Abstract. Metabolic syndrome (MS) is associated with a high incidence rate of cardiovascular disease. It is characterized by abdominal obesity, elevated blood pressure, atherogenic dyslipidemia [high LDL-c (low density lipoprotein cholesterol) and low HDL-c (high density lipoprotein cholesterol)] and insulin resistance or glucose intolerance. In the context of MS, alterations in the plasmatic levels of some soluble forms of cell adhesion molecules can appear, e.g., soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin) and soluble CD40L (sCD40L). The objective of this study was to compare the serum levels of sVCAM-1, sE-selectin and sCD40L in MS and non-MS groups and to associate these molecules with the diagnostic criteria of MS. A total of 185 non-smokers between 45 and 64 years of age were included. Of these, 93 corresponded to the MS group and the remaining 92 to a non-MS group (according to modified ATP III criteria). The serum concentration of sVCAM-1, sE-selectin and sCD40L was determined by commercial solid phase ELISA. The results were expressed as a median and interquartile range. The MS group showed high levels of sVCAM-1 (558.9 ng/ml; 481.3-667.6 ng/ml) compared with the non-MS group (405.2 ng/ml; 361.0-470.5 ng/ml) (p<0.0001). As well, the median level of sCD40L (3.0 ng/ml; 2.1l-11.7 ng/ml) was significantly higher in the MS group than that in the non-MS group (2.6 ng/ml; 2.3-3.4 ng/ml) (p=0.0061). sE-selectin levels did not differ significantly between the groups: 73.9 ng/ml (58.3-87.0 ng/ml) and 68.5 ng/ml (51.6-97.5 ng/ml) in the MS and non-MS group, respectively. In conclusion, the serum levels of sVCAM-1 and sCD40L, but not sE-selectin, were significantly higher in patients with MS than in subjects that did not present MS. MS may therefore increase the expression of cell adhesion molecules, probably through endothelial activation.
IntroductionMetabolic syndrome (MS) is a cluster of cardiovascular risk factors including central obesity, hypertension, dyslipidemias and glucose intolerance (1). Clinically, it has reached epidemic proportions, and with an increase in the elderly population its incidence and prevalence will further multiply (2).Visceral adipose tissue, an important feature in individuals with MS, produces a range of circulating molecules with proinflammatory and pro-atherosclerotic actions. Several of these adipokines, including tumour necrosis factor · (TNF-·) and interleukin 6 (IL-6), have been linked to alterations in endothelial functions (3).An alteration that characterizes endothelial dysfunction involves the secretion of cellular adhesion molecules (CAMs) on the surface of endothelial cells (ECs), thus enabling the CAMs to bind leukocytes (4,5). VCAM-1 (vascular cell adhesion molecule-1) is not expressed at high levels on the endothelium, but can be regulated in vitro in response to TNF-·, IL-4 and interferon-Á (IFN-Á) cytokines that are synthesized by adipose as well as other tissues. Soluble VCAM-1 (sVCAM-1) is found in the serum of healthy pe...