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P74 ROLES OF THE METABOLIC SYNDROME AND CORONARY ATHEROSCLEROSIS IN SUBCLINICAL INFLAMMATION
32
Atherosclerosis Supplements 11, no. 2 (2010) 17–108
(n = 30) and acute myocardial infarction (AMI) group (n = 31). Blood samples for measurement of Lp-PLA2 , CRP and IL-6 were taken before coronary angiography. Results: Serum Lp-PLA2 levels in CHDs were significantly higher than that in controls (P < 0.01). Compared with SAP group, the levels were also significantly increased in UAP group and AMI group (P < 0.01), higher levels remained significant after adjustment for traditional risk factors; No statistical significance was found in Lp-PLA2 levels between patients with AMI and UAP (P>0.05); Serum Lp-PLA2 level was positively correlated with CRP (r = 0.722, P < 0.01), and IL-6 level (r = 0.665, P < 0.01) by bivariate correlation analysis. Conclusion: The serum levels of Lp-PLA2 may be used as a parameter to predict severity of inflammation in coronary heart diseases. Keywords: Lipoprotein-associated Phospholipase A2 ; Coronary Heart Disease; Inflammation P74 ROLES OF THE METABOLIC SYNDROME AND CORONARY ATHEROSCLEROSIS IN SUBCLINICAL INFLAMMATION P. Rein1,2,3 , C.H. Saely1,2,3 , S. Beer1,2,3 , A. Vonbank1,2,3 , H. Drexel1,2,3,4 . 1 Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), 2 Academic Teaching Hospital Feldkirch, Feldkirch, Austria, 3 Private University of the Pricipality of Liechtenstein, Triesen, Liechtenstein, 4 Drexel University College of Medicine, Philadelphia, PA, USA Background: The metabolic syndrome (MetS) and stable coronary artery disease (CAD) frequently coincide; the individual contributions of these entities to subclinical inflammation are unknown. Methods: We enrolled 1010 consecutive patients undergoing coronary angiography for the evaluation of suspected or established stable CAD. The MetS was defined according to the AHA revision of the NCEP ATP-III criteria; coronary stenoses with lumen narrowing 50% were considered significant. Results: From our patients 564 (55.8%) had significant CAD and 459 (45.4%) had the MetS; the prevalence of significant CAD was higher in patients with the MetS than in subjects without the MetS (59.5% vs. 52.8%; p = 0.034). Serum CRP did not differ significantly between patients with significant CAD and subjects without significant CAD (p = 0.706), but it was significantly higher in MetS patients than in those without the MetS (p < 0.001). Regarding the individual MetS traits, the MetS criteria low HDL-C (p < 0.001), large waist circumference (p = 0.007) and high glucose (p = 0.023) but not the high triglycerides (p = 0.813) and high blood pressure criteria (p = 0.170) proved significantly associated with CRP. When all MetS traits were entered simultaneously into one ANCOVA model, only the HDL-C criterion independently of age, gender, LDL-C, smoking, cardiovascular medications and of all other MetS criteria proved independently associated with CRP (F=44.19; p < 0.001). Conclusions: CRP is strongly associated with the MetS but not with angiographically diagnosed coronary atherosclerosis. The overall association of the MetS with subclinical inflammation is driven by the low HDL cholesterol feature. P75 A NOVEL ANTHROPOMETRIC MEASURE FOR PREDICTING ALL-CAUSE MORTALITY ¨ ˚ A. Rosenblad, J. Leppert, G. Nilsson. Center for Clinical Research Vaster as, ¨ ˚ Sweden Uppsala University, Vaster as, Purpose: To compare the predictive ability for all-cause mortality of the novel anthropometric measure Waist-Hip-Height Ratio (WHHR) with Body Mass Index (BMI), Waist Circumference (WC), Waist-Hip Ratio (WHR) and Waist-Height Ratio (WHtR). Methods: Men and women aged 40 and 50 from the county of Vastmanland, ¨ Sweden were examined during the years 1990−99 (participation rate=48%). All-cause mortality was followed up until August 2008. For persons with complete anthropometric measures (n = 33493, men = 48%), Cox regression was performed for BMI, WC, WHR, WHtR and WHHR (defined as WHR divided by height). Multivariate adjustment added age, diabetic status, smoking, systolic and diastolic blood pressure, heart rate and glucose level. The predictive ability was calculated with a Pseudo R2 -measure and compared to WHHR using bootstrap. Table: Predictive ability of anthropometric measures Univariate
Multivariate (change from model without anthropometric measure)
Men
Women
Men
Poster Presentations
Results: During follow up 1301 persons (4%, men = 58%) died. The predictive ability was highest for WHHR followed by WHR, WHtR, WC and BMI. The difference was usually significant or close to significant using a one-sided p-value <0.05. Conclusions: WHHR performs better than WHR, WHtR, WC and BMI in predicting all-cause mortality. P76 PREGNANCY OUTCOMES IN FAMILIAL HYPERCHOLESTEROLEMIA WITH SPECIAL EMPHASIS ON PRETERM DELIVERY, BIRTH WEIGHT AND CONGENITAL MALFORMATIONS. A REGISTRY-BASED STUDY I. Toleikyte1 , K. Retterstøl2 , T.P. Leren3 , P.O. Iversen1 . 1 Department of Nutrition, Faculty of Medicine, University of Oslo, 2 Lipid Clinic, 3 Medical Genetics Laboratory, Oslo University Hospital, Rikshospitalet, Oslo, Norway Background and Aims: Circumstantial findings have linked hypercholesterolemia to preterm delivery and offspring with low birth weight, but firm data are lacking. Hence, the aim of this study was to examine whether women with familiar hypercholesterolemia (FH) have a higher risk of adverse birth outcomes compared to women in the general population. Study design and subjects: We identified 1,871 genetically verified FH women of fertile age from the Medical Genetics Laboratory-Registry at Oslo University Hospital. This data-set was coupled to that of the Medical Birth Registry of Norway, identifying women who had been pregnant and their birth outcomes between 1967 and 2006. The obtained data were compared to corresponding data from the general population in Norway, comprising about 2.3 million births, for the same period. Results: The registry-match resulted in 2,319 births of 1,102 women with heterozygous FH. Compared with the general population the FH population did not have significantly higher risk of i. giving birth prematurely (<37 gestational weeks), ii. delivering children with low birth weight (<2,500 g), or iii. having children with congenital malformations. The introduction of statins in 1992 in the treatment of hypercholesterolemia did not significantly increase the incidence of the three outcomes (i−iii) in the FH population, when comparing the period 1979–1991, i.e. before and the period 1999–2006, i.e. after statin introduction. Conclusion: FH women are apparently not at a higher risk of either preterm or low birth weight outcomes or births with congenital malformations than are women in the general population. P77 PROTHROMBOGENESIS IN SUBJECTS WITH METABOLIC SYNDROME AND CENTRAL OBESITY A.A. Razak, T.S. Tengku Ismail, M.R. Mohamad Taib, M. Mustafa Kamal, S. Abd Muid, M.T. Osman, K. Yusoff, H. Nawawi. Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia Background: Metabolic syndrome (MS) represents a cluster of abnormalities associated with an increased risk of coronary heart disease which may be partially explained by enhanced prothrombogenesis. Objective: The aim of the study was to evaluate the levels of prothrombogenic markers in MS subjects with different glycaemic status and centrally obese subjects. Methods: A total of 262 subjects (Mean±SD: 52±11, 90 Males) were recruited and divided into 5 groups: MS with normoglycaemia (MSNG), MS with impaired fasting glucose (MSIFG), MS with diabetes (MSDM), central obesity without MS (OBXMS) and non-MS control (NC). In addition, MSNG, MSIFG and MSDM were grouped as all MS group with a total number of 157. The blood levels of fibrinogen, homocysteine, tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) were evaluated. Results: MSNG group compared to NC group had higher fibrinogen (p < 0.05), homocysteine (p < 0.005), tPA (p < 0.05) and PAI-1 (p < 0.05). MSIFG group compared to NC group had higher homocysteine (p < 0.05) and tPA (p < 0.005). MSDM group compared to NC group had higher homocysteine (p < 0.05), tPA (p < 0.001) and PAI-1 (p < 0.05). In addition, All MS group compared to NC group had higher homocysteine (p < 0.005), tPA (p < 0.001) and PAI-1 (p < 0.01). OBXMS group compared to NC group had higher homocysteine (p < 0.05). Conclusions: MS irrespective of glycaemic status have enhanced prothrombogenesis compared to control. There is also enhanced prothrombogenesis in central obesity, suggesting a vital role of waist circumference in obesity-related health risk.
Women
Anthropometric measure
Pseudo R2
P-value
Pseudo R2
P-value
Pseudo R2 increase
P-value
Pseudo R2 increase
P-value
WHHR
0.142
ref.
0.163
ref.
0.020
ref.
0.023
ref.
WHR
0.117
0.023
0.146
0.098
0.016
0.100
0.019
0.175
WHtR
0.075
<0.001
0.125
0.041
0.007
0.014
0.014
0.089
WC
0.047
<0.001
0.105
0.010
0.004
0.010
0.010
0.051
BMI
0.014
<0.001
0.053
<0.001
0.000
0.007
0.002
0.012
P78 METABOLIC SYNDROME AND SUBCLINICAL ATHEROSCLEROSIS IN YOUNG ADULTS E.E. Babes, V.V. Babes, M.I. Popescu, A. Ardelean. Faculty of Medicine, Oradea, Romania Background: The metabolic syndrome (MS) is a constellation of interrelated metabolic risk factors that directly promote the development of atherosclerotic cardiovascular disease.
Atherosclerosis Supplements 11, no. 2 (2010) 17–108
(n = 30) and acute myocardial infarction (AMI) group (n = 31). Blood samples for measurement of Lp-PLA2 , CRP and IL-6 were taken before coronary angiography. Results: Serum Lp-PLA2 levels in CHDs were significantly higher than that in controls (P < 0.01). Compared with SAP group, the levels were also significantly increased in UAP group and AMI group (P < 0.01), higher levels remained significant after adjustment for traditional risk factors; No statistical significance was found in Lp-PLA2 levels between patients with AMI and UAP (P>0.05); Serum Lp-PLA2 level was positively correlated with CRP (r = 0.722, P < 0.01), and IL-6 level (r = 0.665, P < 0.01) by bivariate correlation analysis. Conclusion: The serum levels of Lp-PLA2 may be used as a parameter to predict severity of inflammation in coronary heart diseases. Keywords: Lipoprotein-associated Phospholipase A2 ; Coronary Heart Disease; Inflammation P74 ROLES OF THE METABOLIC SYNDROME AND CORONARY ATHEROSCLEROSIS IN SUBCLINICAL INFLAMMATION P. Rein1,2,3 , C.H. Saely1,2,3 , S. Beer1,2,3 , A. Vonbank1,2,3 , H. Drexel1,2,3,4 . 1 Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), 2 Academic Teaching Hospital Feldkirch, Feldkirch, Austria, 3 Private University of the Pricipality of Liechtenstein, Triesen, Liechtenstein, 4 Drexel University College of Medicine, Philadelphia, PA, USA Background: The metabolic syndrome (MetS) and stable coronary artery disease (CAD) frequently coincide; the individual contributions of these entities to subclinical inflammation are unknown. Methods: We enrolled 1010 consecutive patients undergoing coronary angiography for the evaluation of suspected or established stable CAD. The MetS was defined according to the AHA revision of the NCEP ATP-III criteria; coronary stenoses with lumen narrowing 50% were considered significant. Results: From our patients 564 (55.8%) had significant CAD and 459 (45.4%) had the MetS; the prevalence of significant CAD was higher in patients with the MetS than in subjects without the MetS (59.5% vs. 52.8%; p = 0.034). Serum CRP did not differ significantly between patients with significant CAD and subjects without significant CAD (p = 0.706), but it was significantly higher in MetS patients than in those without the MetS (p < 0.001). Regarding the individual MetS traits, the MetS criteria low HDL-C (p < 0.001), large waist circumference (p = 0.007) and high glucose (p = 0.023) but not the high triglycerides (p = 0.813) and high blood pressure criteria (p = 0.170) proved significantly associated with CRP. When all MetS traits were entered simultaneously into one ANCOVA model, only the HDL-C criterion independently of age, gender, LDL-C, smoking, cardiovascular medications and of all other MetS criteria proved independently associated with CRP (F=44.19; p < 0.001). Conclusions: CRP is strongly associated with the MetS but not with angiographically diagnosed coronary atherosclerosis. The overall association of the MetS with subclinical inflammation is driven by the low HDL cholesterol feature. P75 A NOVEL ANTHROPOMETRIC MEASURE FOR PREDICTING ALL-CAUSE MORTALITY ¨ ˚ A. Rosenblad, J. Leppert, G. Nilsson. Center for Clinical Research Vaster as, ¨ ˚ Sweden Uppsala University, Vaster as, Purpose: To compare the predictive ability for all-cause mortality of the novel anthropometric measure Waist-Hip-Height Ratio (WHHR) with Body Mass Index (BMI), Waist Circumference (WC), Waist-Hip Ratio (WHR) and Waist-Height Ratio (WHtR). Methods: Men and women aged 40 and 50 from the county of Vastmanland, ¨ Sweden were examined during the years 1990−99 (participation rate=48%). All-cause mortality was followed up until August 2008. For persons with complete anthropometric measures (n = 33493, men = 48%), Cox regression was performed for BMI, WC, WHR, WHtR and WHHR (defined as WHR divided by height). Multivariate adjustment added age, diabetic status, smoking, systolic and diastolic blood pressure, heart rate and glucose level. The predictive ability was calculated with a Pseudo R2 -measure and compared to WHHR using bootstrap. Table: Predictive ability of anthropometric measures Univariate
Multivariate (change from model without anthropometric measure)
Men
Women
Men
Poster Presentations
Results: During follow up 1301 persons (4%, men = 58%) died. The predictive ability was highest for WHHR followed by WHR, WHtR, WC and BMI. The difference was usually significant or close to significant using a one-sided p-value <0.05. Conclusions: WHHR performs better than WHR, WHtR, WC and BMI in predicting all-cause mortality. P76 PREGNANCY OUTCOMES IN FAMILIAL HYPERCHOLESTEROLEMIA WITH SPECIAL EMPHASIS ON PRETERM DELIVERY, BIRTH WEIGHT AND CONGENITAL MALFORMATIONS. A REGISTRY-BASED STUDY I. Toleikyte1 , K. Retterstøl2 , T.P. Leren3 , P.O. Iversen1 . 1 Department of Nutrition, Faculty of Medicine, University of Oslo, 2 Lipid Clinic, 3 Medical Genetics Laboratory, Oslo University Hospital, Rikshospitalet, Oslo, Norway Background and Aims: Circumstantial findings have linked hypercholesterolemia to preterm delivery and offspring with low birth weight, but firm data are lacking. Hence, the aim of this study was to examine whether women with familiar hypercholesterolemia (FH) have a higher risk of adverse birth outcomes compared to women in the general population. Study design and subjects: We identified 1,871 genetically verified FH women of fertile age from the Medical Genetics Laboratory-Registry at Oslo University Hospital. This data-set was coupled to that of the Medical Birth Registry of Norway, identifying women who had been pregnant and their birth outcomes between 1967 and 2006. The obtained data were compared to corresponding data from the general population in Norway, comprising about 2.3 million births, for the same period. Results: The registry-match resulted in 2,319 births of 1,102 women with heterozygous FH. Compared with the general population the FH population did not have significantly higher risk of i. giving birth prematurely (<37 gestational weeks), ii. delivering children with low birth weight (<2,500 g), or iii. having children with congenital malformations. The introduction of statins in 1992 in the treatment of hypercholesterolemia did not significantly increase the incidence of the three outcomes (i−iii) in the FH population, when comparing the period 1979–1991, i.e. before and the period 1999–2006, i.e. after statin introduction. Conclusion: FH women are apparently not at a higher risk of either preterm or low birth weight outcomes or births with congenital malformations than are women in the general population. P77 PROTHROMBOGENESIS IN SUBJECTS WITH METABOLIC SYNDROME AND CENTRAL OBESITY A.A. Razak, T.S. Tengku Ismail, M.R. Mohamad Taib, M. Mustafa Kamal, S. Abd Muid, M.T. Osman, K. Yusoff, H. Nawawi. Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia Background: Metabolic syndrome (MS) represents a cluster of abnormalities associated with an increased risk of coronary heart disease which may be partially explained by enhanced prothrombogenesis. Objective: The aim of the study was to evaluate the levels of prothrombogenic markers in MS subjects with different glycaemic status and centrally obese subjects. Methods: A total of 262 subjects (Mean±SD: 52±11, 90 Males) were recruited and divided into 5 groups: MS with normoglycaemia (MSNG), MS with impaired fasting glucose (MSIFG), MS with diabetes (MSDM), central obesity without MS (OBXMS) and non-MS control (NC). In addition, MSNG, MSIFG and MSDM were grouped as all MS group with a total number of 157. The blood levels of fibrinogen, homocysteine, tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) were evaluated. Results: MSNG group compared to NC group had higher fibrinogen (p < 0.05), homocysteine (p < 0.005), tPA (p < 0.05) and PAI-1 (p < 0.05). MSIFG group compared to NC group had higher homocysteine (p < 0.05) and tPA (p < 0.005). MSDM group compared to NC group had higher homocysteine (p < 0.05), tPA (p < 0.001) and PAI-1 (p < 0.05). In addition, All MS group compared to NC group had higher homocysteine (p < 0.005), tPA (p < 0.001) and PAI-1 (p < 0.01). OBXMS group compared to NC group had higher homocysteine (p < 0.05). Conclusions: MS irrespective of glycaemic status have enhanced prothrombogenesis compared to control. There is also enhanced prothrombogenesis in central obesity, suggesting a vital role of waist circumference in obesity-related health risk.
Women
Anthropometric measure
Pseudo R2
P-value
Pseudo R2
P-value
Pseudo R2 increase
P-value
Pseudo R2 increase
P-value
WHHR
0.142
ref.
0.163
ref.
0.020
ref.
0.023
ref.
WHR
0.117
0.023
0.146
0.098
0.016
0.100
0.019
0.175
WHtR
0.075
<0.001
0.125
0.041
0.007
0.014
0.014
0.089
WC
0.047
<0.001
0.105
0.010
0.004
0.010
0.010
0.051
BMI
0.014
<0.001
0.053
<0.001
0.000
0.007
0.002
0.012
P78 METABOLIC SYNDROME AND SUBCLINICAL ATHEROSCLEROSIS IN YOUNG ADULTS E.E. Babes, V.V. Babes, M.I. Popescu, A. Ardelean. Faculty of Medicine, Oradea, Romania Background: The metabolic syndrome (MS) is a constellation of interrelated metabolic risk factors that directly promote the development of atherosclerotic cardiovascular disease.