Abstract
We assessed the association between metabolic health and markers of inflammation and of endothelial dysfunction using data from the Ewha Birth and Growth Cohort Study. The data of 195 subjects aged 13–15 years were analyzed. To assess metabolic syndrome, continuous metabolic syndrome (cMets) scores were calculated. We measured the levels of high-sensitivity C-reactive protein (hs-CRP), intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) as markers of inflammation and endothelial dysfunction. An increase of one SD in the cMets score resulted in a 1.25-fold (95% CI 1.10–1.42) increase in the risk of acute inflammatory status and a 1.26-fold (95% CI 1.11–1.43) increase in the risk of endothelial dysfunction as defined by ICAM-1, while VCAM-1 showed a meaningless trend. Of the metabolic components, body mass index (BMI) was positively associated with elevated hs-CRP levels and high-density lipoprotein cholesterol (HDL-c) levels were negatively associated with elevated ICAM-1 levels. Additionally, a mediation analysis showed that a high BMI was directly related to elevated hs-CRP levels and indirectly related to elevated ICAM-1 levels via HDL-c. Our findings show that poor metabolic health was related to an unfavorable inflammatory status and endothelial dysfunction in adolescents.
Highlights
Metabolic syndrome is a clustering of obesity, high blood pressure, poor glucose tolerance, and dyslipidemia, and is a risk factor for cardiovascular disease (CVD)
The risk of an elevated highsensitivity C-reactive protein (hs-CRP) level increased with increasing body mass index (BMI) and the risk of an elevated intercellular adhesion molecule 1 (ICAM-1) level increased with decreasing high-density lipoprotein cholesterol (HDL-c)
A high BMI was directly related to elevated hs-CRP levels and indirectly related to elevated ICAM-1 levels via HDL-c
Summary
Metabolic syndrome is a clustering of obesity, high blood pressure, poor glucose tolerance, and dyslipidemia, and is a risk factor for cardiovascular disease (CVD). Regarding the effect of metabolic health on CVD development, abnormal metabolic components contribute to endothelial dysfunction accompanied by inflammation of the vessel wall, leading to the development of atherosclerosis and CVD [8]. Based on these assumptions, the associations between metabolic components and inflammatory markers (e.g., high-sensitivity C-reactive protein [hs-CRP], interleukin-6 [IL]-6) [6,9,10,11], and markers of endothelial dysfunction (e.g., intercellular adhesion molecule [ICAM-1] and vascular cell adhesion molecule [VCAM-1]) [6,11,12] have been evaluated. To identify an implementable and effective intervention strategy, we used mediation analysis to evaluate the direct/indirect association between BMI and an unfavorable inflammatory status and endothelial dysfunction
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