Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men

Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
Atherosclerosis (Impact Factor: 3.99). 04/2008; 197(1):392-9. DOI: 10.1016/j.atherosclerosis.2007.06.022
Source: PubMed


This study examined whether inflammation adds to the prediction of coronary heart disease (CHD) beyond metabolic syndrome (MetS), and whether these associations differ between sexes.
Among 30,111 women from the Nurses' Health Study and 16,695 men from the Health Professionals Follow-up Study without prior cardiovascular disease, 249 women and 266 men developed non-fatal myocardial infarction or fatal CHD during 8 and 6 years of follow-up, respectively. Controls were selected 2:1 within each cohort matched on age, smoking, and date of blood draw. Subjects with MetS had a significantly increased relative risk (RR) of CHD compared to individuals without MetS, and this RR was significantly higher in women (3.01; 95%-CI 1.98-4.57) than in men (1.62; 95%-CI 1.13-2.33; p interaction=0.03). Adjustment for most inflammatory markers did not substantially attenuate the risk estimates, although the association was no longer significant in men after adjustment for CRP. Vice versa, associations of inflammatory markers with CHD risk among women were no longer significant after further adjustment for MetS. Among men, CRP and sICAM remained significant predictors of CHD independent of MetS.
MetS is a stronger predictor of CHD in women than in men. Most inflammatory markers did not add appreciable information beyond MetS to predict CHD; only CRP and sICAM remained independently predictive of CHD among men. The basis for these sex-based differences warrants further study.

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    • "Finally, it can be considered that oxidative stress is one of the key factors explaining some of the pathophysiological mechanisms associated with inflammatory conditions such as CVD and periodontitis [39] [40], as lipid peroxidation is one of its most well known effects. In fact, increased lipid peroxidation has been observed in periodontitis [8], and it is accepted that lipid peroxidation indirectly reflects intracellular ROS generation. It is interesting to note that superoxide plays a major role in the release of cytokines (for example, TNF-α, IL-1β, and IL-6) [41], which are involved in the pathogenesis of periodontal disease and CVD [7] and this is also induced by P. gingivalis LPS treatment. "

    • "Some evidences are available concerning the association between the appearance of MetS and chronic inflammatory response, characterized by the abnormal cytokine production and the activations of inflammatory signaling pathways.[67] Furthermore, some inflammatory biomarkers, such as C-reactive protein (CRP) and interleukin-6 are in associated with the MetS and its components in different settings.[678910111213] Moreover, there is a proven association between the increased white blood cell (WBC) count as a biological marker of systemic and the components of the MetS.[1415] "
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    ABSTRACT: C-reactive protein (CRP) and white blood cell (WBC) are proinflammatory markers. They are major pathophysiological for the development of metabolic syndrome (MetS). This study aimed to address the independent associations between MetS and WBC counts and serum CRP levels and evaluation of their magnitude in relation to the MetS, based on the sex in the Iranian adults. In this cross-sectional study, subjects who met the MetS criteria, based on the Adult Treatment Panel III were selected from the Isfahan Healthy Heart Program database. A questionnaire containing the demographic data, weight, height, waist, and hip circumference of the respondents was completed for each person. Blood pressure was measured and the anthropometric measurements were done, and fasting blood samples were taken for 2 h postload plasma glucose (2 hpp). Serum [total, high-density lipoprotein (HDL), and low-density lipoprotein] levels of cholesterol, triglyceride, and CRP as well as WBC counts were determined. The univariate analyses were carried out to assess the relation between the CRP levels, WBC counts with the MetS in both sexes the. In men with the abdominal obesity, the higher levels of WBC count, high serum triglyceride and blood glucose levels, a low serum HDL level, and raised systolic and diastolic blood pressure were observed. However, the higher serum CRP levels were only observed in those with the low serum HDL-cholesterol levels. The mean values of the WBC counts were statistically different between the men with and without MetS, but the mean values of the CRP levels were similar between the two groups. In women, the mean values of WBC count and CRP levels were statistically different in the subjects with and without a MetS components (except for the low serum HDL levels and high diastolic blood pressure for the WBC measures and abdominal obesity for the CRP measures) and for those with and without MetS. The age and smoking adjusted changes in the CRP levels and WBC counts correlated with the number of Mets components in the women. The findings of this study suggest substantial implications for the prevention and management of the MetS and atherosclerotic diseases, as these involve the suppression of inflammatory conditions rather than the incitement of anti-inflammatory conditions.
    Journal of research in medical sciences 06/2013; 18(6):467-72. · 0.65 Impact Factor
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    • "The association between metabolic syndrome and some of the inflammatory biomarkers has been examined in the past [2,9,10,12,16]. The current literature provides evidence of elevated levels of CRP, tumor necrosis factor alpha, interleukin 6 in individuals with central fat when compared to those with normal fat distribution [25,26]. "
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    ABSTRACT: Background Prior studies reported conflicting findings on the association between metabolic syndrome and inflammatory biomarkers. We tested the cross-sectional associations between metabolic syndrome and nine inflammatory markers. Methods We measured C-reactive protein, CD40 ligand, interleukin-6, intercellular adhesion molecule-1, monocyte chemoattractant protein-1, osteoprotegerin, P-selectin, tumor necrosis factor-alpha, and tumor necrosis factor receptor-2 in 2570 Framingham Offspring Study participants free of diabetes and cardiovascular disease at examination 7. Metabolic syndrome was defined by National Cholesterol Education Program criteria. We performed multivariable linear regressions for each biomarker with metabolic syndrome as the exposure adjusting for age, sex, smoking, aspirin use, and hormone replacement. We subsequently added to the models components of the metabolic syndrome as continuous traits plus lipid lowering and hypertension treatments. We considered P < 0.05 as statistically significant. Results Metabolic syndrome was present in 984 (38%) participants and was statistically significantly associated with each biomarker (all P < 0.02) except osteoprotegerin. After adjusting for its component variables, the metabolic syndrome was associated only with P-selectin (1.06 fold higher in metabolic syndrome, 95% CI 1.02, 1.10, p = 0.005). Conclusions Metabolic syndrome was associated with multiple inflammatory biomarkers. However, adjusting for each of its components eliminated the association with most inflammatory markers, except P-selectin. Our results suggest that the relation between metabolic syndrome and inflammation is largely accounted for by its components.
    Diabetology and Metabolic Syndrome 06/2012; 4(1):28. DOI:10.1186/1758-5996-4-28 · 2.17 Impact Factor
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