Adhesion Molecules in Obesity and Metabolic Syndrome - Adhesion Molecules - page 203

Soluble adhesion molecules lacking cytoplasmic and membrane spanning
domains are a rel ection of endothelial activation. h ey can be found in the
circulation (Pigott et al. 1992) and increased levels have been found in both carotid
atherosclerosis and CHD (Hwang et al. 1997).
ADHESION MOLECULES AND OBESITY
h e dei nition of obesity varies with ethnicity and gender, but in general an adult
who has a body mass index (BMI) between 25 and 29.9 is considered overweight,
whereas an adult who has a BMI of 30 or higher is considered obese. h e rate of
increase in the number of overweight and obese individuals has risen dramatically
in the past two decades (Li et al. 2007), with the excess body weight being
stored as fat. h e distribution of the body fat, however, is of utmost importance.
In epidemiology studies, despite the plethora of methods used to measure fat
(including waist-hip ratio (WHR) and subscapular skinfold measurements), the
i ndings have demonstrated a consistent association between central adiposity
and CVD risk, strokes and CHD mortality. h is has been observed in both men
and women and in most cases is independent of BMI. h ose individuals with
visceral obesity appear to represent the group of individuals with greatest CVD
risk (Després et al. 2008).
Adhesion Molecules and WHR and BMI
Evidence relating WHR and BMI to circulating cellular adhesion molecule levels
is not clear cut. Some studies indicate a positive correlation between, for example,
sICAM-1 and WHR (Demerath et al. 2001) and sICAM-1 and BMI (Hwang et al.
1997) and others do not (DeSouza et al. 1997, Rohde et al. 1999, Miller et al. 2003,
Ponthieux et al. 2004). Likewise, sE-selectin has been shown to be related to WHR
or BMI in some studies (Hwang et al. 1997, Miller et al. 2003, Ponthieux et al.
2004, Miller and Cappuccio 2006) but not all (DeSouza et al. 1997).
In a study to investigate the relationship between adhesion molecules and
measures of obesity we found the strongest and most consistent relationships
were those between sE-selectin and both WHR and BMI (Miller and Cappuccio
2006). h e associations for the total group studied are shown in Table 1. h ese
relationships were maintained following adjustment for multiple confounders
including blood pressure and serum lipids and there was no interaction with
gender or ethnicity. A 0.01 unit higher WHR and a 1 unit greater BMI would be
associated with an approximate 2% higher sE-selectin level (Fig. 3) .
In the Health Professional Follow-up Study of 18,225 men, sICAM-1 and
sVCAM-1 were found to be directly associated with obesity and CHD risk factors.
Following multiple adjustment the relative risk of CHD was 1.69 [1.14-2.51
(95%CI)] for sICAM-1 and 1.34 [0.91-1.96] for sVCAM-1. Furthermore, those