Soluble intercellular adhesion molecule 1 and flow-mediated dilatation are related to the estimated risk of coronary heart disease independently from each other.
BACKGROUND
Flow mediated dilatation (FMD) of the brachial artery and soluble intercellular adhesion molecule 1 (sICAM-1) are measures of distinct functions of the endothelium, reflecting nitric oxide (NO)-mediated and pro-inflammatory status, respectively. The comparative value of the two measures in relation to cardiovascular risk is unknown.


OBJECTIVE
To study and quantify the relation between these two measures, and their relative value in relation to the risk of coronary heart disease as estimated by the Framingham risk function.


METHODS
We performed a single centre population-based study of 85 men and 81 women, aged 18-73 years. Endothelial function was assessed biochemically by sICAM-1 and functionally by FMD. In addition traditional cardiovascular risk factors, CRP, leukocyte count, homocysteine and fibrinogen were determined. Analyses were performed with multivariate linear regression, adjusted for age, gender, and CRP.


RESULTS
Median sICAM-1 levels were 217.0 microg/l (interquartile range: 174.0-348.5). Mean FMD was 4.5% (S.D.: 3.9). The regression coefficient for the association between sICAM-1 and FMD was -3.3 microg/l (95% CI: -6.0;-0.6) per percentage rise in FMD, after adjustment for age, gender, smoking, oral contraceptives (OC) use, classical risk factors and CRP. After adjustment for CRP and sICAM-1, the estimated risk of coronary heart disease in the next 10 years varied from 1.55% (95%CI: 0.89; 2.70) in the highest quintile of FMD to 3.92% (95% CI: 2.23; 6.92) in the lowest quintile. For sICAM-1, estimated risk, adjusted for FMD and CRP varied from 1.50% (95%CI: 0.85; 2.64) in the lowest quintile of sICAM-1 to 4.15% (95%CI: 2.35; 7.34) in the highest quintile. P-values for trends were 0.02 and 0.01 for quintiles of FMD and quintiles of sICAM-1, respectively.


CONCLUSIONS
These findings indicate that sICAM-1 and FMD are related in healthy individuals, independently of cardiovascular risk factors and CRP, and that they are both related to the estimated risk of coronary heart disease, independently of each other.
Witte
D R
DR
Julius Center for Health Sciences and Primary Care, D.01.335, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Broekmans
W M R
WM
Kardinaal
A F M
AF
Klöpping-Ketelaars
I A A
IA
van Poppel
G
G
Bots
M L
ML
Kluft
C
C
Princen
J M G
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D004108:Dilatation, Pathologic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D012995:Solubility; D013223:Statistics as Topic; D013599:Systole / Q000502:physiology; D014280:Triglycerides / Q000097:blood; D014664:Vasodilation / Q000502:physiology*
D015415:Biomarkers; D001786:Blood Glucose; D008078:Cholesterol, LDL; D014280:Triglycerides; D018799:Intercellular Adhesion Molecule-1; D005340:Fibrinogen; D002097:C-Reactive Protein