Association of inflammatory and oxidative stress markers with metabolic syndrome in asian indians in India
Veena S Rao, Radhika K Nagaraj, Sridhara Hebbagodi, Natesha B Kadarinarasimhiah, Vijay V Kakkar, Veena S Rao, Radhika K Nagaraj, Sridhara Hebbagodi, Natesha B Kadarinarasimhiah, Vijay V Kakkar
Abstract
Metabolic syndrome (MetS) is a primary risk factor for cardiovascular disease and is associated with a proinflammatory state. Here, we assessed the contribution of inflammatory and oxidative stress markers towards prediction of MetS. A total of 2316 individuals were recruited in Phase I of the Indian Atherosclerosis Research Study (IARS). Modified ATPIII guidelines were used for classification of subjects with MetS. Among the inflammatory and oxidative stress markers studied, levels of hsCRP (P < .0001), Neopterin (P = .036), and oxLDL (P < .0001) were significantly higher among subjects with MetS. Among the markers we tested, oxLDL stood out as a robust predictor of MetS in the IARS population (OR 4.956 95% CI 2.504-9.810; P < .0001) followed by hsCRP (OR 1.324 95% CI 1.070-1.638; P = .010). In conclusion, oxLDL is a candidate predictor for MetS in the Asian Indian population.
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3018645/bin/CRP2011-295976.001.jpg)
![Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3018645/bin/CRP2011-295976.002.jpg)
References
- Reaven GM. Banting Lecture 1988. Role of insulin resistance in human disease. 1988. Nutrition. 1997;13(1):65–66.
- Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications—part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetic Medicine. 1998;15(7):539–553.
- Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) Circulation. 2002;106(25):3143–3421.
- Alberti KG, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. Lancet. 2005;366(9491):1059–1062.
- Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365(9468):1415–1428.
- Festa A, D’Agostino R, Jr., Howard G, Mykkänen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the insulin resistance atherosclerosis study (IRAS) Circulation. 2000;102(1):42–47.
- Ridker PM, Wilson PWF, Grundy SM. Should C-reactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk? Circulation. 2004;109(23):2818–2825.
- Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism. 1987;36(1):54–59.
- Pittas AG, Joseph NA, Greenberg AS. Adipocytokines and insulin resistance. Journal of Clinical Endocrinology and Metabolism. 2004;89(2):447–452.
- Rutter MK, Meigs JB, Sullivan LM, D’Agostino RB, Wilson PWF. C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham offspring study. Circulation. 2004;110(4):380–385.
- Matsuzawa Y, Funahashi T, Kihara S, Shimomura I. Adiponectin and metabolic syndrome. Arteriosclerosis, Thrombosis, and Vascular Biology. 2004 ;24:29–33.
- Masella R, Varì R, D'Archivio M, et al. Oxidised LDL modulate adipogenesis in 3T3-L1 preadipocytes by affecting the balance between cell proliferation and differentiation. FEBS Letters. 2006;580(10):2421–2429.
- Maddux BA, See W, Lawrence JC, Jr., Goldfine AL, Goldfine ID, Evans JL. Protection against oxidative stress-induced insulin resistance in rat l6 muscle cells by micromolar concentrations of α-lipoic acid. Diabetes. 2001;50(2):404–410.
- Holvoet P, Lee DH, Steffes M, Gross M, Jacobs DR. Association between circulating oxidized low-density lipoprotein and incidence of the metabolic syndrome. Journal of the American Medical Association. 2008;299(19):2287–2293.
- Van Guilder GP, Hoetzer GL, Greiner JJ, Stauffer BL, DeSouza CA. Influence of metabolic syndrome on biomarkers of oxidative stress and inflammation in obese adults. Obesity. 2006;14(12):2127–2131.
- Misra A, Vikram NK. Insulin resistance syndrome (metabolic syndrome) and Asian Indians. Current Science. 2002;83(12):1483–1496.
- Toshima SI, Hasegawa A, Kurabayashi M, et al. Circulating oxidized low density lipoprotein levels: a biochemical risk marker for coronary heart disease. Arteriosclerosis, Thrombosis, and Vascular Biology. 2000;20(10):2243–2247.
- Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105(9):1135–1143.
- Murray JL, Lopez AD. The Global Burden of Disease: a Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Boston, Mass, USA: The Harvard School of Public Health; 1996.
- Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. New England Journal of Medicine. 2002;347(20):1557–1565.
- Hansel B, Giral P, Nobecourt E, et al. Metabolic syndrome is associated with elevated oxidative stress and dysfunctional dense high-density lipoprotein particles displaying impaired antioxidative activity. Journal of Clinical Endocrinology and Metabolism. 2004;89(10):4963–4971.
- Jacobs M, Van Greevenbroek MMJ, Van Der Kallen CJH, et al. 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. European Journal of Clinical Investigation. 2009;39(6):437–444.
- Després J-P. Inflammation and cardiovascular disease: is abdominal obesity the missing link? International Journal of Obesity. 2003;27(supplement 3):S22–S24.
- Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. Journal of the American Medical Association. 2002;288(21):2709–2716.
- Holvoet P. Oxidized LDL and coronary heart disease. Acta Cardiologica. 2004;59(5):479–484.
- Lamarche B. Abdominal obesity and its metabolic complications: implications for the risk of ischaemic heart disease. Coronary Artery Disease. 1998;9(8):473–481.
- Enas EA, Senthilkumar A. Coronary artery disease in Asian Indians: an update and review. International Journal of Cardiology. 2001;1:p. 2.
- Mission statement. American Association of Physicians of Indian Origin Coronary Artery Disease Committee, 2002,
- Trevisan M, Liu J, Bahsas FB, Menotti A. Syndrome X and mortality: a population-based study. American Journal of Epidemiology. 1998;148(10):958–966.
- Holvoet P, Kritchevsky SB, Tracy RP, et al. The metabolic syndrome, circulating oxidized LDL, and risk of myocardial infarction in well-functioning elderly people in the health, aging, and body composition cohort. Diabetes. 2004;53(4):1068–1073.
- Sigurdardottir V, Fagerberg B, Hulthe J. Circulating oxidized low-density lipoprotein (LDL) is associated with risk factors of the metabolic syndrome and LDL size in clinically healthy 58-year-old men (AIR study) Journal of Internal Medicine. 2002;252(5):440–447.
- Yamagishi SI, Matsuoka H, Kitano S, et al. Elevated circulating oxidized LDL levels in Japanese subjects with the metabolic syndrome. International Journal of Cardiology. 2007;118(2):270–272.
Source: PubMed