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Serum caeruloplasmin as a coronary risk factor in the elderly: the Rotterdam Study

Published online by Cambridge University Press:  09 March 2007

Kerstin Klipstein-Grobusch
Affiliation:
Department of Epidemiology and Biostatistics, Erasmus University, Rotterdam, The Netherlands Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
Diederick E. Grobbee
Affiliation:
Department of Epidemiology and Biostatistics, Erasmus University, Rotterdam, The Netherlands Julius Center for Patient Oriented Research, Utrecht University Hospital, The Netherlands
J. F. Koster
Affiliation:
Department of Biochemistry, Cardiovascular Research Institute, Erasmus University, Rotterdam, The Netherlands
J. Lindemans
Affiliation:
Central Clinical Chemical Laboratory, Erasmus University, Rotterdam, The Netherlands
Heiner Boeing
Affiliation:
Department of Epidemiology and Biostatistics, Erasmus University, Rotterdam, The Netherlands
Albert Hofman
Affiliation:
Department of Epidemiology and Biostatistics, Erasmus University, Rotterdam, The Netherlands
Jacqueline C. M. Witteman*
Affiliation:
Department of Epidemiology and Biostatistics, Erasmus University, Rotterdam, The Netherlands
*
*Corresponding author: Dr Jacqueline C. M. Witteman, fax +31 10 436 5933, email [email protected]
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Abstract

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Serum Cu and caeruloplasmin levels have been suggested to be independent risk factors for CHD operating through oxidative modification of LDL. However, given its function as an acute-phase protein, the question has been raised whether an elevated caeruloplasmin level is not merely an indicator of inflammation. In the current study, we investigated whether serum caeruloplasmin was associated with subsequent myocardial infarction, taking into account indices of inflammation. The study population consisted of 210 cases of first myocardial infarction and controls, frequency-matched on age (5-year categories) and sex, selected from the population-based cohort of the Rotterdam Study. Serum caeruloplasmin levels were significantly elevated in cases of myocardial infarction compared with controls (510 (sd 110) v. 470 (sd 100) mg/1; P = 0·007). Risk of myocardial infarction for the highest compared with the lowest quartile of caeruloplasmin was 2·46 (95 % CI 1·04, 6·00; Ptrend = 0·043) after adjustment for age, sex, BMI, pack-years smoked, serum cholesterol, systolic blood pressure, and income. The relative risk was most evident in current smokers. Adjustment for C-reactive protein and leucocyte count reduced the excess risk by 33 %. This suggests that a substantial part of the observed association between serum caeruloplasmin and CHD may be attributed to inflammation processes rather than to the pro-oxidant activity of caeruloplasmin.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1999

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