The inflammatory score and cardiovascular risk in young adults with overweight or obesity: The African-PREDICT study.

OBJECTIVES: A complex relationship of adipokines and cytokines with cardiovascular risk motivates the use of an integrated approach to identify early signs of adiposity-related inflammation. We compared the inflammatory profiles, including an integrated inflammatory score, and cardiovascular profiles of young adults who are living with overweight and/or obesity (OW/OB). DESIGN AND METHODS: This cross-sectional study included 1194 men and women with a median age of 24.5 ± 3.12 years from the African Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT). Participants were divided into approximate quartiles based on adiposity measures (body mass index, waist circumference, and waist-to-height ratio). We compared an integrated inflammatory score (including leptin, adiponectin, interleukin-6, interleukin-8, interleukin-10, and tumour necrosis factor-α) as well as the individual inflammatory markers, between extreme quartiles. We also compared blood pressure measures, left ventricular mass index, carotid-femoral pulse wave velocity, and carotid intima-media thickness between these groups. RESULTS: Individuals in the top quartile had worse inflammatory- and cardiovascular profiles as the integrated inflammatory score, leptin, interleukin-6, blood pressure measures, and left ventricular mass index were higher, while adiponectin was lower (all p ≤ 0.003). Unexpectedly, carotid-femoral pulse wave velocity was also lower (p < 0.001) in the top quartile. Exclusively in the top quartile, all adiposity measures related positively with the integrated inflammatory score and central systolic blood pressure (both r ≥ 0.24; p < 0.001), and negatively with interleukin-10 (all r ≤ -0.13; p < 0.03). Of these relationships, the correlations with the integrated inflammatory score were the strongest (p < 0.001). The percentage difference of being in the top quartile of all adiposity measures were higher for the inflammatory score (all ≥ 263 %), leptin (all ≥ 175 %), interleukin-6 (all ≥ 134 %), and tumour necrosis factor-α (all ≥ 26 %), and lower for adiponectin (all ≥ 57 %), interleukin-10 (all ≥ 9 %), and interleukin-8 (all ≥ 15 %) compared to being in the bottom quartile. CONCLUSION: The inflammatory score, as a comprehensive marker of adiposity-related inflammation, is strongly related to adiposity and may be an indication of early cardiovascular risk in young adults; however, further work is required to establish the clinical use thereof.

Twenty-four-hour ambulatory, but not clinic blood pressure associates with leptin in young adults with overweight or obesity: The African-PREDICT study.

Hypertension and obesity are known pro-inflammatory conditions, and limited studies explored various blood pressure modalities and inflammatory markers in young adults with overweight or obesity (OW/OB). We assessed the relationship of clinic and 24 h ambulatory blood pressure with an array of inflammatory markers in young adults with OW/OB. This cross-sectional study included women and men of Black and White ethnicity (n = 1194) with a median age of 24.5 ± 3.12 years. Participants were divided into normal weight and OW/OB groups according to body mass index. Clinic and 24 h ambulatory systolic and diastolic blood pressure were measured. Inflammatory markers included leptin, interleukin-6, interleukin-8, tumour necrosis factor-α, adiponectin, interleukin-10, and C-reactive protein. After adjustments for age, sex, and ethnicity, the OW/OB group had higher blood pressure and an overall worse inflammatory profile compared to the normal weight group (all p ≤ 0.024). In the OW/OB group, 24 h systolic (r = 0.22; p < 0.001) and diastolic blood pressure (r = 0.28; p < 0.001) correlated with leptin, independent of age, sex, and ethnicity. In fully adjusted regression models, 24 h systolic blood pressure (adj.R2 = 0.25; ß = 0.28; p = 0.035) and diastolic blood pressure (adj.R2 = 0.10; ß = 0.32; p = 0.034), associated with leptin in the OW/OB group and significance remained with additional adjustments for visceral adiposity index. Twenty-four-hour ambulatory, but not clinic blood pressure, is related to leptin in young adults with OW/OB. Leptin shows a stronger relationship with adiposity when compared to other inflammatory markers and may play a role in subcutaneous adiposity-related increased blood pressure.

Blood pressure and nitric oxide synthesis capacity in physically active and inactive groups: the SABPA study.

Physical activity affects the vasculature through mechanisms related to nitric oxide bioavailability, oxidative stress, and inflammation; with endothelial function at the centre of this triad. In a South African setting, with the prevalence of hypertension and physical inactivity being alarmingly high, we aimed to investigate relationships of vascular function with markers of oxidative stress, inflammation and nitric oxide synthesis capacity in physically active and inactive groups. Based on the 2010 World Health Organisation guidelines, black and white school teachers were divided into physically active (n = 84) and physically inactive (n = 132) groups. Twenty-four-hour blood pressure (24 h BP), total peripheral resistance and Windkessel compliance were measured. Markers of oxidative stress, inflammation and nitric oxide synthesis capacity were analysed. Windkessel compliance (p = 0.041) and homoarginine (p = 0.006) were higher in the physically active group. In the same group, 24 h diastolic BP associated with total glutathione (ß = 0.17; p = 0.056), and 24 h BP (systolic blood pressure: ß = 0.23, p = 0.006; diastolic blood pressure: ß = 0.22, p = 0.019) associated with homoarginine. In the physically inactive group, 24 h BP (systolic blood pressure: ß = 0.26, p < 0.001; diastolic blood pressure: ß = 0.23, p = 0.007) associated with symmetric dimethylarginine (SDMA). These associations were independent of inflammation. Despite only reaching moderate physical activity levels, vascular function and nitric oxide synthesis capacity were more favourable in the physically active population compared to the physically inactive population. These results may suggest that even moderate physical activity could increase nitric oxide synthesis capacity, which in turn may mitigate the development of cardiovascular disease in this population.