Low plasma retinol predicts coronary events in healthy middle-aged men: The PRIME Study K. Fred Gey, Pierre Ducimetière, Alun Evans, Philippe Amouyel,

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Low plasma retinol predicts coronary events in healthy middle-aged men: The PRIME Study K. Fred Gey, Pierre Ducimetière, Alun Evans, Philippe Amouyel, Dominique Arveiler, Jean Ferrières, Gerald Luc, Frank Kee, Annie Bingham, John Yarnell, François Cambien Atherosclerosis Volume 208, Issue 1, Pages 270-274 (January 2010) DOI: 10.1016/j.atherosclerosis.2009.07.018 Copyright © 2009 Terms and Conditions

Fig. 1 Low plasma retinol (<601μg/l, quintile 1) predicts significantly increased relative risk (RR) of CHD: the PRIME Study. Ordinates, and figures above all columns indicate centre-adjusted RRs in comparison with the reference status (quintile 5). Abcissa: quintiles in controls of plasma retinol in μg/l. Front row: unadjusted retinol; Middle row: multi-adjusted retinol (for systolic blood pressure, smoking, alcohol intake, diabetes, HDL- and total cholesterol, triglycerides, Body mass index, fibrinogen, hs-CRP, and log Interleukin-6). Back row: lipid-standardised retinol (to 220mg/dl cholesterol and 110mg/dl triglycerides). Statistical significance of columns of quintile 1 (<600μg/l) (P<0.004, 0.02, 0.004) and of the linear trend of increasing RR from quintile 5 to 1 (P=0.0001). Atherosclerosis 2010 208, 270-274DOI: (10.1016/j.atherosclerosis.2009.07.018) Copyright © 2009 Terms and Conditions

Fig. 2 Centre-adjusted RRs of retinol and of other risk factors for CHD behave additively but independently: the PRIME Study. Ordinates and figures within columns: RRs after multivariate adjustment for covariates as for column (c) of Fig. 1. Front row: low plasma retinol (<601μg/l) associated with high RRs; Back row: higher retinol levels (>601μg/l) associated with moderately low to no substantial RR. Abscissae: other risk factors in combination with plasma retinol: Panel A: tertiles of plasma Interleukin-6 (IL-6) in μg/ml with increasing risk gradient; Panel B: tertiles of HDL-cholesterol/total cholesterol ratio with decreasing risk gradient. Grey columns: observed RRs. Black columns: RRs computed under the hypothesis of no interaction between paired risk factors. The lack of statistically significant differences between grey columns (observed RRs) and the adjoining black columns (computed RRs) excludes significant multiplicative interaction between the paired variables (Chi2 (2DF)=1.26, NS for IL-6, and Chi2 (2DF)=0.38, NS for HDL-cholesterol/total cholesterol ratio). Atherosclerosis 2010 208, 270-274DOI: (10.1016/j.atherosclerosis.2009.07.018) Copyright © 2009 Terms and Conditions