Abstract
BackgroundThe aim of this cross-sectional study was to determine the association between lowered endothelial function measured by peripheral arterial tonometry (PAT) and cardio-metabolic risk factors. The study population consisted of Finnish municipal workers who were at risk of diabetes or cardiovascular disease and who had expressed a need to change their health behaviour.MethodsA total of 312 middle-aged municipal workers underwent a physical medical examination and anthropometry measurements. Levels of total cholesterol, HDL cholesterol, triglycerides, fasting glucose, glycated haemoglobin, and high sensitivity C-reactive protein were taken from the blood samples. PAT measured the increase in digital pulse volume amplitude during reactive hyperemia, and the index of endothelial function, F-RHI, was defined as the ratio of post-deflation amplitude to baseline amplitude.ResultsIn the linear regression model, male sex was associated with lower F-RHI. In sex-adjusted linear regression models, each of the variables; waist circumference, fasting glucose, glycated hemoglobin, triglycerides, body fat percentage, body mass index, current smoking, and impaired fasting glucose or diabetes were separately associated with lower F-RHI, and HDL cholesterol and resting heart rate were associated with higher F-RHI.HDL cholesterol, sex, body mass index, and current smoking entered a stepwise multivariable regression model, in which HDL cholesterol was associated with higher F-RHI, and smoking, male sex and body mass index were associated with lower F-RHI. This model explains 28.3% of the variability in F-RHI.ConclusionsF-RHI is associated with several cardio-metabolic risk factors; low level of HDL cholesterol, male sex, overweight and smoking being the most important predictors of a lowered endothelial function. A large part of variation in F-RHI remains accounted for by unknown factors.
Highlights
The aim of this cross-sectional study was to determine the association between lowered endothelial function measured by peripheral arterial tonometry (PAT) and cardio-metabolic risk factors
We used twenty separate sexadjusted linear regression models to find the association of Framingham reactive hyperemia index (F-RHI) with each of the following cardiovascular and metabolic risk factors: age, body mass index (BMI), waist circumference (WC), body fat percentage assessed by bioelectrical impedance (BIA), total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, fasting glucose, Glycated hemoglobin (HbA1c), high sensitivity C-reactive protein (hs-CRP), systolic and diastolic blood pressure, resting heart rate, rate-pressure product, hypertension treatment, lipid lowering treatment, impaired fasting glucose or diabetes, family history of cardiovascular disease (CVD), and current smoking
Associations of F-RHI with cardiometabolic risk factors Male sex was associated with lower F-RHI in the separate linear regression model
Summary
The aim of this cross-sectional study was to determine the association between lowered endothelial function measured by peripheral arterial tonometry (PAT) and cardio-metabolic risk factors. The study population consisted of Finnish municipal workers who were at risk of diabetes or cardiovascular disease and who had expressed a need to change their health behaviour. The assessment of traditional risk factors is a basic element in the primary prevention of cardiovascular disease (CVD). The measurements of endothelial function are promising indicators of vascular health [2]. Endothelial dysfunction contributes to the initiation and progression of atherosclerotic disease and is an individual cardiovascular risk factor with prognostic value [2,3]. Many interventions that reverse endothelial dysfunction reduce cardiovascular risk, and one potential use for the measurements of endothelial function is the evaluation of interventions to reduce CVD risk [2]
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