Low-grade inflammation can partly explain the association between the metabolic syndrome and either coronary artery disease or severity of peripheral arterial disease: the CODAM study

被引:84
作者
Jacobs, M. [1 ,2 ]
van Greevenbroek, M. M. J. [2 ]
van der Kallen, C. J. H. [2 ]
Ferreira, I. [2 ,5 ]
Blaak, E. E. [6 ,7 ]
Feskens, E. J. M. [3 ]
Jansen, E. H. J. M. [4 ]
Schalkwijk, C. G. [2 ]
Stehouwer, C. D. A. [2 ]
机构
[1] Maastricht Univ, Lab Metab & Vasc Med, Cardiovasc Res Inst Maastricht CARIM, NL-6200 MD Maastricht, Netherlands
[2] Univ Hosp Maastricht, Dept Internal Med, Maastricht, Netherlands
[3] Wageningen Univ, Div Human Nutr, Wageningen, Netherlands
[4] Natl Inst Publ Hlth & Environm, Lab Hlth Protect Res, NL-3720 BA Bilthoven, Netherlands
[5] Univ Hosp Maastricht, Dept Clin Epidemiol & Med Technol Assessment KEMT, Maastricht, Netherlands
[6] Maastricht Univ, Dept Human Biol, NL-6200 MD Maastricht, Netherlands
[7] Maastricht Univ, Nutr & Toxicol Res Inst Maastricht NUTRIM, NL-6200 MD Maastricht, Netherlands
关键词
Ankle-arm index; coronary artery disease; inflammation; metabolic syndrome; peripheral arterial disease; C-REACTIVE PROTEIN; INTERCELLULAR-ADHESION MOLECULE-1; CARDIOVASCULAR RISK-FACTORS; INSULIN-RESISTANCE; HEART-DISEASE; DIABETES-MELLITUS; OBESE-PATIENTS; MARKERS; INTERLEUKIN-6; ATHEROSCLEROSIS;
D O I
10.1111/j.1365-2362.2009.02129.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Low-grade inflammation has been hypothesized to underlie the coronary artery disease (CAD) risk associated with the metabolic syndrome, but the evidence is not conclusive. For peripheral arterial disease (PAD; as measured by the ankle-arm index), this association has not been studied before. The aim was to study whether the association between the metabolic syndrome and CAD or the severity of PAD can be explained by low-grade inflammation. The Cohort study Diabetes and Atherosclerosis Maastricht population includes 574 subjects, with an increased risk of type 2 diabetes, of whom 560 were included in the analyses (343 males; age: 59.5 +/- 7.0 years). The inflammation markers that were measured were C-reactive protein, interleukin 6, soluble vascular cell adhesion molecule-1, soluble intercellular adhesion molecule-1 and serum amyloid A. All analyses were adjusted for age, sex and smoking. Logistic regression showed that the metabolic syndrome was significantly associated with CAD [odds ratio (OR) = 1.86, 95% CI: 1.21; 2.84, P = 0.004]. Further adjustment for inflammatory status, as captured in a combination of the inflammation markers (using an averaged Z-score), resulted in significant associations of both the metabolic syndrome and inflammatory status with CAD [ORmetabolic syndrome (95% CI) = 1.58 (1.01; 2.46), P = 0.044; ORinflammation (95% CI) = 1.59 (1.14; 2.21), P = 0.007]. Linear regression analysis showed similar results for the ankle-arm index. The association between the metabolic syndrome, on the one hand, and prevalence of CAD or the severity of PAD, on the other, can be partly but not completely, 26% and 29% respectively, explained by low-grade inflammation.
引用
收藏
页码:437 / 444
页数:8
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