Abstract P033: Biomarkers Relation to Prevalent Metabolic Syndrome in African Americans: A Multimarker Approach
Introduction: Multiple biological pathways have been related to metabolic syndrome (MetS) in both human and animal models. Whether biomarkers representing these pathways are associated with MetS has not been thoroughly investigated in African Americans.
Hypothesis: We tested the hypothesis that at least one biomarker from a panel of seven biomarkers representing inflammatory (high sensitivity C-reactive protein; leptin), neuro-hormonal activation (aldosterone, B-natriuretic peptide, BNP; cortisol), and endothelial dysfunction (endothelin; homocysteine) are associated with prevalent metabolic syndrome in a large African American sample population.
Methods: This study consisted of a total of 4,006 Jackson Heart Study participants (53±13 years, 64% female) that attended two consecutive examination cycles five (4.7±0.8) years apart. Prevalent MetS was defined as the presence of at least 3 of the following conditions: elevated BP (≥ 130 mm Hg systolic, ≥ 85 mm Hg diastolic or treatment with antihypertensive medications); increased waist circumference (≥ 102 cm in mean or ≥ 88 cm in women); hyperglycemia (fasting glucose ≥ 100 mg/ dL) or treatment with oral hypoglycemic agents or insulin; hypertriglyceridemia (≥ 150 mg/dL) or treatment with lipid lowering agents, and low HDL cholesterol (< 40 mg/dL in men, < 50 mg/dL in women). We used backward selection in multiple logistic regression models to identify biomarkers significantly associated with MetS. To account for effect of clinical correlates, we forced age, sex, waist circumference, systolic and diastolic pressures, fasting glucose and log triglycerides into the model.
Results: Prevalent MetS was 27 % in the entire JHS participants (70% of which were women). Most participants had elevated blood pressure (85%), followed by high waist circumference (28 %) and HDL-cholesterol (20 %). We observed that prevalent metabolic syndrome was significantly associated with serum leptin (P<0.0001) and aldosterone (P<0.0001) after accounting for clinical correlates. Estimated effects, odds ratios (95% confidence interval) were 1.62 (1.38, 1.91) and 1.28 (1.13, 1.40) for serum leptin concentration and aldosterone, respectively.
Conclusions: In this large community-based epidemiological study we found using a multimarker approach that serum leptin and aldosterone are significantly related to prevalent MetS. These findings support the role of inflammation and neuro-hormonal transmitters in this clinical syndrome in African Americans. Further studies are needed to identify whether these markers predict incident metabolic syndrome and can serve as targets for medical therapy and clinical management.
- © 2012 by American Heart Association, Inc.