title: Surrogate markers for atherosclerosis in overweight subjects with atherogenic dyslipidemia: the GEMS project.
abstract: Metabolic syndrome is a constellation of major risk factors for cardiovascular disease. In affected individuals with this syndrome, the independent contribution of low high-density lipoprotein-cholesterol and increased triglyceride levels to the development of atherosclerosis remains to be clarified. We assessed the relationship between these 2 parameters and several surrogate markers for atherosclerosis. One hundred and twenty overweight cases, defined as having high-density lipoprotein-cholesterol (<or=25 age- and gender-specific percentile in general population) and high triglyceride values (>or=75 percentile) were compared with 120 discordant overweight controls defined on lipid values (high-density lipoprotein-cholesterol >or=50 percentile and triglycerides <or=50 percentile). Case-control pairs were matched for age and gender. Carotid and femoral arteries were examined to determine carotid intima-media thickness and the presence of atherosclerotic plaque(s). Endothelial function was assessed by laser Doppler flowmetry in the skin microvasculature. Daytime ambulatory blood pressure monitoring was performed for each subject. Cases had higher prevalence of atherosclerotic plaques (mean 1.50 +/- 0.15 vs 0.80 +/- 0.15, P < .001), increased carotid intima-media thickness (mean 0.66 +/- 0.15 vs 0.61 +/- 0.15, P < .01), and a significantly reduced temperature-induced and postischemic endothelial vasodilation compared with controls. In conclusion, low high-density lipoprotein-cholesterol and high triglycerides levels are major contributors to peripheral atherosclerosis and are associated with an increase in intima-media thickness and impaired microvascular endothelial function in overweight individuals.
authors.affiliation: Department of Internal Medicine, CHUV-University Hospital, Lausanne, Switzerland.
authors.forename: Myriam
authors.initials: M
authors.lastname: Genoud
authors.forename: Vincent
authors.initials: V
authors.lastname: Wietlisbach
authors.forename: François
authors.initials: F
authors.lastname: Feihl
authors.forename: Alice
authors.initials: A
authors.lastname: Mermod
authors.forename: Diane
authors.initials: D
authors.lastname: Morin
authors.forename: Roger
authors.initials: R
authors.lastname: Darioli
authors.forename: Pascal
authors.initials: P
authors.lastname: Nicod
authors.forename: Vincent
authors.initials: V
authors.lastname: Mooser
authors.forename: Bernard
authors.initials: B
authors.lastname: Waeber
authors.forename: Daniel
authors.initials: D
authors.lastname: Hayoz
authors.forename: Gérard
authors.initials: G
authors.lastname: Waeber
mesh_terms: D050197:Atherosclerosis / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D016017:Odds Ratio; D050177:Overweight / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012867:Skin / Q000098:blood supply; D014280:Triglycerides / Q000097:blood*; D014463:Ultrasonography; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides