Acute phase proteins as prospective risk markers for arterial stiffness: The Malmö Diet and Cancer cohort

PLoS One. 2017 Jul 31;12(7):e0181718. doi: 10.1371/journal.pone.0181718. eCollection 2017.

Abstract

Background and objectives: Arterial stiffness plays a significant role in the development and progression of adverse cardiovascular events and all-cause mortality. This observational study aims to explore the relationship between six acute phase proteins namely, ceruloplasmin, alpha-1-antitrypsin, orosomucoid, haptoglobin, complement C3 and C-reactive protein (CRP), and carotid-femoral pulse wave velocity (c-f PWV) in a population-based cohort, and to also explore the effect of low-grade inflammation on the relationship between diabetes and c-f PWV.

Method: The study consisted of participants from the Malmö Diet and Cancer study with data from baseline examinations (1991-1994) and follow-up examinations (2007-2012). Arterial stiffness was measured at follow-up by determining c-f PWV. After excluding participants with missing data, the total study population included 2338 subjects. General linear models were used to assess the relationship between baseline acute phase proteins and c-f PWV.

Results: After adjusting for traditional risk factors the participants in the 4th quartile vs 1st quartile of alpha-1-antitrypsin (geometric mean: 10.32 m/s vs 10.04 m/s) (p<0.05), C3 (10.35 m/s vs 10.06 m/s) (p<0.05) and CRP (10.37 m/s vs 9.96 m/s) (p<0.001) showed significant association with c-f PWV. Diabetes at follow-up was also associated with high c-f PWV, however, this relationship was independent of low grade inflammation.

Conclusion: Alpha-1-antitrypsin, C3 and CRP are associated with arterial stiffness. The results indicate that low grade inflammation is associated with arterial stiffness in addition to established cardiovascular risk factors.

MeSH terms

  • Acute-Phase Proteins / analysis*
  • Aged
  • Arteries / physiopathology*
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Ceruloplasmin / analysis
  • Cohort Studies
  • Complement C3 / analysis
  • Female
  • Follow-Up Studies
  • Haptoglobins / analysis
  • Humans
  • Inflammation
  • Linear Models
  • Male
  • Middle Aged
  • Orosomucoid / analysis
  • Prospective Studies
  • Pulse Wave Analysis
  • Risk Factors
  • Vascular Stiffness*
  • alpha 1-Antitrypsin / analysis

Substances

  • Acute-Phase Proteins
  • Complement C3
  • HP protein, human
  • Haptoglobins
  • Orosomucoid
  • alpha 1-Antitrypsin
  • C-Reactive Protein
  • Ceruloplasmin

Grants and funding

This MDC Re-exam study was supported by the Medical Research Council of Sweden (grant K2011-65X-20752-04-6; 2014-2265), the Region Skåne County Council (ALF), the Swedish Heart and Lung foundation (grant 20150469) and Ernhold Lundstrom Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.