Ann Lab Med.  2016 Nov;36(6):542-549. 10.3343/alm.2016.36.6.542.

Soluble ST2 Levels and Left Ventricular Structure and Function in Patients With Metabolic Syndrome

• Celic V
• Majstorovic A
• Pencic-Popovic B
• Sljivic A
• Lopez-Andres N
• Roy I
• Escribano
• Beunza M
• Melero A
• Floridi F
• Magrini L
• Marino R
• Salerno G
• Cardelli P
• Di Somma S

• KMID: 2373592
• DOI: http://doi.org/10.3343/alm.2016.36.6.542

Abstract

BACKGROUND
A biomarker that is of great interest in relation to adverse cardiovascular events is soluble ST2 (sST2), a member of the interleukin family. Considering that metabolic syndrome (MetS) is accompanied by a proinflammatory state, we aimed to assess the relationship between sST2 and left ventricular (LV) structure and function in patients with MetS.
METHODS
A multicentric, cross-sectional study was conducted on180 MetS subjects with normal LV ejection fraction as determined by echocardiography. LV hypertrophy (LVH) was defined as an LV mass index greater than the gender-specific upper limit of normal as determined by echocardiography. LV diastolic dysfunction (DD) was assessed by pulse-wave and tissue Doppler imaging. sST2 was measured by using a quantitative monoclonal ELISA assay.
RESULTS
LV mass index (β=0.337, P<0.001, linear regression) was independently associated with sST2 concentrations. Increased sST2 was associated with an increased likelihood of LVH [Exp (B)=2.20, P=0.048, logistic regression] and increased systolic blood pressure [Exp (B)=1.02, P=0.05, logistic regression]. Comparing mean sST2 concentrations (adjusted for age, body mass index, gender) between different LV remodeling patterns, we found the greatest sST2 level in the group with concentric hypertrophy. There were no differences in sST2 concentration between groups with and without LV DD.
CONCLUSIONS
Increased sST2 concentration in patients with MetS was associated with a greater likelihood of exhibiting LVH. Our results suggest that inflammation could be one of the principal triggering mechanisms for LV remodeling in MetS.

Keyword

Soluble ST2; Metabolic syndrome; Echocardiography; Left ventricular hypertrophy

MeSH Terms

Adult
Age Factors
Aged
Area Under Curve
Blood Pressure
Body Mass Index
Cross-Sectional Studies
Echocardiography, Doppler
Enzyme-Linked Immunosorbent Assay
Female
Humans
Hypertrophy, Left Ventricular/diagnostic imaging
Interleukin-1 Receptor-Like 1 Protein/*analysis
Linear Models
Logistic Models
Male
Metabolic Syndrome X/metabolism/*physiopathology
Middle Aged
ROC Curve
Sex Factors
Ventricular Function, Left/*physiology
Ventricular Remodeling/physiology
Interleukin-1 Receptor-Like 1 Protein

Figure

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  Fig. 1 Partial regression plot: Relation between soluble ST2 (sST2) and two-dimensional echocardiographic left ventricular (LV) mass index.

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  Fig. 2 ROC: Sensitivities and specificities of the soluble ST2 criteria for left ventricular hypertrophy determined by two-dimensional echocardiography.

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