Multimarker approach to evaluate the incidence of the metabolic syndrome and longitudinal changes in metabolic risk factors - The framingham offspring study

被引:155
作者
Ingelsson, Erik
Pencina, Michael J.
Tofler, Geoffrey H.
Benjamin, Emelia J.
Lanier, Katherine J.
Jacques, Paul F.
Fox, Caroline S.
Meigs, James B.
Levy, Daniel
Larson, Martin G.
Selhub, Jacob
D'Agostino, Ralph B., Sr.
Wang, Thomas J.
Vasan, Ramachandran S.
机构
[1] Boston Univ, Sch Med, Framingham Heart Study, Framingham, MA 01702 USA
[2] Boston Univ, Sch Med, Dept Math, Boston, MA 02118 USA
[3] Boston Univ, Sch Med, Cardiol Div & Prevent Med, Boston, MA 02118 USA
[4] Royal N Shore Hosp, Sydney, NSW, Australia
[5] Tufts Univ, Jean Mayer US Dept Agr Human Nutr Res Ctr Aging, Boston, MA 02111 USA
[6] Brigham & Womens Hosp, Div Endocrinol, Boston, MA 02115 USA
[7] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA
[8] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA
[9] NHLBI, Bethesda, MD 20892 USA
关键词
aldosterone; epidemiology; metabolic syndrome X; plasminogen activator inhibitor 1; risk factors;
D O I
10.1161/CIRCULATIONAHA.107.708537
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-The metabolic syndrome (MetS) is associated with increased cardiovascular risk. We evaluated the relative contributions of circulating biomarkers representing distinct biological pathways to the incidence of MetS and to longitudinal changes of its constituent risk factors. Methods and Results-We measured 8 circulating biomarkers reflecting inflammation (C-reactive protein), hemostasis (plasminogen activator inhibitor-1, fibrinogen), neurohormonal activity (aldosterone, renin, B-type natriuretic peptide, N-terminal proatrial natriuretic peptide), and endothelial dysfunction (homocysteine) in 2292 Framingham Offspring Study participants (mean age, 57 years; 56% women). We related the biomarker panel to incidence of MetS on follow-up initially and then related biomarkers associated with incident MetS to longitudinal change in its components. On follow-up ( mean, 2.9 years), 282 participants (of 1473 participants without prevalent MetS at baseline) developed MetS. After adjustment for clinical risk factors, the biomarker panel was associated with incident MetS (P=0.008). On backward elimination, plasminogen activator inhibitor-1 and aldosterone remained associated with incident MetS (multivariable-adjusted odds ratio per 1-SD increment log marker, 1.31 [P=0.004] and 1.21 [P=0.015], respectively). In multivariable analyses evaluating longitudinal change in MetS components (analyzed as continuous variables), plasminogen activator inhibitor-1 was significantly and positively associated with changes in fasting glucose, systolic blood pressure, and triglycerides ( all P < 0.05). Serum aldosterone was associated positively with change in systolic blood pressure (P=0.023) and inversely with change in high-density lipoprotein cholesterol (P=0.001). Conclusions-Higher circulating plasminogen activator inhibitor-1 and aldosterone levels are associated with the development of MetS and with longitudinal change of its components, suggesting that these biomarkers and related pathways play a key role in mediating metabolic risk.
引用
收藏
页码:984 / 992
页数:9
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