Soluble ST2 Levels and Left Ventricular Structure and Function in Patients With Metabolic Syndrome

Abstract

BackgroundA biomarker that is of great interest in relation to adverse cardiovascular events is soluble ST2 (sST2), a member of the interleukin family. Considering that metabolic syndrome (MetS) is accompanied by a proinflammatory state, we aimed to assess the relationship between sST2 and left ventricular (LV) structure and function in patients with MetS.MethodsA multicentric, cross-sectional study was conducted on180 MetS subjects with normal LV ejection fraction as determined by echocardiography. LV hypertrophy (LVH) was defined as an LV mass index greater than the gender-specific upper limit of normal as determined by echocardiography. LV diastolic dysfunction (DD) was assessed by pulse-wave and tissue Doppler imaging. sST2 was measured by using a quantitative monoclonal ELISA assay.ResultsLV mass index (β=0.337, P<0.001, linear regression) was independently associated with sST2 concentrations. Increased sST2 was associated with an increased likelihood of LVH [Exp (B)=2.20, P=0.048, logistic regression] and increased systolic blood pressure [Exp (B)=1.02, P=0.05, logistic regression]. Comparing mean sST2 concentrations (adjusted for age, body mass index, gender) between different LV remodeling patterns, we found the greatest sST2 level in the group with concentric hypertrophy. There were no differences in sST2 concentration between groups with and without LV DD.ConclusionsIncreased sST2 concentration in patients with MetS was associated with a greater likelihood of exhibiting LVH. Our results suggest that inflammation could be one of the principal triggering mechanisms for LV remodeling in MetS.

Sex‐related differences in contemporary biomarkers for heart failure: a review

“…155 However, sex differences become apparent in older children (≥15 years), with males demonstrating higher levels of sST2 compared with females. 155 These sex-related differences persist in both healthy individuals 41,43,156,157 (average median values ± SD: 24.0 ± 0.78 μg/L in men and 17.2 ± 1.18 μg/L in women), as well as in HF patients 52,81,158 (Figure 3B). Although male sex appears to be consistently associated with higher sST2 levels, the direct effect of sex hormones may only partly explain this phenomenon.…”

The ST2/IL-33 Axis in Immune Cells during Inflammatory Diseases

“…sST2 levels are also increased in patients suffering from intestinal (13–16) and metabolic diseases (27, 28, 197, 198); however, the data from these studies so far are correlative and have not passed the qualification for biomarkers that can be used in clinic (199). …”

“…In a multicenter, cross-sectional study of 180 patients with metabolic syndrome with normal LV ejection fraction, LV mass index was independently associated with serum sST2 concentrations. Increased sST2 associated with increased likelihood of LV hypertrophy and increased systolic blood pressure ( 198 ). New-onset posttransplantation diabetes mellitus (PTDM) is a common occurrence after allo-HCT.…”

IL-33/ST2 Pathway and Galectin-3 as a New Analytes in Pathogenesis and Cardiometabolic Risk Evaluation in Psychosis

“…IL-33/ST2 signals have anti- or pro- inflammatory effects in diseases by activating cells of innate and adaptive immune systems, but it is still unclear what kind of immune cells are first induced to produce IL-33 ( 28 ). IL-33 can have protective properties in atherosclerosis development ( 30 ) and blood concentrations of sST2 are markedly increased in cardiac diseases ( 31 ) and metabolic syndrome ( 32 ).…”