Factors behind the Increase in Cardiovascular Mortality in Russia: Apolipoprotein AI and B Distribution in the Arkhangelsk Study 2000

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Abstract
Background: Cardiovascular mortality is markedly higher in Russia than in Western Europe and the US. Little is known about indicators of atherosclerotic risk in the Russian population. To our knowledge, this is the first study of apolipoprotein (apo) AI and B in Russia based on the WHO-IFCC standard. Methods: We measured apo AI and B by immunoturbidimetric assay in 3694 men and women from Arkhangelsk, Russia, in 1999–2000. Results: The age-related distribution of apo B was similar to that in other countries, whereas the apo AI profile was different. For men ≥20 years, apo AI was considerably higher than in studies from other countries. Women had also relatively high apo AI concentrations, although the difference was not as pronounced as in men. The apo AI concentration was positively associated with age and lifestyle variables such as alcohol consumption and physical activity, and negatively associated with body mass index and self-reported myocardial infarction. γ-Glutamyltransferase was positively associated with apo AI in both sexes. Conclusions: The apparently favorable apolipoprotein profiles contrast with official death statistics indicating high cardiovascular mortality in Russia. High apo AI might indicate excessive alcohol consumption.