Abstract 14216: Cardiovascular Disease Risk Factor Modification Decreases HS-CRP and Macrophage Migration Inhibitory Factor (MIF): Influence of Gender

Abstract

Background: Inflammation and gender are key factors in cardiovascular disease (CVD) pathogenesis and outcomes. Macrophage migration inhibitory factor (MIF) is a pro-inflammatory cytokine that contributes to CVD risk through inflammatory vulnerable plaque formation, while CRP is a systemic marker of inflammation. Lifestyle modification programs focusing on nutrition, exercise, and stress management are effective in mediating CVD risk through traditional measures like weight, blood pressure, and lipids; however, little is known about gender-related differences and response of emerging risk factors such as MIF to lifestyle modification.

Methods: In a prospective study of patients with elevated CVD risk matched to controls by age, gender and CVD risk factors (n=85/group), we investigated 1) changes in circulating MIF and HS-CRP, 2) the influence of gender on changes in MIF and HS-CRP, 3) correlation between changes in MIF and HS-CRP during an intensive CVD risk reduction program.

Results: Baseline MIF and HS-CRP were higher in women vs. men (P=0.04) in patients enrolled in the lifestyle modification program (MIF: 3.1 ± 1.9 vs. 2.8 ± 1.9 ng/ml; HS-CRP: 5.9 ± 7.7 vs. 3.5 ± 2.7 ng/ml) and controls (MIF: 3.3 ± 2.0 vs. 2.5 ± 1.7 ng/ml; HS-CRP: 3.7 ± 3.6 vs. 1.6 ± 2.0 ng/ml). After 3 months of lifestyle modification, female gender accounted for the majority of decrease in MIF and HS-CRP. Women showed a 23% decrease in MIF (3.1 ± 1.9 vs. 2.4 ± 1.2 ng/ml, P=0.05) and a 40% decrease in HS-CRP (5.9 ± 7.7 vs. 3.5 ± 4.5 ng/ml, P=0.06), but neither MIF nor HS-CRP changed significantly in controls or men in the lifestyle modification program. Pair wise correlation did not show a relationship between changes in MIF and HS-CRP.

Conclusions: Pro-inflammatory MIF and HS-CRP decreased in response to intensive diet/lifestyle intervention, with improvement being more evident in women than men. While changes in weight and blood pressure were similar in both genders during the lifestyle intervention, changes in inflammatory markers were dependent on gender. This suggests intensive lifestyle modification may lessen CVD risk in women through different mechanisms than in men.