Circulating early biomarkers of atherogenesis in participants of the Longitudinal Study of Adult Health (ELSA-Brasil) without diabetes or cardiovascular disease

ABSTRACT Objective Our aim was to describe the distribution of selected biomarkers according to age and sex, adjusted for HOMA-IR and adiposity, in a subset of middle-aged individuals of Brazilian Longitudinal Study of Adult Health-ELSA without diabetes mellitus or CVD. Subjects and methods This cross-sectional study was conducted in 998 participants of the ELSA-Brasil without diabetes and/or cardiovascular disease. In addition to the traditional risk factors, several biomarkers concentrations were compared according to sex, age groups (35-44; 45-54 yrs) and HOMA-IR tertiles. Linear regression was used to examine independent associations of sex and age with selected novel biomarkers, adjusted for body adiposity and HOMA-IR. Results Fifty-five percent were women. Men had higher mean values of body mass index, waist circumference, blood pressure, plasma glucose, HOMA-IR, worse lipid profile and higher E-selectin and lower leptin concentrations than women; while women had higher levels of HDL-cholesterol and leptin than men. Mean values of waist circumference, systolic BP, plasma glucose and apolipoprotein B (Apo B) increased with age in both sexes. Leptin and E-selectin concentrations increased across HOMA-IR tertiles. Independent associations of Apo B with age were found only in male sex, while of leptin with body mass index and HOMA-IR, and of E-selectin with HOMA-IR in both sexes. Conclusions In conclusion, our data indicate age, sex, adiposity and, consequently, insulin resistance, influence circulating levels of Apo B, leptin and E-selectin, suggesting that those aspects should be taken into consideration when assessing these parameters for research or clinical purposes in individuals at relatively low cardiometabolic risk.摘要 研究目的：本研究旨在校正胰岛素抵抗稳态模型评估（HOMA-IR）与体脂状况后，描述巴西成人健康纵向研究（ELSA-Brasil）中无糖尿病或心血管疾病的中年亚组人群的特定生物标志物按年龄与性别的分布特征。 研究对象与方法：本横断面研究纳入了ELSA-Brasil的998名无糖尿病和/或心血管疾病的参与者。除传统危险因素外，研究者按性别、年龄组（35~44岁、45~54岁）及HOMA-IR三分位组，对多种生物标志物浓度进行了比较。采用线性回归模型，在校正体脂与HOMA-IR后，分析性别与年龄对所选新型生物标志物的独立关联。 研究结果：本研究人群中55%为女性。与女性相比，男性的体重指数、腰围、血压、血浆葡萄糖、HOMA-IR均值更高，血脂谱更差，E-选择素浓度更高而瘦素浓度更低；女性的高密度脂蛋白胆固醇与瘦素水平则高于男性。在两性中，腰围、收缩压、血浆葡萄糖及载脂蛋白B（Apo B）的均值均随年龄增长而升高。瘦素与E-选择素的浓度随HOMA-IR三分位组升高而上升。仅在男性群体中观察到载脂蛋白B与年龄的独立关联；而在两性中均存在瘦素与体重指数、HOMA-IR，以及E-选择素与HOMA-IR的独立关联。 研究结论：综上，本研究数据显示，年龄、性别、体脂状况及由此产生的胰岛素抵抗，会影响循环中载脂蛋白B、瘦素与E-选择素的水平。这提示在针对代谢心血管风险相对较低的人群开展相关研究或临床指标评估时，应将上述因素纳入考量。