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Rakhmat II, Nugraha GI, Ariyanto EF, Pratiwi YS, Linasari D, Fatimah SN, Ghozali M, Syamsunarno MRAA, Akbar MR, Achmad TH. Strong Association of Metabolic Parameters with ADMA and VCAM-1 in Normo-Weight Subjects with Metabolic Syndrome. Diabetes Metab Syndr Obes 2024; 17:833-839. [PMID: 38406267 PMCID: PMC10888057 DOI: 10.2147/dmso.s448650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/11/2024] [Indexed: 02/27/2024] Open
Abstract
Background Metabolic syndrome (MetS) is a risk factor for cardiovascular disease and is linked to obesity. Subjects with MetS who have normo-weight potentially show higher mortality and morbidity. Purpose This study aims to reveal the critical essential metabolic parameters associated with endothelial dysfunction in MetS subjects with normo-weight compared to obese. Patients and Methods The study was designed using a case-control approach. Ninety-nine MetS subjects (34 Normo-weight and 65 obese) from the urban population were enrolled in this study. The components of MetS are based on NCEP/ATP III criteria. Asymmetric dimethylarginine (ADMA) and vascular cell adhesion molecule 1 (VCAM-1) as markers for endothelial dysfunction were measured in both groups. Results Fasting blood glucose (FBG) levels were higher in the normo-weight group (143.38 ± 79.8 mg/dL) compared to the obese group (120.89 ± 46.5 mg/dL). High-density lipoprotein cholesterol (HDL-c) levels in the normo-weight group were lower (42.82 ± 10.1 mg/dL) compared to obesity (45.74 ± 9.3 mg/dL), while triacylglycerol (TAG) levels were higher in the obese (197.25 ± 110.5 mg/dL) compared to the normo-weight group (167.03 ± 98.4 mg/dL), although the differences were statistically not significant (all p > 0.05). The difference between ADMA and VCAM-1 levels was statistically not significant in both groups. Correlation between MetS components with endothelial dysfunction parameters shows that metabolic parameters correlate strongly. Interestingly, a stronger correlation between FBG and ADMA was observed in normo-weight (r = 0.519) compared to obese groups (r = 0.445). In addition, TAG consistently shows a significant correlation with ADMA and VCAM-1 in normo-weight groups. Conclusion Metabolic parameters, especially FBG and TAG, correlate strongly with endothelial dysfunction parameters in normo-weight subjects with metabolic syndrome.
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Affiliation(s)
- Iis Inayati Rakhmat
- Doctoral Study Program Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biochemistry, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, West Java, Indonesia
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Gaga Irawan Nugraha
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Eko Fuji Ariyanto
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Yuni Susanti Pratiwi
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Desy Linasari
- Department of Community Medicine, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, West Java, Indonesia
| | - Siti Nur Fatimah
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Mohammad Ghozali
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Mas Rizky A A Syamsunarno
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Mohammad Rizki Akbar
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Tri Hanggono Achmad
- Cardiometabolic Working Group Study, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
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CD147 Levels in Blood and Adipose Tissues Correlate with Vascular Dysfunction in Obese Diabetic Adults. J Cardiovasc Dev Dis 2021; 9:jcdd9010007. [PMID: 35050217 PMCID: PMC8781676 DOI: 10.3390/jcdd9010007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 02/07/2023] Open
Abstract
CD147 is a glycoprotein that stimulates the production of matrix metalloproteinases (MMPs), known contributors to cardiovascular risk. The activity of CD147 protein depends on its glycosylation. However, it is unclear whether CD147 protein expression or glycosylation are influenced by the diabetic milieu characterized by hyperglycemia and abundant glycation-end-products (AGEs). We examined the circulating and visceral adipose tissue (VAT) levels of CD147 and their correlation with vascular function in obese, obese diabetic, and non-obese controls (n = 40, each). The circulating levels of CD147 and the glycosylated CD147 protein in VAT were considerably higher in obese, particularly obese diabetic subjects compared to controls. Obese diabetics had the lowest brachial and arteriolar vasoreactivity and the highest carotid pulse-wave velocity (PWV, a measure of arterial stiffness) among the three groups. CD147 correlated positively with body mass index (BMI), total and visceral fat mass, PWV, and plasma levels of glucose, insulin, MMPs, and AGEs and negatively with brachial artery and VAT-arteriolar vasoreactivity and nitric oxide production. Multivariate regression revealed that BMI, body fat mass, insulin, and glucose levels significantly predicted CD147. Our data suggest that higher levels of CD147 in obese subjects, particularly those with diabetes, are linked to vascular dysfunction and several cardiometabolic risk factors.
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Zhang F, Liu L, Zhang C, Ji S, Mei Z, Li T. Association of Metabolic Syndrome and Its Components With Risk of Stroke Recurrence and Mortality: A Meta-analysis. Neurology 2021; 97:e695-e705. [PMID: 34321360 DOI: 10.1212/wnl.0000000000012415] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/19/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Because metabolic syndrome is a significant risk factor for cardio-cerebrovascular diseases and the relationship between metabolic syndrome (including its components) and the prognosis of stroke is controversial, this study was conducted to evaluate whether metabolic syndrome is associated with a high recurrence and mortality of stroke. METHODS This study was registered in the PROSPERO database (CRD42020177118). We searched for relevant observational cohort studies published from inception to April 23, 2020, using PubMed, Embase, and the Cochrane Library. Effect estimates with 95% confidence intervals (CIs) were pooled using the random-effects model. The primary and secondary outcomes were stroke recurrence and all-cause mortality, respectively. Leave-one-out sensitivity analyses and nonparametric trim-and-fill method were used to identify the stability of the results. RESULTS Thirteen cohort studies comprising 59,919 participants >60 years of age were included for analysis. Overall, metabolic syndrome was significantly associated with stroke recurrence (relative risk [RR] 1.46, 95% CI 1.07-1.97, p = 0.02). Among the metabolic syndrome components, low levels of high-density lipoprotein cholesterol (HDL-C) (RR 1.32, 95% CI 1.11-1.57, p = 0.002) and ≥2 metabolic syndrome components (RR 1.68, 95% CI 1.44-1.94, p < 0.001) significantly predicted stroke recurrence, whereas elevated triglycerides, elevated waist circumference, hyperglycemia, and hypertension failed to account for risk factors for stroke recurrence. Moreover, metabolic syndrome, not its components, was significantly associated with all-cause mortality (RR 1.27, 95% CI 1.18-1.36, p < 0.001). The stability of these results was further confirmed by the leave-one-out sensitivity analyses and nonparametric trim-and-fill method. CONCLUSIONS The present study indicates that metabolic syndrome and some of its components (low HDL-C and number of metabolic syndrome components) seem to be risk factors for stroke recurrence. Although metabolic syndrome is also associated with all-cause mortality, the role of its components in predicting all-cause mortality deserves further study.
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Affiliation(s)
- Fangfang Zhang
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Lili Liu
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Chundong Zhang
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Shiliang Ji
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Zubing Mei
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China.
| | - Tian Li
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
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Lee EY, Han K, Kim DH, Park YM, Kwon HS, Yoon KH, Kim MK, Lee SH. Exposure-weighted scoring for metabolic syndrome and the risk of myocardial infarction and stroke: a nationwide population-based study. Cardiovasc Diabetol 2020; 19:153. [PMID: 32993664 PMCID: PMC7525999 DOI: 10.1186/s12933-020-01129-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/18/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) status changes over time, but few studies have investigated the relationship between the extent or duration of exposure to MetS and the risk of cardiovascular disease (CVD). We investigated the cumulative effects of MetS and its components on the risk of myocardial infarction (MI) and stroke. METHODS From the Korean National Health Insurance database, 2,644,851 people who received annual health examinations from 2010 to 2013 were recruited. Exposure-weighted scores for MetS during this 4-year period were calculated in two ways: cumulative number of MetS diagnoses (MetS exposure score, range: 0-4) and the composite of its five components (MetS component exposure score, range: 0-20). The multivariable Cox proportional-hazards model was used to assess CVD risk according to the exposure-weighted scores for MetS. RESULTS MetS was identified at least once in 37.6% and persistent MetS in 8.2% of subjects. During the follow-up (median, 4.4 years), 10,522 cases of MI (0.4%) and 10,524 cases of stoke (0.4%) occurred. The risk of MI and stroke increased gradually with increasing exposure scores of MetS and its components (each P for trend < 0.0001). The hazard ratio [(HR) (95% CI)] of MI and stroke were 5.27 (4.20-6.62) and 3.90 (3.09-4.93), respectively, in those with a score of 20 compared with those with a MetS component exposure score of 0. People fulfilling only two MetS components out of 20 already had 22% increased risk of MI, and those with three MetS components had 24% increased risk of stroke. These associations were consistent in the subgroup and sensitivity analyses. CONCLUSIONS A dose-response relationship between the cumulative exposure to metabolic disturbances and incident MI or stroke was evident. Even minimal exposure to MetS components was sufficient to increase the risk of CVD significantly, highlighting the importance of intensive risk management for the prevention of CVD.
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Affiliation(s)
- Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, 06978, South Korea
| | - Da Hye Kim
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #10 63-ro, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #10 63-ro, Yeongdeungpo-gu, Seoul, 07345, South Korea.
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea.
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