Jose F Varona1, Roberto Ortiz-Regalón2, Isabel Sánchez-Vera3, Beatriz López-Melgar4, Cira García-Durango3, Jose María Castellano Vázquez4, Jorge Solís5, Leticia Fernández-Friera4, Fernando Vidal-Vanaclocha6. 1. Departamento de Medicina Interna, Hospital Universitario HM Montepríncipe, Grupo HM Hospitales, Madrid, Spain; Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain. Electronic address: jfvarona@hmhospitales.com. 2. Departamento de Medicina Interna, Hospital Universitario HM Montepríncipe, Grupo HM Hospitales, Madrid, Spain. 3. Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain. 4. Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario HM Montepríncipe, Grupo HM Hospitales, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. 5. Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario HM Montepríncipe, Grupo HM Hospitales, Madrid, Spain. 6. George Washington Univ School of Medicine and Health Sciences, Washington DC, USA.
Abstract
BACKGROUND: Metabolic syndrome (MetS) is a heterogeneous clinical entity associated with insulin resistance, low-grade proinflammatory balance and impaired endothelial function, accelerating atherosclerosis. Atherosclerotic lesions worsen with age, smoking and co-morbidities, making it difficult to accurately diagnose the cardiovascular disease (CVD) risk. AIM: We investigate the association between subclinical atherosclerosis and the presence of blood parameters related to adipocyte and vascular endothelial cell dysfunction, in non-smokers with MetS, under 60 and without previous CVD events. METHODS: Seventy-eight asymptomatic individuals (average 46.5 years, 69% male; 59 MetS and 19 controls) were studied prospectively. Subclinical CVD was defined by the presence of carotid plaque and/or carotid intima-media thickness (CIMT) > 0.9 in 2/3D ultrasound-studies, left ventricular hypertrophy (LVH) or high coronary calcium score (CCS). Multiplex immunoassay by Luminex xMAP was performed to measure plasma levels of adipokines and endothelial cell-derived molecules. RESULTS: Compared with controls, MetS patients had higher prevalence of carotid plaque (25 vs. 0%, p = 0.01), CIMT>0.9 (73 vs. 26%, p = 0.001) and higher CCS (69 vs. 5, p = 0.01), which were associated with a remarkable decrease in plasma Omentin levels and increase in sICAM-1, sVCAM-1 and PAI-1 (p <0.05). There was a statistically significant association between CIMT and sICAM-1 (OR: 14.57, 95% CI: 2.56-82.73, p <0.001), sVCAM-1 (OR:7.33, 95% CI: 1,58-33.96, p = 0.007) and PAI-1 (OR:7.80, 95% CI: 1.04-22.10, p = 0.036) in patients with carotid plaque and/or CIMT>0.9. Positive correlation between plaque volume and sICAM-1 levels was also detected (r = 0.40, p = 0.045). CONCLUSIONS: We demonstrated that the increase of sICAM-1, sVCAM-1 and PAI-1, together with decrease of omentin-1 led to a proinflammatory imbalance pointing to the presence of subclinical atherosclerosis, and improving CVD risk stratification in non-smoking patients at early stage MetS beyond traditional scores.
BACKGROUND:Metabolic syndrome (MetS) is a heterogeneous clinical entity associated with insulin resistance, low-grade proinflammatory balance and impaired endothelial function, accelerating atherosclerosis. Atherosclerotic lesions worsen with age, smoking and co-morbidities, making it difficult to accurately diagnose the cardiovascular disease (CVD) risk. AIM: We investigate the association between subclinical atherosclerosis and the presence of blood parameters related to adipocyte and vascular endothelial cell dysfunction, in non-smokers with MetS, under 60 and without previous CVD events. METHODS: Seventy-eight asymptomatic individuals (average 46.5 years, 69% male; 59 MetS and 19 controls) were studied prospectively. Subclinical CVD was defined by the presence of carotid plaque and/or carotid intima-media thickness (CIMT) > 0.9 in 2/3D ultrasound-studies, left ventricular hypertrophy (LVH) or high coronary calcium score (CCS). Multiplex immunoassay by Luminex xMAP was performed to measure plasma levels of adipokines and endothelial cell-derived molecules. RESULTS: Compared with controls, MetS patients had higher prevalence of carotid plaque (25 vs. 0%, p = 0.01), CIMT>0.9 (73 vs. 26%, p = 0.001) and higher CCS (69 vs. 5, p = 0.01), which were associated with a remarkable decrease in plasma Omentin levels and increase in sICAM-1, sVCAM-1 and PAI-1 (p <0.05). There was a statistically significant association between CIMT and sICAM-1 (OR: 14.57, 95% CI: 2.56-82.73, p <0.001), sVCAM-1 (OR:7.33, 95% CI: 1,58-33.96, p = 0.007) and PAI-1 (OR:7.80, 95% CI: 1.04-22.10, p = 0.036) in patients with carotid plaque and/or CIMT>0.9. Positive correlation between plaque volume and sICAM-1 levels was also detected (r = 0.40, p = 0.045). CONCLUSIONS: We demonstrated that the increase of sICAM-1, sVCAM-1 and PAI-1, together with decrease of omentin-1 led to a proinflammatory imbalance pointing to the presence of subclinical atherosclerosis, and improving CVD risk stratification in non-smoking patients at early stage MetS beyond traditional scores.
Authors: Raphaëlle Bourgeois; Arnaud Girard; Nicolas Perrot; Jakie Guertin; Patricia L Mitchell; Christian Couture; Clarisse Gotti; Sylvie Bourassa; Paolo Poggio; Elvira Mass; Romain Capoulade; Corey A Scipione; Audrey-Anne Després; Patrick Couture; Arnaud Droit; Philippe Pibarot; Michael B Boffa; Sébastien Thériault; Marlys L Koschinsky; Patrick Mathieu; Benoit J Arsenault Journal: CJC Open Date: 2020-12-03
Authors: Anna S Huerta-Delgado; Daniel N Roffe-Vazquez; Adrian M Gonzalez-Gil; José R Villarreal-Calderón; Oscar Tamez-Rivera; Nora A Rodriguez-Gutierrez; Elena C Castillo; Christian Silva-Platas; Gerardo Garcia-Rivas; Leticia Elizondo-Montemayor Journal: J Diabetes Res Date: 2020-09-04 Impact factor: 4.011