title: Association between lowered endothelial function measured by peripheral arterial tonometry and cardio-metabolic risk factors - a cross-sectional study of Finnish municipal workers at risk of diabetes and cardiovascular disease.
abstract: BACKGROUND
  The aim of this cross-sectional study was to determine the association between lowered endothelial function measured by peripheral arterial tonometry (PAT) and cardio-metabolic risk factors. The study population consisted of Finnish municipal workers who were at risk of diabetes or cardiovascular disease and who had expressed a need to change their health behaviour.
  
  
  METHODS
  A total of 312 middle-aged municipal workers underwent a physical medical examination and anthropometry measurements. Levels of total cholesterol, HDL cholesterol, triglycerides, fasting glucose, glycated haemoglobin, and high sensitivity C-reactive protein were taken from the blood samples. PAT measured the increase in digital pulse volume amplitude during reactive hyperemia, and the index of endothelial function, F-RHI, was defined as the ratio of post-deflation amplitude to baseline amplitude.
  
  
  RESULTS
  In the linear regression model, male sex was associated with lower F-RHI. In sex-adjusted linear regression models, each of the variables; waist circumference, fasting glucose, glycated hemoglobin, triglycerides, body fat percentage, body mass index, current smoking, and impaired fasting glucose or diabetes were separately associated with lower F-RHI, and HDL cholesterol and resting heart rate were associated with higher F-RHI.HDL cholesterol, sex, body mass index, and current smoking entered a stepwise multivariable regression model, in which HDL cholesterol was associated with higher F-RHI, and smoking, male sex and body mass index were associated with lower F-RHI. This model explains 28.3% of the variability in F-RHI.
  
  
  CONCLUSIONS
  F-RHI is associated with several cardio-metabolic risk factors; low level of HDL cholesterol, male sex, overweight and smoking being the most important predictors of a lowered endothelial function. A large part of variation in F-RHI remains accounted for by unknown factors.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a, A, FI-00250 Helsinki, Finland. jussi.konttinen@ttl.fi.
authors.forename: Jussi
authors.initials: J
authors.lastname: Konttinen
authors.forename: Harri
authors.initials: H
authors.lastname: Lindholm
authors.forename: Juha
authors.initials: J
authors.lastname: Sinisalo
authors.forename: Eeva
authors.initials: E
authors.lastname: Kuosma
authors.forename: Janne
authors.initials: J
authors.lastname: Halonen
authors.forename: Leila
authors.initials: L
authors.lastname: Hopsu
authors.forename: Jukka
authors.initials: J
authors.lastname: Uitti
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D009111:Local Government; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D016272:Occupational Health / Q000639:trends; D012307:Risk Factors