Endothelin-1 and Metabolic Syndrome in Bangladeshi Rural Women

Background and purpose: Metabolic alterations and endothelial dysfunction in patients with type 2diabetes and metabolic syndrome (Met S) often develop concurrently and measurement of circulating ET-1 levels is a well recognized marker of endothelial atherosclerotic and cardiovascular diseases. Here, we assess association between vasoactive peptide, endothelin-1 (ET-1), with Met S in rural Bangladeshi women. Methods and subjects: Plasma levels of ET-1 were measured by ELISA and Met S was defined according to criteria of NCEP-ATP III. Multiple regressions were used to examine association between circulatory ET-1 levels and Met S. Results: A total of 1236 rural Bangladeshi women aged ≥15 years were studied using a population based cross sectional survey. The prevalence of Met S was 25.1%. Mean values of BMI, waist circumference, blood pressure (SBP, DBP), plasma fasting glucose, triglyceride, mean arterial pressure and fasting insulin were significantly higher, whereas levels of HDL cholesterol were significantly lower in Met S group compared to non Met S group. ET-1 levels significantly increased in Met S subjects [(Met S vs. non-Met S: 3.17±0.12 vs. 2.31±0.05, p=<0.001]. Based on univariate analyses, after adjusting for age, levels of ET-1 showed significant associations with waist circumference, SBP, DBP, mean arterial pressure, HDL cholesterol and fasting plasma glucose. However, in a stepwise multiple regression analysis, after adjusting for age and all other potential variables, only MAP, fasting plasma glucose and HDL cholesterol was found to be independently correlated with ET-1. We also found that mean plasma levels of ET-1 increased in direct proportion to levels of Met S components (p for trend=0.015). Conclusions: Here, we provide the first evidence demonstrating an association between ET-1 plasma levels and Met S in Bangladeshi rural women. These data implicate ET-1 in Met S and indicate that plasma ET-1 could potentially be used as a surrogate biomarker for this disease and its associated complications. The present study is the first to assess relationship between levels of plasma ET-1 in Met S subjects from a South Asian country.