Archives of the Turkish Society of Cardiology
Impact of metabolic syndrome and systemic inflammation on endothelial function in postmenopausal women [Turk Kardiyol Dern Ars]
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

Ning Ma1, Hongju Zhang1, Tao Sun2, Yutong Cheng2, Jing Zhang3, HaiXia Zhang3, Chayakrit Krittanawong4, Edward El-Am5, Roukoz Abou Karam6, Su Wang2, Qian Wang2
1Department of Echocardiography, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health
2Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University
3Department of Ultrasound, Shunyi Maternal and Children’s Hospital of Beijng Children’s Hospital
4Section of Cardiology, Baylor College of Medicine
5Department of Medicine, Indiana University School of Medicine
6The 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.

Keywords: 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
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