Metabolic syndrome aggravates the increased endothelial activation and low-grade inflammation in subjects with familial low HDL

Background. Inhibition of cytokine-induced expression of adhesion molecules is one of the atheroprotective mechanisms of high-density lipoprotein (HDL). Aim. We investigated whether increased endothelial activation and low-grade inflammation are present in Finnish subjects with familial low HDL, and which factors contribute to the inflammatory parameters. Method. High-sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), and sE-selectin were measured in 91 subjects with low HDL-cholesterol from 41 low-HDL families and in 112 normolipidemic controls with comparable age- and gender distribution. Presence of the features of the metabolic syndrome (MetS) was recorded. Results. sVCAM-1, sICAM-1, sE-selectin, and hsCRP were significantly higher in low-HDL subjects than in the controls (sVCAM-1: 560 +/- 147 ng/mL versus 496 +/- 95 ng/mL, P=0.001; sICAM-1: 247 +/- 60 ng/mL versus 215 +/- 47 ng/mL, P < 0.001; sE-selectin: 52 +/- 20 ng/mL versus 44 +/- 16 ng/mL, P=0.022; and hsCRP: 1.73 +/- 2.05 mg/L versus 0.85 +/- 1.10 mg/L, P < 0.001). Low-HDL subjects had increased body mass index (BMI) and waist, and elevated insulin and triglyceride levels. Adhesion molecules and hsCRP increased according to the number of the features of the MetS. Conclusions. The presence of the MetS in subjects with familial low HDL-cholesterol aggravates the low-grade inflammation and endothelial activation, and ultimately may add to the higher susceptibility for atherosclerotic disease in these individuals.