Turk Kardiyol Dern Ars. 2022; 50(1): 57-65 | DOI: 10.5543/tkda.2022.47443
Impact of metabolic syndrome and systemic inflammation on endothelial function in postmenopausal women
, Hongju Zhang1
, Tao Sun2
, Yutong Cheng2
, Jing Zhang3
, HaiXia Zhang3
, Chayakrit Krittanawong4
, Edward El-Am5
, Roukoz Abou Karam6
, Su Wang2
, Qian Wang21
Department of Echocardiography, Beijing Childrens Hospital, Capital Medical University, National Center for Childrens Health2
Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University3
Department of Ultrasound, Shunyi Maternal and Childrens Hospital of Beijng Childrens Hospital4
Section of Cardiology, Baylor College of Medicine5
Department of Medicine, Indiana University School of Medicine6
The Cardiovascular Division Department of Medicine, Beth Israel Deaconess Medical Center Harvard Medical School
OBJECTIVE Data on the impact of metabolic syndrome (MetS) and systemic inflammation on endothelial function remains scarce. In this study, we aimed to investigate the combined effects of MetS and systemic inflammation on endothelial function in postmenopausal women.
METHODS We identified 423 postmenopausal women from February 2019 through July 2020. MetS was diagnosed according to the International Diabetes Federation (IDF) criteria, and high sensitivity C-reaction protein (hs-CRP) was measured to assess the degree of underlying inflammation. The measurement of endothelial function was using digital arterial tonometry by assessing reactive hyperemia-induced vasodilation in one arm and adjusting for changes in the contralateral arm (reactive hyperemia index, RHI).
RESULTS There were 156 patients with MetS and 267 without MetS. Compared to the group without MetS, patients with MetS had significantly lower natural logarithmic RHI (0.66±0.29 versus 0.91±0.31; p<0.001), but higher levels of hs-CRP (0.98 [0.31, 3.54] versus 0.53 [0.20, 2.14]; p<0.001). In sequential multivariable analysis, the presence of hs-CRP (ΔR2 =0.047, p=0.004) had a significant and independent influence on natural logarithmic RHI. Furthermore, the interaction of hs-CRP*MetS was synergistically associated with endothelial dysfunction even in the fully adjusted model (β=-0.107, 95% CI [-0.161~-0.053], p=0.009).
CONCLUSION MetS and systemic inflammation are synergistically associated with endothelial dysfunction in postmenopausal women. Postmenopausal women with both these conditions appear to be at a significantly higher risk for adverse cardiovascular events.
Post-menopausal, Metabolic syndrome, Systemic inflammation, Endothelial function
How to cite this article
Ning Ma, Hongju Zhang, Tao Sun, Yutong Cheng, Jing Zhang, HaiXia Zhang, Chayakrit Krittanawong, Edward El-Am, Roukoz Abou Karam, Su Wang, Qian Wang. Impact of metabolic syndrome and systemic inflammation on endothelial function in postmenopausal women. Turk Kardiyol Dern Ars. 2022; 50(1): 57-65
Corresponding Author: Ning Ma, China
Manuscript Language: English