The association between the metabolic syndrome and peripheral, but not coronary, artery disease is partly mediated by endothelial dysfunction: The CODAM study

Jacobs, Marjon, van Greevenbroek, Marleen M. J., van der Kallen, Carla J. H., Ferreira, Isabel, Blaak, Ellen E., Feskens, Edith J. M., Jansen, Eugene H. J. M., Schalkwijk, Casper G. and Stehouwer, Coen D. A. (2011) The association between the metabolic syndrome and peripheral, but not coronary, artery disease is partly mediated by endothelial dysfunction: The CODAM study. European Journal of Clinical Investigation, 41 2: 167-175. doi:10.1111/j.1365-2362.2010.02392.x


Author Jacobs, Marjon
van Greevenbroek, Marleen M. J.
van der Kallen, Carla J. H.
Ferreira, Isabel
Blaak, Ellen E.
Feskens, Edith J. M.
Jansen, Eugene H. J. M.
Schalkwijk, Casper G.
Stehouwer, Coen D. A.
Title The association between the metabolic syndrome and peripheral, but not coronary, artery disease is partly mediated by endothelial dysfunction: The CODAM study
Journal name European Journal of Clinical Investigation   Check publisher's open access policy
ISSN 0014-2972
1365-2362
Publication date 2011
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1365-2362.2010.02392.x
Open Access Status
Volume 41
Issue 2
Start page 167
End page 175
Total pages 9
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Abstract Eur J Clin Invest 2011; 41 (2): 167-175Background The metabolic syndrome is associated with coronary artery disease (CAD) and with peripheral artery disease (PAD), but the underlying mechanisms explaining these associations have not yet been completely clarified. The aim was to investigate (i) whether endothelial dysfunction can explain the association between the metabolic syndrome and CAD and/or the severity of PAD, as measured by the ankle-arm index (AAIx); and (ii) whether any such mediation is independent of that from low-grade inflammation.Materials and methods We studied 539 subjects (232 men) aged 59.4 ± 6.9 years, with an increased risk of type 2 diabetes and cardiovascular diseases. Endothelial dysfunction and inflammation scores were calculated from three markers of endothelial dysfunction (soluble E-selectin, soluble vascular cell adhesion molecule-1 and von Willebrand factor) and six of inflammation (C-reactive protein, interleukin 6, soluble intercellular adhesion molecule-1, serum amyloid A, ceruloplasmin and haptoglobin). The association between the metabolic syndrome and CAD and/or PAD, and the mediating role of endothelial dysfunction herein was examined with logistic and linear regression analyses, all adjusted for age, sex and smoking.Results Subjects with the metabolic syndrome (n = 289; 54%) had higher prevalence of CAD [OR (95%CI) = 1.75 (1.14; 2.69)] and lower AAIx [β (95% CI) = -0.036 (-0.056; -0.016)]. Endothelial dysfunction explained 6% of the association between the metabolic syndrome and CAD, and 19% of the association with AAIx, whereas low-grade inflammation explained 26% and 28% of these associations, respectively. Together, the two scores explained 24% and 36% of the association between the metabolic syndrome and CAD and AAIx, respectively.Conclusions Endothelial dysfunction explains part of the association between the metabolic syndrome and the severity of PAD, but is not involved in the association between the metabolic syndrome and CAD. This indicates that the pathophysiologies of coronary and peripheral artery disease are essentially distinct. © 2010 The Authors. European Journal of Clinical Investigation
Keyword Ankle-arm index
Coronary artery disease
Endothelial dysfunction
Low grade inflammation
Metabolic syndrome
Peripheral arterial disease
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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Created: Wed, 20 May 2015, 16:39:54 EST by Isabel Ferreira on behalf of School of Public Health