2.4.5 The Metabolic Syndrome

The metabolic syndrome is associated with high risk for CHD, and persons with the metabolic syndrome are at increased risk for developing CHD as well as increased mortality from CHD. Holvoet and colleagues examined the relationship between the metabolic syndrome components and circulating oxLDL in the Health ABC cohort. They showed for the first time that in a population cohort the metabolic syndrome is associated with higher levels of circulating oxLDL and that this association was consistent across gender and race. As in previous studies the metabolic syndrome showed predictive value for CHD and increased the risk for incident MI. However, a new and important finding was that oxLDL increased the risk of incident of MI, suggesting an effect of oxidized LDL on myocardial infarction independent of the metabolic syndrome, adding prognostic information concerning future risk for MI.

Sigurdardottir and colleagues at the Sahlgrenska University Hospital, Gothenburg, Sweden studied the link between the presence of oxLDL in these healthy patients and factors related to the metabolic syndrome in subjects from the AIR study. They found that baseline levels of oxLDL add clinically important prognostic information to the metabolic syndrome. The metabolic syndrome was found to be associated with high levels of circulating oxLDL with the underlying mechanism seeming to be linked to the occurrence of small, dense LDL particles. The proposed pro-atherogenic properties of small LDL particles relate to their ability to penetrate the arterial wall, to bind more easily to arterial proteoglycans, and thus be more susceptible to oxidation.

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