with several CVD risk markers. There was a non-linear relationship between NGAL and CVD risk. In analyses adjusted for established risk factors, the hazard ratio (95% CI) for CVD in a comparison of the top quartile versus bottom quartiles 1–2 of NGAL values was 1.35 (1.05–1.75; P = 0.022), which was abrogated after additional adjustment for other potential confounders (mainly attributed to high sensitivity C-reactive protein) 1.20 (0.92–1.57; P = 0.176). The association was considerably attenuated following further adjustment for renal function 1.05 (0.79–1.40; P = 0.745). The association between NGAL and CVD risk did not vary importantly in relevant clinical subgroups. Conclusion: Evidence suggests a non-linear association between NGAL and CVD risk, which is dependent on inflammation and renal function.

AB - Background: Neutrophil gelatinase-associated lipocalin (NGAL), a novel biomarker of acute kidney injury, might play a role in the development of atherosclerotic cardiovascular disease (CVD). We aimed to assess the association of circulating NGAL with CVD risk. Materials and methods: Plasma NGAL concentrations were measured at baseline in 5275 participants in the PREVEND prospective study. Hazard ratios (95% confidence intervals [CI]) for CVD were estimated. Results: After a median follow-up of 8.3 years, 338 participants developed first CVD events. Plasma NGAL was weakly to moderately correlated with several CVD risk markers. There was a non-linear relationship between NGAL and CVD risk. In analyses adjusted for established risk factors, the hazard ratio (95% CI) for CVD in a comparison of the top quartile versus bottom quartiles 1–2 of NGAL values was 1.35 (1.05–1.75; P = 0.022), which was abrogated after additional adjustment for other potential confounders (mainly attributed to high sensitivity C-reactive protein) 1.20 (0.92–1.57; P = 0.176). The association was considerably attenuated following further adjustment for renal function 1.05 (0.79–1.40; P = 0.745). The association between NGAL and CVD risk did not vary importantly in relevant clinical subgroups. Conclusion: Evidence suggests a non-linear association between NGAL and CVD risk, which is dependent on inflammation and renal function.

KW - Cardiovascular disease

KW - Cohort study

KW - Neutrophil gelatinase-associated lipocalin

KW - Risk factor

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DO - 10.1016/j.cca.2018.07.034

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SN - 0009-8981

VL - 486

SP - 66

EP - 75

JO - Clinica Chimica Acta

JF - Clinica Chimica Acta

ER -

Plasma neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease: Findings from the PREVEND prospective cohort study

Abstract

Keywords

UN SDGs

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