Abstract P212: Circulating Homocysteine, Aldosterone and Brain Natriuretic Peptide Levels Predict the Development of Metabolic Syndrome and Longitudinal Changes in Metabolic Syndrome Components: Findings from fhe Jackson Heart Study
Background: The relative contribution of selected circulatory biomarkers that represent distinct biological pathways to the incidence of metabolic syndrome (MetS) in African Americans is not well elucidated despite the greater prevalence of cardiovascular diseases in this ethnic group. Thus, we aimed to assess the relative contribution of a panel of representative cardiometabolic biomarkers with the hypothesis that they are predictors of incident MetS and longitudinal changes in MetS components.
Materials and Methods: At the end of the second JHS examination cycle (average 4.7 years from baseline), 178 participants of the total 1055 without prevalent MetS at baseline had developed MetS. We selected informative markers from a panel of 7 representing inflammation (C - reactive protein and leptin), neurohormonal activity (aldosterone, BNP, cortisol), and endothelial function (endothelin and homocysteine) that were significantly associated with incident metabolic syndrome (MetS). Biomarker selection was performed using stepwise selection in multivariable logistic regression models. We adjusted for baseline age, gender, systolic and diastolic BP, log triglycerides, fasting glucose and HDL cholesterol, and waist circumference measurements.
Results: Serum homocysteine, aldosterone and B-natriuretic peptide (BNP) concentration were retained as significantly associated with incident MetS, with p-values 0.037, 0.008 and 0.022, respectively. The multivariable adjusted OR (95%CI) were 1.28 (1.02 to 1.62) for homocysteine; 1.33 (1.08 to 1.65) for aldosterone, and 2.47 (1.31 to 4.66) for 2nd BNP quartile compared to the first quartile. In multivariable analyses evaluating longitudinal change in MetS components (analyzed as continuous variables); homocysteine was significantly and positively associated with diastolic BP. Serum aldosterone was associated with all MetS risk factors, while higher levels of plasma circulating BNP were associated with all risk factors except sex-standardized waist circumference. Discussion and
Conclusions: Higher circulating homocysteine and aldosterone levels were directly associated with the development of MetS and with longitudinal change of its components except HDL cholesterol and sex standardized waist circumference, which were negatively associated with aldosterone. The second and fourth quartiles of circulating plasma BNP concentration were significantly associated with greater odds of developing MetS than the first quartile. Further, higher concentration of BNP was associated with positive changes in all risk components except for HDL cholesterol and waist circumference. These results suggest that the biomarkers and their related pathways are essential in mediating metabolic risk in African Americans.
- © 2012 by American Heart Association, Inc.