Marker Of Abdominal Adiposity Research Articles

Evaluation of Waist Circumference, Waist-Hip Ratio and Waist-Length Ratio in Insulin Resistance: Which is A Powerful Predictor?

Introduction: The most important cause of insulin resistance(IR) is obesity. Abdominal adiposity (AA) is more important than general obesity in IR formation. The aim of this study is to evaluate waist circumference (WC), waist-hip ratio (WHR) and waist-length ratio (WLR) as the AA markers, and to question their predictive properties in IR. Material and Methods: Individuals diagnosed with IR were retrospectively examined. Seventy patients between 20-65 ages without systemic disease and drug use were included in the study. The patients were evaluated in terms of age, gender, and obesity grades. They were divided into the risk groups according to WC, WHR, WLR and compared each other in terms of HOMA-IR levels. Results: Of the cases 78.6% were female and 21.4% were male. The mean age was 43.04 years. The mean HOMA-IR level was 5.38. Severe obesity was in 35 (50%) patients. WC, in 87.2% of women 60% of men, WHR, in 65.4% of women 93.3% of men, and WLR, in 98.1% of women 93.3% of men were high. HOMA-IR level was found to be statistically different in the WLR risky group compared to the others(p<0.05). WLR was more significant and indicated IR with 70% sensitivity and 80% specificity with a HOMA IR level of 3.03 and above. Conclusion: WLR is a stronger predictor than WC and WHR in all obesity grades for IR. It can be preferred as a powerful predictor for the risk assessment of abdominal obesity and IR status.

Overweight, Obesity, and CVD Risk: a Focus on Visceral/Ectopic Fat.

Despite its prevalence and well-documented impact on population health, obesity has not emerged as a strong independent risk factor for cardiovascular disease after control for intermediate risk factors. The purpose of this brief narrative review is to highlight results from imaging studies that have not only documented the remarkable heterogeneity of body fat topography but also the importance of visceral adiposity as a key body fat depot associated with cardiovascular disease risk and type 2 diabetes. Simple tools are also discussed in order to refine cardiometabolic risk assessment in persons with overweight/obesity. It is proposed that four lifestyle vital signs should be considered in clinical practice to improve discrimination of health risk in individuals with overweight/obesity: waist circumference as a simple marker of abdominal adiposity, cardiorespiratory fitness, overall diet quality, and level of reported physical activity. Heterogeneity of obesity is proposed as an example of a condition that would benefit from a precision lifestyle medicine approach.

Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community

BackgroundInsulin resistance carries increased risk of heart failure, although the pathophysiological mechanisms remain unclear. LV global longitudinal strain (LVGLS) assessed by speckle-tracking echocardiography has emerged as an important tool to detect early LV systolic abnormalities. This study aimed to investigate the association between insulin resistance and subclinical left ventricular (LV) dysfunction in a sample of the general population without overt cardiac disease.Methods We investigated 539 participants who voluntarily underwent extensive cardiovascular health check including laboratory test and speckle-tracking echocardiography. Glycemic profiles were categorized into 3 groups according to homeostatic model assessment of insulin resistance (HOMA-IR): absence of insulin resistance (HOMA-IR < 1.5), presence of insulin resistance (HOMA-IR ≥ 1.5) and diabetes mellitus (DM). Multivariable logistic regression models were conducted to evaluate the association between abnormal glucose metabolism and impaired LVGLS (> − 16.65%).ResultsForty-five (8.3%) participants had DM and 66 (12.2%) had abnormal HOMA-IR. LV mass index and E/e′ ratio did not differ between participants with and without abnormal HOMA-IR, whereas abnormal HOMA-IR group had significantly decreased LVGLS (− 17.6 ± 2.6% vs. − 19.7 ± 3.1%, p < 0.05). The prevalence of impaired LVGLS was higher in abnormal HOMA-IR group compared with normal HOMA-IR group (42.4% vs. 14.0%) and similar to that of DM (48.9%). In multivariable analyses, glycemic abnormalities were significantly associated with impaired LVGLS, independent of traditional cardiovascular risk factors and pertinent laboratory and echocardiographic parameters [adjusted odds ratio (OR) 2.38, p = 0.007 for abnormal HOMA-IR; adjusted OR 3.02, p = 0.003 for DM]. The independent association persisted even after adjustment for waist circumference as a marker of abdominal adiposity. Sub-group analyses stratified by body mass index showed significant association between abnormal HOMA-IR and impaired LVGLS in normal weight individuals (adjusted OR 4.59, p = 0.001), but not in overweight/obese individuals (adjusted OR 1.62, p = 0.300).ConclusionsIn the general population without overt cardiac disease, insulin resistance carries independent risk for subclinical LV dysfunction, especially in normal weight individuals.

Whole Grain Intake Is Prospectively Associated with Lower Gain in Abdominal Obesity over 18 Years of Follow-up (OR33-04-19)

ObjectivesAbdominal adiposity has been associated with greater risk of metabolic and cardiovascular diseases independent of overall BMI. Prospective studies examining the relationship between whole grain (WG) and refined grain (RG) consumption and abdominal adiposity are scarce. We examined the prospective relationship between WG and RG consumption and both weight and waist circumference (WC), a surrogate marker of abdominal adiposity, over 18 years of follow-up. MethodsSubjects were participants in the Framingham Offspring cohort (3514 subjects with 13,864 unique observations) with mean baseline age of 54.2 years (SE = 0.16) and mean BMI of 27.3 kg/m2 (SE = 0.11). Diet, health, and lifestyle data were collected approximately every 4 years up to 5 times over a total median of 18 years of follow-up. Dietary information was assessed using a semi-quantitative food-frequency questionnaire. WG intake was estimated in grams per day and grouped into pre-determined categories (≤8 g/d, 8–16 g/d, 16–24 g/d, and 24+ g/d). RG intake was estimated in servings per day and grouped into quartiles. Annualized change in weight and WC was examined using mixed models accounting for repeated measures. ResultsWG intake ranged from a median of 4.5 g/d in the lowest category to 34.3 g/d in the highest category. After adjustment for demographic and lifestyle factors, greater WG intake was associated with less four-year gain in WC, with those in the highest category gaining (mean ± SE) 1.77 ± 0.08 cm in WC compared to 2.86 ± 0.12 cm in the lowest category (P-trend < 0.001). Conversely, greater RG intake was associated with greater four-year gain in WC. Those in the highest quartile (median intake of 4.3 servings/d) gained more (2.82 ± 0.12 cm gain in WC) compared to the lowest quartile (median intake of 1.2 servings/d) (1.66 ± 0.1 cm gain in WC). These associations remained significant even when subjects were stratified by baseline BMI or WC. WG intake was not associated with 4-year change in overall body weight after adjusting for lifestyle factors. However, RG intake was associated with greater 4-year gain in body weight among overweight or abdominally obese subjects. ConclusionsGreater WG intake and less RG intake is prospectively associated with less gain in WC. Replacing RG foods with WG equivalents may be an effective dietary modification to attenuate abdominal weight gain and reduce the risk for cardiometabolic disease. Funding SourcesNIH/NHLBI(Contract N01-HC-25195), USDA (Agreement No. 58-1950-4-003), and General Mills Bell Institute of Health and Nutrition.

Hubungan antara Obesitas dengan Penurunan Fungsi Faal Paru pada Polisi Wanita di Polda Jawa Timur

Background: The prevalence of obesity is increasing in Indonesia, and there is evidence that obesity, in particular abdominal obesity as a marker of insulin resistance, is negatively associated with pulmonary function. The mechanism for this association and the best marker of abdominal adiposity in relation to pulmonary function is not known. Study objectives: We assessed the association between pulmonary function (ie, FEV1 and FVC) [with maneuvers performed in the sitting position] with adiposity markers (ie, body mass index (BMI) and waist circumference (WC), as markers of adiposity and body fat distribution in Policewomen in East Java Police Departement. We used paired student t test to analyze the association of pulmonary function and abdominal adiposity markers. Design: Observational cross sectional analytic study. Setting and participants: A random sample of policewomen (n = 120) from the general population East Java Police Departement, 20 to 45 years of age, who fulfill inclusion criterion of this study. Results: The measures of adiposity (ie. Waist circumference and BMI) were not significantly related to %FEV1 and %FVC after analyzed with correlation Pearson and Spearman test (p &gt; 0.05). Conclusion: BMI categories and waist circumference (WC) were not associated with FEV1 percent predicted and FVC percent predicted, may be the physical activity twice a week can maintain health status.

Effect of central adiposity on lung function tests in adolescents

Objectives: The objectives of the study were to study the relation of total body adiposity and abdominal adiposity markers with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in adolescents in Bengaluru. Methods: 125 healthy children from a school and 70 asthmatics from Ramaiah hospital between 10 and 15 years were included in the study. Anthropometry including weight, body mass index (BMI), waist and hip circumference, and abdominal height was done in all study adolescents. The subjects were categorized according to BMI. Pulmonary function tests (PFTs) were done by Knudson methodand FEV1, FVC, and peak expiratory flow (PEF) were measured. The patients were classified by their asthma severity according to GINA guidelines. Results: BMI, weight, waist and hip circumference correlated with abdominal height in male asthmatics and controls where they revealed significant correlations with FEV1/FVC% ratio. In females, abdominal height correlated with BMI, weight, waist and hip circumference in both the groups. PEF correlated with BMI, weight, waist circumference, and abdominal height in healthy females. FEV1/FVC correlated with BMI, abdominal height in female asthmatics, with weight in healthy females.Independent predictors of FEV1/FVC% ratio were hip circumference in males and abdominal height, and waist circumference in females. Conclusion: Increase in obesity is associated with reduced lung volumes and flows. The abdominal adiposity markers (waist and hip circumference, and abdominal height) are significant and effective predictors of obesity and the variations of PFT’s than total adiposity markers (BMI and weight).

Erratum to: Risk of breast, endometrial, colorectal, and renal cancers in postmenopausal women in association with a body shape index and other anthropometric measures.

A body shape index (ABSI) has been proposed as a possible improvement over waist circumference (WC) as a marker of abdominal adiposity because it removes the correlation of WC with body mass index (BMI) and with height. We assessed the association of ABSI with four obesity-related cancers compared to that of other anthropometric measures of adiposity. We used data from the Women’s Health Initiative, a large cohort of postmenopausal women, recruited between 1993 and 1998 and followed until September 2013, to assess the associations of ABSI and other anthropometric measures with risk of cancers of the breast, endometrium, colorectum, and kidney. The four comparison anthropometric measures were BMI, WC, waist circumference-to-height ratio (WHtR), and waist-hip ratio (WHR). Over a median of 12.7 years of follow-up, among 143,901 women, we identified 7,039 invasive breast cancers, 1,157 endometrial cancers, 1,908 colorectal cancers, and 376 kidney cancers. We used Cox proportional hazards models to estimate the association of quintiles of the five measures with risk of the four cancers. Unlike the other anthropometric indices, ABSI was not associated with increased risk of breast or endometrial cancer. BMI and WC were comparable as predictors of breast and endometrial cancer, and these associations were unchanged after mutual adjustment. For colorectal and kidney cancers, ABSI was a significant predictor comparable to BMI; however, WC showed the strongest association with colorectal cancer, and WC, WHtR, and WHR all showed stronger associations with kidney cancer. In contrast to other anthropometric measures, ABSI showed no association with risk of breast or endometrial cancer and was more weakly associated with risk of colorectal and kidney cancers compared to more established measures of central adiposity.

Increased fetal adiposity prior to diagnosis of gestational diabetes in South Asians: more evidence for the \u2018thin\u2013fat\u2019 baby

Aims/hypothesisGestational diabetes mellitus (GDM) is associated with an increased future risk of obesity in the offspring. Increased adiposity has been observed in the newborns of women with GDM. Our aim was to examine early fetal adiposity in women with GDM.MethodsObstetric and sonographic data was collated for 153 women with GDM and 178 controls from a single centre in Chennai, India. Fetal head circumference (HC), abdominal circumference (AC), femur length (FL) and biparietal diameter (BPD) were recorded at 11, 20 and 32 weeks. Anterior abdominal wall thickness (AAWT) as a marker of abdominal adiposity at 20 and 32 weeks was compared between groups. Adjustments were made for maternal age, BMI, parity, gestational weight gain, fetal sex and gestational age.ResultsFetuses of women with GDM had significantly higher AAWT at 20 weeks (β 0.26 [95% CI 0.15, 0.37] mm, p < 0.0001) despite lower measures of HC, FL, BPD and AC. AAWT remained higher in the fetuses of women with GDM at 32 weeks (β 0.48 [0.30, 0.65] mm, p < 0.0001) despite similar measures for HC, FL, BPD and AC between groups. Both groups had similar birthweights at term. There was an independent relationship between fasting plasma glucose levels and AAWT after adjustment as described above.Conclusions/interpretationA ‘thin but fat’ phenotype signifying a disproportionate increase in adiposity despite smaller or similar lean body mass was observed in the fetuses of mothers with GDM, even at 20 weeks, thus pre-dating the biochemical diagnosis of GDM. Increased AAWT may serve as an early marker of GDM.

Effect of upper body fat distribution on pulmonary functions in medical students

Background: The prevalence of obesity is increasing, and there is evidence that obesity, in particular abdominal obesity as a marker of insulin resistance, is negatively associated with pulmonary function. The mechanism for this association and the best marker of abdominal adiposity in relation to pulmonary function is not known. Study objectives: We assessed the association between pulmonary function and body mass index (BMI), waist/hip ratio and Body fat percentage as markers of adiposity and body fat distribution. We used Pearson correlation coefficient to analyse the association of pulmonary function (i.e., FEV1 and FVC) [with manoeuvres performed in the sitting position] with overall adiposity markers (i.e., Body fat percentage and BMI) and abdominal adiposity markers (WHR). Methods: One forty male subjects underwent physical examination, computerised pulmonary function tests (spirometry, lung volumes) and various anthropometric measurements (waist-hip ratio, BMI, skin fold thickness) out of which seventy were case and seventy were control. Results: Result showed that expiratory reserve volume and FVC were showed negative correlation with WHR in obese group (p<0.001).There was negative correlation observed between BF% and ERV (-0.49), FVC (-0.05), and MVV (-0.11). There was negative correlation observed between BMI and ERV (-0.46) and MVV (-0.17).WHR also showed negative correlation with ERV (-0.14). Conclusion: ERV and FVC were significantly decreased in subjects with WHR more than 0.93.These results suggest that abdominal adiposity is a better predictor of pulmonary function than Body fat percentage or BMI, and investigators should consider it when investigating the determinants of pulmonary function.

Risk of breast, endometrial, colorectal, and renal cancers in postmenopausal women in association with a body shape index and other anthropometric measures.

A body shape index (ABSI) has been proposed as a possible improvement over waist circumference (WC) as a marker of abdominal adiposity because it removes the correlation of WC with body mass index (BMI) and with height. We assessed the association of ABSI with four obesity-related cancers compared to that of other anthropometric measures of adiposity. We used data from the Women's Health Initiative, a large cohort of postmenopausal women, recruited between 1993 and 1998 and followed until September 2013, to assess the associations of ABSI and other anthropometric measures with risk of cancers of the breast, endometrium, colorectum, and kidney. The four comparison anthropometric measures were BMI, WC, waist circumference-to-height ratio (WHtR), and waist-hip ratio (WHR). Over a median of 12.7years of follow-up, among 143,901 women, we identified 7,039 invasive breast cancers, 1,157 endometrial cancers, 1,908 colorectal cancers, and 376 kidney cancers. We used Cox proportional hazards models to estimate the association of quintiles of the five measures with risk of the four cancers. Unlike the other anthropometric indices, ABSI was not associated with increased risk of breast or endometrial cancer. BMI and WC were comparable as predictors of breast and endometrial cancer, and these associations were unchanged after mutual adjustment. For colorectal and kidney cancers, ABSI was a significant predictor comparable to BMI; however, WC showed the strongest association with colorectal cancer, and WC, WHtR, and WHR all showed stronger associations with kidney cancer. In contrast to other anthropometric measures, ABSI showed no association with risk of breast or endometrial cancer and was more weakly associated with risk of colorectal and kidney cancers compared to more established measures of central adiposity.

Inverse relationship between “a body shape index” (ABSI) and fat-free mass in women and men: Insights into mechanisms of sarcopenic obesity

Sarcopenic obesity may be defined by a high fat to fat-free mass (FM/FFM) ratio. Skeletal muscle may be negatively influenced by the pro-inflammatory milieu associated with visceral fat, while the loading effect induced by a heavier body mass index (BMI) may enhance muscle anabolism. Recently, a new anthropometric measure based on waist circumference (A Body Shape Index, ABSI) was developed. In this study we have assessed the predictive power of ABSI on the FFM index (FFMI), a surrogate marker of lean mass. Standard anthropometric parameters and ABSI as well as body composition data (fat and fat-free mass determined by bioelectrical impedance analysis) were assessed in 111 female and 89 male overweight/obese subjects, with no clinically significant co-morbidities. Groups with higher- or lower-ABSI were identified according to median values of this index. In women and men, ABSI did not correlate with BMI, while multiple linear regression indicated that BMI (β-coefficients: 0.62 and 0.77, respectively) and ABSI (β-coefficients: -0.26 and -0.22, respectively) independently predicted FFMI (multiple R: 0.72 and 0.83, respectively, P < 0.001). Men and women with lower-ABSI exhibited significantly greater FFMI than the higher-ABSI groups for comparable values of BMI. In men, ABSI was correlated positively with C-reactive protein (CRP) (R = 0.30; P < 0.05) and negatively with the reciprocal of insulin (R = 0.28; P < 0.05), an index of insulin sensitivity. FM/FFM ratio significantly (P < 0.01) correlated with CRP (R = 0.31) in women only. ABSI, a recently introduced marker of abdominal adiposity, may contribute to define the risk of sarcopenia in overweight/obese individuals.

Usefulness of waist circumference as a marker of abdominal adiposity in peritoneal dialysis: a cross-sectional and prospective analysis

Waist circumference (WC) has been well recognized as a surrogate marker of abdominal adiposity. In peritoneal dialysis (PD) patients, however, aspects related to this dialysis modality, such as abdominal distension, presence of catheter and frequent hernia, raise questions regarding the reliability of WC measurements. Herein, we investigated for the first time whether WC is a reliable marker of abdominal adiposity in PD population. This study included 107 prevalent PD patients [56% male, age 52 ± 17 years, 35% diabetics, body mass index (BMI) 24.8 ± 3.9 kg/m(2)]. WC measured at umbilicus level was evaluated against the trunk fat assessed by dual-energy x-ray absorptiometry at baseline and after 6 months. All measurements were taken with the empty abdominal cavity. At baseline, a strong correlation of WC with trunk fat (r = 0.81; P < 0.001) was observed. Adjusting for gender, age, dialysis vintage and BMI, WC was independently associated with trunk fat (β = 0.30; P < 0.001; R(2) = 0.77). The agreement between WC and trunk fat was 0.59 (kappa statistic) and the area under the curve was 0.90. In the prospective evaluation, we observed that changes in WC correlated with changes in trunk fat as well (r = 0.49; P < 0.001). The kappa statistic of 0.48 remained indicative of a moderate agreement between the methods. The receiver operating characteristic curve analysis showed that WC was sensitive to detect changes in trunk fat (area under the curve 0.76). In the logistic regression analysis adjusting for gender, age and BMI, changes in WC were independently associated with changes in trunk fat. The simple anthropometric method of WC is a reliable marker of abdominal adiposity in PD patients.

Use of waist circumference and its optimal value to identify obesity in relation to hypertension: a cross-sectional study among adult male slum dwellers of Eastern India

Background: Waist circumference (WC) is a useful surrogate marker of abdominal adiposity and a risk factor of cardiovascular disease and hypertension. Asians have higher abdominal fat at a lower level of body mass index (BMI). Previous studies showed that WC was the best measure and correlate of abdominal fat and general adiposity, respectively, among the Bengalee people of Eastern India including the present sample.This study aimed to evaluate the clinical usefulness of waist circumference and its appropriate cut-off in identifying obesity and hypertension.Methods: Adult male slum dwellers aged between 18 and 60 years were included in the study. Height, weight, skinfolds, waist circumference, systolic- (SBP) and diastolic blood pressures (DBP) were measured.Body mass index (BMI) and percent body fat (PBF) were also calculated. Obesity was defined as &gt;25% of body fat. Mean (+ SD) and range statistics were used to describe the variables. WC values were divided into four categories, viz. &lt;72cm, 72-79.9cm, 80-84.9cm and ≥ 85.0cm. ANCOVA was performed to observe the differences in mean SBP and, DBP between the WC categories, with age, smoking and alcohol consumption status as covariates. Pearson correlation and multiple linear regressions were employed to examine the relationship of WC with SBP and DBP. Adjusted odds ratios for hypertension by WC categories were obtained through logistic regression analysis. Receiver operating characteristic (ROC) curve analysis revealed the optimal value of WC to identify obesity. Results and conclusions: PBF increased significantly (F = 208.74, p&lt;0.001) from the lowest WC category (10.6%) to the highest one (26.9%). Mean SBP and DBP also increased significantly from the lowest to the highest WC categories. Waist circumference had significant positive effect on both SBP (T=2.559, p&lt;0.01) and DBP (T=3.256, p&lt;0.05) irrespective of age and PBF. WC value &gt;80.9cm could be accepted as the best cut-off point for WC to identify obesity. Participants with a WC of 80-84.9 cm were around three times more likely to have HT(p&lt;0.005), however the likelihood increased to over 5 for those with a WC of &gt; 85.0 cm when compared to lower WC categories. The odds ratio significantly increased for WCs at or above 80cm.Therefore the measurement of WC could be used to identify general obesity and be used as a screening toolfor HT risk factors in Bengalee urban slum dwelling men. The WC cut off to define obesity and identifyinghypertension was around 81cm

Physical inactivity, abdominal obesity and risk of coronary heart disease in apparently healthy men and women

To test the hypothesis that for any given body mass index (BMI) category, active individuals would have a smaller waist circumference than inactive individuals. Our second objective was to examine the respective contribution of waist circumference and physical inactivity on coronary heart disease (CHD) risk. Prospective, population-based study with an 11.4-year follow-up. A total of 21 729 men and women aged 45-79 years, residing in Norfolk, UK. During follow-up, 2191 CHD events were recorded. Physical activity was evaluated using a validated lifestyle questionnaire that takes into account both leisure-time and work-related physical activity. Waist circumference was measured and BMI was calculated for each participant. For both men and women, we observed that within each BMI category (<25.0, 25-30 and >or=30.0 kg m(-2)), active participants had a lower waist circumference than inactive participants (P<0.001). In contrast, within each waist circumference tertile, BMI did not change across physical activity categories (except for women with an elevated waist circumference). Compared with active men with a low waist circumference, inactive men with an elevated waist circumference had a hazard ratio (HR) for future CHD of 1.74 (95% confidence interval (CI), 1.34-2.27) after adjusting for age, smoking, alcohol intake and parental history of CHD. In the same model and after further adjusting for hormone replacement therapy use, compared with active women with a low waist circumference, inactive women with an elevated waist circumference had an HR for future CHD of 4.00 (95% CI, 2.04-7.86). In any BMI category, inactive participants were characterized by an increased waist circumference, a marker of abdominal adiposity, compared with active individuals. Physical inactivity and abdominal obesity were both independently associated with an increased risk of future CHD.

Pulmonary Function and Abdominal Adiposity in the General Population

The prevalence of obesity is increasing, and there is evidence that obesity, in particular abdominal obesity as a marker of insulin resistance, is negatively associated with pulmonary function. The mechanism for this association and the best marker of abdominal adiposity in relation to pulmonary function is not known. We assessed the association between pulmonary function and weight, body mass index (BMI), waist circumference, waist/hip ratio, and abdominal height as markers of adiposity and body fat distribution. We used multiple linear regression to analyze the association of pulmonary function (ie, FEV(1) and FVC) [with maneuvers performed in the sitting position] with overall adiposity markers (ie, weight and BMI) and abdominal adiposity markers, stratified by gender, and adjusted for height, age, race, smoking, and other covariates. A random sample of individuals (n = 2,153) from the general population living in western New York state, 35 to 79 years of age. In women, abdominal height and waist circumference were negatively associated with FEV(1) percent predicted, while all five adiposity markers were negatively associated with FVC percent predicted. In men, all overall and abdominal adiposity markers were inversely associated with FEV(1) percent predicted and FVC percent predicted. These results suggest that abdominal adiposity is a better predictor of pulmonary function than weight or BMI, and investigators should consider it when investigating the determinants of pulmonary function.

The Levels of Soluble Adhesion Molecules in Diabetic and Nondiabetic Patients with Combined Hyperlipoproteinemia and the Effect of Ciprofibrate Therapy

Cell adhesion molecules are thought to play a role in atherosclerosis. Several clinical trials have shown that fibrate treatment leads to a reduction in coronary events, although the mechanisms are not fully understood. Soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-selectin plasma concentrations were measured in 10 obese dyslipidemic men (group A), in 10 obese dyslipidemic type 2 diabetic men without coronary artery disease (CAD) (group B), and in 10 dyslipidemic type 2 diabetic men with angiographically documented CAD (group C) before and after 12 weeks of treatment with ciprofibrate. Compared with nondiabetic dyslipidemic men, diabetic patients with CAD or without documented CAD had significantly increased levels of sVCAM-1 (512 +/-39 versus 750 +/-139 ng/mL; p<0.0001 and 566 +/-78 ng/mL; p<0.01, respectively) and sE-selectin (54.8 +/-6.9 versus 65.9 +/-8.8 ng/mL; p<0.001 and 62.6 +/-9.4 ng/mL; p=0.056, respectively). The levels of sICAM-1 were similar in all 3 groups. Multivariate analyses showed that the higher sCAM levels in patients occurred independently of lipoprotein levels. Waist circumference as a marker of abdominal adiposity was the only independent predictor of elevated concentrations of all 3 cell adhesion molecules in multivariate analyses. sE-selectin was associated with HbA1C levels (p<0.01) in diabetic men at baseline. After 12 weeks of ciprofibrate therapy, sVCAM-1 levels were reduced by 13.5 +/-2.1%, sICAM-1 levels by 11.8 +/-2.2%, and sE-selectin levels by 17.1 +/-3.5% (p<0.01 for all) with the greatest sE-selectin reduction in the diabetic subgroups (p<0.001). There was no correlation between the lowering of soluble adhesion molecules and the magnitude of lipid-lowering effect. An increased level of circulating adhesion molecules may be a mechanism by which dyslipidemia and/or diabetes mellitus promotes atherogenesis, and treatment with ciprofibrate may alter vascular cell activation.