title: The study of markers of endothelial dysfunction in metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome (MetS) consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Endothelial dysfunction is one of the key components of MetS which is caused by imbalance between vasodilatory substances like nitric oxide (NO) and vaso-constrictive substances like endothelin and prothrombotic factors like plasminogen activator inhibitor-1 (PAI-1).
  
  
  OBJECTIVE
  To study the markers of endothelial dysfunction (NO and endothelin) and prothrombotic markers (PAI-1) among the study subjects.
  
  
  METHODS
  We enrolled 50 diagnosed cases of MetS as per International Diabetes Federation (IDF) criteria and 50 healthy volunteers as controls. Clinical evaluation included anthropometric, routine biochemical, hematological, serum insulin, NO, endothelin and PAI-1 measurements.
  
  
  RESULTS
  Subjects with MetS had higher insulin, endothelin and PAI-1 levels and low NO levels as compared to controls and the difference was found to be significant. The serum insulin levels were positively correlated with PAI-1 and endothelin, and negatively correlated with NO.
  
  
  CONCLUSIONS
  Endothelial functional status as reflected by decreased NO and increased serum endothelin levels along with insulin resistance is seen in MetS. Moreover, higher serum level of PAI-1 also tilts towards a more prothrombotic milieu in the vascular endothelium. Hence endothelial dysfunction and prothrombotic markers may be used to guide for early diagnosis of cardiovascular disease and type 2 diabetes in patients with MetS.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Ahirwar
authors.forename: Anju
authors.initials: A
authors.lastname: Jain
authors.forename: Archana
authors.initials: A
authors.lastname: Singh
authors.forename: Binita
authors.initials: B
authors.lastname: Goswami
authors.forename: M K
authors.initials: MK
authors.lastname: Bhatnagar
authors.forename: Jayashree
authors.initials: J
authors.lastname: Bhatacharjee
mesh_terms: D015415:Biomarkers; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020935:MAP Kinase Signaling System / Q000502:physiology; D024821:Metabolic Syndrome / Q000503:physiopathology*; D009569:Nitric Oxide / Q000097:blood; D052250:Nitric Oxide Synthase Type III / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood
chemical_list: D015415:Biomarkers; D007328:Insulin; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D009569:Nitric Oxide; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III