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Publication Type
Journal Article
Author, Analytic
Rambaran, C. ; Chowienczyk, P. ; Ritter, J. ; Shah, A. ; Wilks, R. ; Forrester, T. ; Kalra, L.
Author Affiliation, Ana.
Tropical Medicine Research Institute
Article Title
The vascular effects of metabolic impairment clusters in subjects of different ethnicities
Medium Designator
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Connective Phrase
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Journal Title
Atherosclerosis
Translated Title
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Reprint Status
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Date of Publication
2006
Volume ID
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Issue ID
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Page(s)
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Language
ENG
Connective Phrase
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Location/URL
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ISSN
0021-9150 (Print)
Notes
Cardiovascular Division, King's College London School of Medicine, London, UK.
Abstract
BACKGROUND: Although metabolic syndrome affects vascular function, the impact of individual impairments and their clustering is unclear. OBJECTIVE: To assess the vascular impact of metabolic impairments before they reach treatment thresholds in different ethnic groups. METHODS: Metabolic variables, inflammatory markers, endothelium dependent vasodilatation (EDV) and carotid intima media thickness (CIMT) were measured in population samples of 82 Caucasians and 78 matched Afro-Caribbeans with no vascular disease. Insulin resistance was assessed using homeostasis model assessment (HOMA-IR). EDV was measured as the change in the height of the inflection point of the digital volume pulse following intravenous infusion of 5mcg/min of albuterol (DeltaRI(ALB)). Regression models were used to investigate the independent effects of metabolic impairment clusters and their interaction with ethnicity on EDV and CIMT. RESULTS: HOMA-IR (2.4-3.8, p<0.0001), IL-6 levels (1.1-2.8pg/mL, p=0.02) and CIMT (0.71-0.83mm, p=0.009) increased whereas in DeltaRI(BASELINE) (77.6-72.9 percentage points, p<0.0001) and DeltaRI(ALB) (15.5-7.1 percentage points, p<0.0001) decreased with the number of metabolic impairments present. DeltaRI(ALB) decreased by 1.6 (95% CI 0.2-3.7) percentage points and CIMT increased by 0.06 (95% CI 0.02-0.10)mm for each metabolic impairment present after adjusting for age, gender, ethnicity and HOMA-IR. There were significant interactions between Afro-Caribbean ethnicity and metabolic impairments for IL-6 (p=0.037) and DeltaRI(ALB) (p=0.002). CONCLUSIONS: Clustering of metabolic impairments is associated with inflammatory activation, impaired EDV and increased CIMT even before reaching treatment thresholds for individual impairments. This effect was more marked in Afro-Caribbean subjects.....
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