Skin Carotenoid Status Is a Potential Surrogate Marker for Cardiovascular Disease Risk Determination in Middle-Aged and Older Adults

Abstract

Abstract Objectives The study aimed to examine the associations between skin carotenoid status and plasma carotenoids with classical cardiovascular disease (CVD) risk factors among a middle-aged and older Singaporean population. It was hypothesized that skin carotenoid status and plasma carotenoids could be used as an indicator for CVD risk. Methods This cross-sectional study recruited 45 men and 59 women, aged 50 to 75 years, from a community in Singapore (n = 104). Dietary information was obtained using 3-day food records, skin carotenoid status was measured using resonance Raman spectroscopy and plasma carotenoids were analyzed with high-performance liquid chromatography. CVD risk was determined using classical risk factors including blood pressure (BP), serum lipid-lipoprotein concentrations, as well as overall CVD risk predictors such as the number of metabolic syndrome components and a 10-year CVD risk prediction using the Framingham Heart Study risk score calculator. Results Multiple linear regression with covariate adjustments indicated that skin carotenoid status and plasma carotenoids were inversely associated with systolic BP (skin: standardized regression coefficient (β) = −0.341, P < 0.001; plasma: β = −0.258, P < 0.05), diastolic BP (skin: β = −0.378, P < 0.001; plasma: β = −0.309, P < 0.005) as well as both the number of metabolic syndrome components (skin: β = −0.383, P < 0.001; plasma: β = −0.434, P < 0.001) and the 10-year CVD risk prediction (skin: β = −0.347, P < 0.001; plasma: β = −0.334, P < 0.001). The associations between skin carotenoid status with metabolic syndrome and the 10-year CVD risk were null with the inclusion of plasma carotenoids as a covariate which suggested its role as a mediator. Despite the positive linear association between skin carotenoid status and dietary carotenoids intake (Pearson's coefficient: 0.204, P < 0.001), dietary carotenoids were not directly correlated with the CVD risk factors analyzed. Conclusions Skin carotenoid status can function not only as a dietary biomarker, but also, as a potential surrogate marker for CVD risk in middle-aged and older Singaporeans. Funding Sources National University of Singapore Ministry of Education, Singapore Agency for Science, Technology and Research (Singapore).