Published online before print June 3, 2004, doi: 10.1161/01.ATV.0000134293.31512.be
© 2004 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Incidence of Obesity-Associated Cardiovascular Disease Is Related to Inflammation-Sensitive Plasma Proteins
A Population-Based Cohort Study
From the Departments of Community Medicine (G.E., B.H., S.J., L.J.), Internal Medicine (L.S., P.L.), and Vascular Diseases (F.L.), Malmö University Hospital, Malmö, Sweden.
Correspondence to Gunnar Engström, Department of Community Medicine, S-20502 Malmö, Sweden. E-mail Gunnar.Engstrom{at}smi.mas.lu.se
Background— Although obesity is associated with increased inflammation, it is unclear whether this accounts for the increased cardiovascular risk in obesity. This population-based study explored whether inflammation-sensitive plasma proteins (ISPs) modify the cardiovascular risk in overweight or obese men.
Methods and Results— The ISPs (fibrinogen, orosomucoid, 
1-antitrypsin, haptoglobin, ceruloplasmin) were measured in 6075 healthy men, aged 28 to 61 years. The incidences of cardiovascular events (myocardial infarction, stroke, cardiovascular deaths), cardiac events (fatal or nonfatal myocardial infarction), and stroke were followed-up over 18±4 years. High ISPs were associated with an increased cardiovascular risk in all categories of body mass index (BMI). The age-adjusted relative risks for cardiovascular events in obese men (BMI >30) were 2.1 (95% CI, 1.4 to 3.4), 2.4 (CI, 1.5 to 3.7), 3.7 (CI, 2.3 to 6.0), and 4.5 (CI, 3.0 to 6.6), respectively, for those with 0, 1, 2, and 
3 ISPs in the top quartile (trend P=0.002) (reference: BMI <25 and no elevated ISP). This trend persisted after adjustments for several potential confounders (P=0.02). Incidence of cardiac events showed similar relations with the number of elevated ISPs in obese men.
Conclusion— The cardiovascular risk varies widely between obese or overweight men with high and low ISPs. Relationships with ISPs contribute to, but cannot fully explain, the increased cardiovascular risk in obese men.
This population-based study explored whether inflammation-sensitive plasma proteins (ISPs) (ie, fibrinogen, orosomucoid, 1-antitrypsin, haptoglobin, ceruloplasmin) modify the obesity-associated risk of myocardial infarction and stroke in initially healthy men (n=6075) followed-up over 18 years. The cardiovascular risk varied widely between obese and overweight men with high and low ISPs.
Key Words: obesity • inflammation • myocardial infarction • stroke • epidemiology
This article has been cited by other articles:
 |
|
 |
|
  M. Hamer and A. Steptoe Prospective study of physical fitness, adiposity, and inflammatory markers in healthy middle-aged men and women Am. J. Clinical Nutrition, January 1, 2009; 89(1): 85 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. K. Kumanyika, E. Obarzanek, N. Stettler, R. Bell, A. E. Field, S. P. Fortmann, B. A. Franklin, M. W. Gillman, C. E. Lewis, W. C. Poston II, et al. Population-Based Prevention of Obesity: The Need for Comprehensive Promotion of Healthful Eating, Physical Activity, and Energy Balance: A Scientific Statement From American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (Formerly the Expert Panel on Population and Prevention Science) Circulation, July 22, 2008; 118(4): 428 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. D. Sinclair, C. Allegrucci, R. Singh, D. S. Gardner, S. Sebastian, J. Bispham, A. Thurston, J. F. Huntley, W. D. Rees, C. A. Maloney, et al. DNA methylation, insulin resistance, and blood pressure in offspring determined by maternal periconceptional B vitamin and methionine status PNAS, December 4, 2007; 104(49): 19351 - 19356. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Calling, B. Hedblad, G. Engstrom, G. Berglund, and L. Janzon Effects of body fatness and physical activity on cardiovascular risk: Risk prediction using the bioelectrical impedance method Scand J Public Health, December 1, 2006; 34(6): 568 - 575. [Abstract] [PDF]
|
|
|
|
 |
|
 H.-J. Chen, C.-H. Bai, W.-T. Yeh, H.-C. Chiu, and W.-H. Pan Influence of Metabolic Syndrome and General Obesity on the Risk of Ischemic Stroke Stroke, April 1, 2006; 37(4): 1060 - 1064. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. P. Van Guilder, G. L. Hoetzer, D. T. Smith, H. M. Irmiger, J. J. Greiner, B. L. Stauffer, and C. A. DeSouza Endothelial t-PA release is impaired in overweight and obese adults but can be improved with regular aerobic exercise Am J Physiol Endocrinol Metab, November 1, 2005; 289(5): E807 - E813. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D. Karelis, M. Faraj, J.-P. Bastard, D. H. St-Pierre, M. Brochu, D. Prud'homme, and R. Rabasa-Lhoret The Metabolically Healthy but Obese Individual Presents a Favorable Inflammation Profile J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4145 - 4150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. S. Coller Leukocytosis and Ischemic Vascular Disease Morbidity and Mortality: Is It Time to Intervene? Arterioscler Thromb Vasc Biol, April 1, 2005; 25(4): 658 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Wassef, L. Bernier, J. Davignon, and J. S. Cohn Synthesis and Secretion of ApoC-I and ApoE during Maturation of Human SW872 Liposarcoma Cells J. Nutr., November 1, 2004; 134(11): 2935 - 2941. [Abstract] [Full Text] [PDF]
|
|