title: Aldosterone, C-reactive protein, and plasma B-type natriuretic peptide are associated with the development of metabolic syndrome and longitudinal changes in metabolic syndrome components: findings from the Jackson Heart Study.
abstract: OBJECTIVE
  Several pathomechanisms are implicated in the pathogenesis of metabolic syndrome (MetS), most of which have not been investigated in African Americans (AAs). We examined the contribution of a selected panel of biomarkers to the development of MetS in Jackson Heart Study (JHS) participants in this investigation.
  
  
  METHODS
  We evaluated 3,019 JHS participants (mean age, 54 years; 64% women) with measurements for seven biomarkers representing inflammation (high-sensitivity C-reactive protein [CRP]), adiposity (leptin), natriuretic pathway (B-natriuretic peptide [BNP]), adrenal pathway (cortisol and aldosterone), and endothelial function (endothelin and homocysteine). We related the biomarker panel to the development of MetS on follow-up and to longitudinal changes in MetS components.
  
  
  RESULTS
  There were 278 (22.9%) of 1,215 participants without MetS at baseline who had development of new-onset MetS at follow-up. The incidence of MetS was significantly associated with serum aldosterone (P=0.004), CRP (P=0.03), and BNP (P for trend=0.005). The multivariable-adjusted odds ratios (95% CI) per SD increment of log biomarker were as follows: 1.25 (1.07-1.45) for aldosterone, 1.20 (1.02-1.43) for CRP, and 1.54 (1.07-2.23) and 1.91 (1.31-2.80) for low and high BNP quartiles, respectively. Aldosterone was positively associated with change in all MetS risk components, except low HDL cholesterol and waist circumference. CRP concentration was significantly and directly associated with change in systolic blood pressure (SBP) and waist circumference but inversely associated with HDL cholesterol. For BNP, we observed a U-shape relation with SBP and triglycerides.
  
  
  CONCLUSIONS
  Our analysis confirms that, in AAs, higher circulating aldosterone and CRP concentrations predict incident MetS. The nonlinear U-shape relation of BNP with MetS and its components has not been reported before and thus warrants replication.
authors.affiliation: Corresponding author: Solomon K. Musani, smusani@umc.edu.
authors.forename: Solomon K
authors.initials: SK
authors.lastname: Musani
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Aurelian
authors.initials: A
authors.lastname: Bidulescu
authors.forename: Jiankang
authors.initials: J
authors.lastname: Liu
authors.forename: Vanessa
authors.initials: V
authors.lastname: Xanthakis
authors.forename: Mario
authors.initials: M
authors.lastname: Sims
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Gawalapu
authors.forename: Tandaw E
authors.initials: TE
authors.lastname: Samdarshi
authors.forename: Michael
authors.initials: M
authors.lastname: Steffes
authors.forename: Herman A
authors.initials: HA
authors.lastname: Taylor
authors.forename: Ervin R
authors.initials: ER
authors.lastname: Fox
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*
chemical_list: D020097:Natriuretic Peptide, Brain; D000450:Aldosterone; D002097:C-Reactive Protein