title: Sex differences in the relationship between inflammatory and hemostatic biomarkers and metabolic syndrome: British 1958 Birth Cohort.
abstract: BACKGROUND
  Circulating levels of C-reactive protein (CRP), fibrinogen, fibrin D-dimer, tissue plasminogen activator antigen (t-PA) and von Willebrand factor (VWF) are associated with incident coronary heart disease (CHD). However, their associations with metabolic syndrome and its components in large populations of men and women have not been well defined.
  
  
  OBJECTIVE
  We compare the sex associations of these biomarkers with established CHD risk factors, metabolic syndrome and its components in a large cohort.
  
  
  METHODS
  8302 men and women aged 45 years from the British 1958 birth cohort provided a blood sample. Analyses were restricted to 3457 men and 3464 women with complete data on all risk factors and no history of cardiovascular disease. Multiple regression analyses adjusted for smoking, social class, alcohol consumption and variables related to biomarker measurement error.
  
  
  RESULTS
  Adjusted sex differences in levels of all biomarkers (except VWF) varied according to presence/absence of metabolic syndrome, its components and obesity (BMI ≥30 kg m(-) (2)). Associations in women were up to twice as strong for CRP, fibrinogen and t-PA with markers of obesity (body mass index, waist circumference), blood pressure, blood lipids and metabolic syndrome. D-dimer showed weaker associations and less heterogeneity by sex. There was no evidence of sex interaction in associations with VWF.
  
  
  CONCLUSIONS
  Associations between CRP, fibrinogen and t-PA and metabolic syndrome and its components were stronger in women than in men. Understanding the reasons for these differences across sex will be important in understanding the pathophysiology of cardiovascular and metabolic disease in men and women.
authors.affiliation: Division of Population Health Sciences and Education, St George's, University of London, Cranmer Terrace, London Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. arudnick@sgul.ac.uk
authors.forename: A R
authors.initials: AR
authors.lastname: Rudnicka
authors.forename: A
authors.initials: A
authors.lastname: Rumley
authors.forename: P H
authors.initials: PH
authors.lastname: Whincup
authors.forename: G D
authors.initials: GD
authors.lastname: Lowe
authors.forename: D P
authors.initials: DP
authors.lastname: Strachan
mesh_terms: D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006487:Hemostasis; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D012737:Sex Factors
chemical_list: D015415:Biomarkers