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Surrogate Markers for Atherosclerosis in Overweight Subjects With Atherogenic Dyslipidemia: The GEMS Project

Department of Internal Medicine, CHUV-University Hospital, Lausanne, Switzerland

Vincent Wietlisbach

Institute of Social Medicine and Epidemiology, CHUV-University Hospital, Lausanne, Switzerland

François Feihl

Division of Clinical Pathophysiology, CHUV-University Hospital, Lausanne, Switzerland

Alice Mermod

Department of Internal Medicine, CHUV-University Hospital, Lausanne, Switzerland

Diane Morin

Roger Darioli

Medical Outpatient Clinic, CHUV-University Hospital, Lausanne, Switzerland

Pascal Nicod

Department of Internal Medicine, CHUV-University Hospital, Lausanne, Switzerland

Vincent Mooser

Medical Genetics, Genetic Research, GlaxoSmithKline, Collegeville Pennsylvania

Bernard Waeber

Division of Clinical Pathophysiology, CHUV-University Hospital, Lausanne, Switzerland

Daniel Hayoz

Division of Angiology, CHUV-University Hospital, Lausanne, Switzerland

Gérard Waeber

Department of Internal Medicine, CHUV-University Hospital, Lausanne, Switzerland, Gerard.Waeber{at}chuv.ch

Metabolic syndrome is a constellation of major risk factors for cardiovascular disease. In affected individuals with this syndrome, the independent contribution of low high-density lipoprotein—cholesterol and increased triglyceride levels to the development of atherosclerosis remains to be clarified. We assessed the relationship between these 2 parameters and several surrogate markers for atherosclerosis. One hundred and twenty overweight cases, defined as having high-density lipoprotein—cholesterol (25 age- and gender-specific percentile in general population) and high triglyceride values (75 percentile) were compared with 120 discordant overweight controls defined on lipid values (high-density lipoprotein—cholesterol 50 percentile and triglycerides 50 percentile). Case-control pairs were matched for age and gender. Carotid and femoral arteries were examined to determine carotid intima-media thickness and the presence of atherosclerotic plaque(s). Endothelial function was assessed by laser Doppler flowmetry in the skin microvasculature. Daytime ambulatory blood pressure monitoring was performed for each subject. Cases had higher prevalence of atherosclerotic plaques (mean 1.50 ± 0.15 vs 0.80 ± 0.15, P < .001), increased carotid intima-media thickness (mean 0.66 ± 0.15 vs 0.61 ± 0.15, P < .01), and a significantly reduced temperature-induced and postischemic endothelial vasodilation compared with controls. In conclusion, low high-density lipoprotein—cholesterol and high triglycerides levels are major contributors to peripheral atherosclerosis and are associated with an increase in intima-media thickness and impaired microvascular endothelial function in overweight individuals.

This version was published on August 1, 2008

Angiology, Vol. 59, No. 4, 484-492 (2008)
DOI: 10.1177/0003319707307768


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