Gender differences in the association of syndecan-4 with myocardial infarction: The population-based Tromsø Study

Autor: Ellisiv B. Mathiesen, Trine M. Reine, Toralf Melsom, Maja-Lisa Løchen, Bjørn Odvar Eriksen, Svein Olav Kolset, Tom Wilsgaard, Trond Jenssen, Marit Dahl Solbu
Rok vydání: 2018
Předmět:
Male
0301 basic medicine
Myocardial Infarction
Disease
030204 cardiovascular system & hematology
general population
Brain Ischemia
Cohort Studies
0302 clinical medicine
Risk Factors
Epidemiology
Myocardial infarction
Endothelial dysfunction
Aged
80 and over
education.field_of_study
Norway
cardiovascular
Hazard ratio
Middle Aged
Stroke
gender differences
Creatinine
Cardiology
epidemiology
Female
Cardiology and Cardiovascular Medicine
Adult
medicine.medical_specialty
animal structures
Population
Glycocalyx
03 medical and health sciences
Sex Factors
Internal medicine
medicine
Albuminuria
Humans
education
Aged
Proportional Hazards Models
business.industry
Proportional hazards model
syndecans
Atherosclerosis
medicine.disease
Confidence interval
030104 developmental biology
Gene Expression Regulation
Syndecan-4
Syndecan-1
business
Zdroj: Atherosclerosis. 278:166-173
ISSN: 0021-9150
Popis: Background and aims Cardiovascular disease is a common cause of morbidity and mortality, with gender differences in pathophysiology. The endothelial glycocalyx maintains vascular integrity, and glycocalyx shedding reflects endothelial dysfunction and early atherosclerosis. Syndecan-1 and -4 are components of the glycocalyx, and increased serum levels indicate glycocalyx damage. We hypothesised that increased serum syndecan-1 and -4 were independently associated with myocardial infarction (MI), ischaemic stroke and all-cause mortality in men and women from a general population. Methods Using a case-cohort design, we included 1495 participants from the Tromso Study 2001-02. Syndecan-1 and -4 were measured in serum. Baseline variables also included age, gender, cardiovascular risk factors and urinary albumin-creatinine ratio (ACR). Hazard ratios were assessed using multivariable Cox regression models. Results Between baseline in 2001-02 and December 2007 fatal or non-fatal MI was experienced by 328 and ischaemic stroke by 191 subjects, and 423 participants died. Syndecan-4 was independently associated with MI (hazard ratio per 10 ng/mL increase 1.32; 95% confidence interval 1.06–1.63), but not ischaemic stroke and mortality, and the associations were unchanged by adjustment for urinary ACR. Interaction between syndecan-4 and sex was borderline significant, and in gender-specific analysis, syndecan-4 was associated with MI in women only. Syndecan-1 was not associated with any endpoint. Conclusions Syndecan-4 was associated with incident MI, and the association was stronger in women than in men. This suggests a link between endothelial glycocalyx shedding and coronary heart disease in women. Use of syndecan-4 as a risk marker in clinical setting needs further investigation.
Databáze: OpenAIRE
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