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Inflammation, obesity and cardiovascular function in African and Caucasian women from South Africa: the POWIRS study

Journal of Human Hypertension volume 20, pages 850–859 (2006)Cite this article

Abstract

The integrated relationship between inflammation, obesity and cardiovascular disease is currently a subject of much research interest. These specific relationships, however, have not been studied in-depth in South African population groups in order to determine the role of ethnicity. It is known that Africans, compared to Caucasians, suffer from a high prevalence of hypertension. It was therefore hypothesized that the levels of inflammatory markers (high-sensitivity C-reactive protein (hsCRP), fibrinogen and leptin) are higher in Africans compared to Caucasians and are notably associated with cardiovascular dysfunction in Africans. Apparently healthy African (N=102) and Caucasian (N=115) women, matched for age and body mass index (BMI), were recruited. Leptin, hsCRP, fibrinogen and lipid levels, waist circumference (WC), BMI, systolic and diastolic blood pressure, cardiac output (CO), total peripheral resistance (TPR) and Windkessel compliance were measured. Results showed that the levels of leptin, hsCRP and fibrinogen were significantly higher (P<0.05) in the African women. The inflammatory markers correlated strongly with cardiovascular parameters, age and obesity (BMI, WC) in both groups, but after adjusting for age and obesity, none of the correlations were significant anymore. Multiple regression analyses (with leptin, hsCRP or fibrinogen as dependent variable) showed that only leptin levels of African women were explained by cardiovascular parameters (BP, TPR and CO). In conclusion, even though African women had significantly higher leptin, hsCRP, fibrinogen and blood pressure levels than Caucasian women, no cardiovascular parameters explained the variation in the inflammatory markers (except for leptin levels of African women).

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References

  1. Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Bonadonna RC et al. Metabolic syndrome: epidemiology and more extensive phenotypic description. Cross-sectional data from the Bruneck Study. Int J Obes Relat Metab Disord 2003; 27: 1283–1289.

    Article  CAS  Google Scholar 

  2. Tan C-E, Chew S-K, Tai E-S . The metabolic syndrome: an Asian perspective. Int Congress Ser 2004; 1262: 546–549.

    Article  Google Scholar 

  3. Caglayan E, Blaschke F, Takata Y, Hsueh WA . Metabolic syndrome-interdependence of the cardiovascular and metabolic pathways. Curr Opin Pharmacol 2005; 5: 135–142.

    Article  CAS  Google Scholar 

  4. World Health Organization. Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation. WHO Technical Report Series 894. World Health Organization: Geneva, 2000, pp 16–48.

  5. Das UN . Is obesity an inflammatory condition? Nutrition 2001; 17: 953–966.

    Article  CAS  Google Scholar 

  6. Feldstein CA, Akopian M, Olivieri AO, Kramer AP, Nasi M, Garrido D . A comparison of body mass index and waist-to-hip ratio as indicators of hypertension risk in an urban Argentine population: a hospital-based study. Nutr Metab Cardiovasc Dis 2005; 15: 310–315.

    Article  Google Scholar 

  7. Kougias P, Chai H, Lin PH, Yao Q, Lumsden AB, Chen C . Effects of adipocyte-derived cytokines on endothelial functions: implication of vascular disease. J Surg Res 2005; 126(1): 121–129.

    Article  CAS  Google Scholar 

  8. Trayhurn P, Beattie JH . Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ. Proc Nutr Soc 2001; 60: 329–339.

    Article  CAS  Google Scholar 

  9. Kazumi T, Kawaguchi A, Hirano T, Yoshino G . C-reactive protein in young, apparently healthy men: associations with serum leptin, qtc interval, and high-density lipoprotein-cholesterol. Metabolism 2003; 52(9): 1113–1116.

    Article  CAS  Google Scholar 

  10. Flier JS . What's in a name? In search of leptin's physiologic role. J Clin Endocrinol Metab 1998; 83(5): 1407–1413.

    CAS  Google Scholar 

  11. Prolo P, Wong M-L, Licinio J . Leptin. Int J Biochem Cell Biol 1998; 30: 1285–1290.

    Article  CAS  Google Scholar 

  12. Wolk R, Berger P, Lennon RJ, Brilakis ES, Johnson BD, Somers VK . Plasma leptin and prognosis in patients with established coronary atherosclerosis. J Am Coll Cardiol 2004; 44(9): 1819–1824.

    Article  CAS  Google Scholar 

  13. Agata J, Masuda A, Takada M, Higashiura K, Murakami H, Miyazaki Y et al. High plasma immunoreactive leptin level in essential hypertension. Am J Hypertens 1997; 10: 1171–1174.

    Article  CAS  Google Scholar 

  14. Fantuzzi G . Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 2005; 115(5): 911–919.

    Article  CAS  Google Scholar 

  15. Rother K, Till GO, Hänsch GM (eds) The Complement System, 2nd edn. Springer-Verlag: Berlin, 1998, pp 71–72.

    Book  Google Scholar 

  16. Engström G, Hedblad B, Stavenow L, Jonsson S, Lind P, Janzon L et al. Incidence of obesity-associated cardiovascular disease is related to inflammation-sensitive plasma proteins: a population-based cohort study. Arterioscler Thromb Vasc Biol 2004; 24: 1498–1502.

    Article  Google Scholar 

  17. Gómez-Ambrosi J, Salvador J, Páramo JA, Orbe J, De Irala J, Diez-Caballero A et al. Involvement of leptin in the association between percentage of body fat and cardiovascular risk factors. Clin Biochem 2002; 35: 315–320.

    Article  Google Scholar 

  18. Maachi M, Piéroni L, Bruckert E, Jardel C, Fellahi S, Hainque B et al. Systemic low-grade inflammation is related to both circulating and adipose tissue TNFa, leptin and IL-6 levels in obese women. J Obes Relat Metab Disord 2004; 28: 993–997.

    Article  CAS  Google Scholar 

  19. Stec JJ, Silbershatz H, Tofler GH, Matheney TH, Sutherland P, Lipinska I et al. Association of fibrinogen with cardiovascular risk factors and cardiovascular disease in the Framingham Offspring Population. Circulation 2000; 102: 1634–1638.

    Article  CAS  Google Scholar 

  20. Ünlü Y, Karapolat S, Karaca Y, Kiziltunç A . Comparison of levels of inflammatory markers and hemostatic factors in the patients with and without peripheral arterial disease. Thromb Res 2006; 117(4): 357–364.

    Article  Google Scholar 

  21. Blake GJ, Rifai N, Buring JE, Ridker PM . Blood pressure, C-reactive protein, and risk of future cardiovascular events. Circulation 2003; 108: 2993–2999.

    Article  CAS  Google Scholar 

  22. Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH . Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation 1998; 98: 731–733.

    Article  CAS  Google Scholar 

  23. Taniguchi H, Momiyama Y, Fayad ZA, Ohmori R, Ashida K, Kihara T et al. In vivo magnetic resonance evaluation of associations between aortic atherosclerosis and both risk factors and coronary artery disease in patients referred for coronary angiography. Am Heart J 2004; 148: 137–143.

    Article  Google Scholar 

  24. Seedat YK . The prevalence of hypertension and the status of cardiovascular health in South Africa. Ethn Dis 1998; 8: 394–397.

    CAS  PubMed  Google Scholar 

  25. Van Rooyen JM, Kruger HS, Huisman HW, Wissing MP, Margetts BM, Venter CS et al. An epidemiological study of hypertension and its determinants in a population in transition: the THUSA study. J Hum Hypertens 2000; 14(12): 779–787.

    Article  CAS  Google Scholar 

  26. Siriwardena AN . Specific health issues in ethnic minority groups. Clin Cornerstone 2004; 611: 34–42.

    Article  Google Scholar 

  27. Albert MA, Glynn RJ, Buring J, Ridker PM . C-reactive protein levels among women of various ethnic groups living in the United States (from the Women's Health Study). Am J Cardiol 2004; 93: 1238–1242.

    Article  CAS  Google Scholar 

  28. Heald AH, Anderson SG, Ivison F, Laing I, Gibson JM, Cruickshank K . C-reactive protein and the insulin-like growth factor (IGF)-system in relation to risk of cardiovascular disease in different ethnic groups. Atherosclerosis 2003; 170: 79–86.

    Article  CAS  Google Scholar 

  29. Mills PJ, Ziegler MG, Morrison TA . Leptin is related to epinephrine levels but not reproductive hormone levels in cycling African-American and Caucasian women. Life Sci 1998; 63(8): 617–623.

    Article  CAS  Google Scholar 

  30. Donahue RP, Zimmet P, Bean JA, Decourten M, Decarlo Donahue RA, Collier G et al. Cigarette smoking, alcohol use, and physical activity in relation to serum leptin levels in a multiethnic population: the Miami Community Health Study. Ann Epidemiol 1999; 9(2): 108–113.

    Article  CAS  Google Scholar 

  31. Schutte R, Huisman HW, Schutte AE, Malan NT . Leptin is favourably associated with vascular function in obese Caucasians, but not in obese Africans. J Hum Hypertens 2005; 19(12): 933–939.

    Article  CAS  Google Scholar 

  32. Schutte AE, Kruger HS, Wissing MP, Underhay C, Vorster HH . The emergence of the metabolic syndrome in urban obese African women: the POWIRS study. S Afr J Sci 2005; 101: 61–67.

    Google Scholar 

  33. Norton K, Olds T . Anthropometrica: A Textbook of Body Measurements for Sports and Health Courses. UNSW Press: Sydney, 1996.

    Google Scholar 

  34. Imholz BPM, Wieling W, Van Montfrans GA, Wesseling KH . Fifteen years experience with finger arterial pressure monitoring, assessment of the technology. Cardiovasc Res 1998; 38: 605–616.

    Article  CAS  Google Scholar 

  35. Clauss A . Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol 1957; 17: 237–246.

    Article  CAS  Google Scholar 

  36. Haffner SM . The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiol 2006; 97: 3A–11A.

    Article  CAS  Google Scholar 

  37. Tataranni PA, Ortega E . Does an adipokine-induced activation of the immune system mediate the effect of overnutrition on type 2 diabetes? Diabetes 2005; 54: 917–927.

    Article  CAS  Google Scholar 

  38. Hansson GK . Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005; 352: 1685–1695.

    Article  CAS  Google Scholar 

  39. Rahmouni K, Haynes WG . Endothelial effects of leptin: implications in health and diseases. Curr Diab Rep 2005; 5: 260–266.

    Article  CAS  Google Scholar 

  40. Wilson AM, Ryan MC, Boyle AJ . The novel role of C-reactive protein in cardiovascular disease: risk marker or pathogen. Int J Cardiol 2006; 106: 291–297.

    Article  Google Scholar 

  41. Opie LH, Seedat YK . Hypertension in sub-saharan African populations. Circulation 2005; 112(23): 3562–3568.

    Article  Google Scholar 

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Acknowledgements

We thank the participants, as well as all supporting staff, for their involvement in this project. We are also grateful to the financial contributors to this project: the National Research Foundation (GUN 2054068), the Medical Research Council and the Research Focus Area 9.1 of the North-West University (Potchefstroom campus).

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Authors and Affiliations

  1. School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa

    A E Schutte, D van Vuuren, J M van Rooyen, H W Huisman, R Schutte, L Malan & N T Malan

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  1. A E Schutte
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  2. D van Vuuren
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  3. J M van Rooyen
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  4. H W Huisman
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Correspondence to A E Schutte.

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Schutte, A., van Vuuren, D., van Rooyen, J. et al. Inflammation, obesity and cardiovascular function in African and Caucasian women from South Africa: the POWIRS study. J Hum Hypertens 20, 850–859 (2006). https://doi.org/10.1038/sj.jhh.1002065

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